Nutrient and Food Intake of Indonesian Children Under 5 Years of Age: A Systematic Review

2021 ◽  
pp. 101053952110410
Author(s):  
Hesti Retno Budi Arini ◽  
Veni Hadju ◽  
Preetha Thomas ◽  
Megan Ferguson

The Indonesian Government’s targets to reduce the prevalence of child malnutrition are unlikely to be met based on current progress. Adequate dietary intake is key to meeting these targets. This systematic review aimed to provide a comprehensive overview of the nutrient and food intake of Indonesian children under 5 years of age. Peer-reviewed and gray literature published between 2007 and 2019 were collected. Of 1500 records, 38 articles met the study inclusion criteria and a narrative analysis was conducted. Children under 5 years were reported to have ranging energy and macronutrient intakes, some with adequate protein intake. Micronutrient deficiencies, particularly iron, zinc, calcium, and vitamin C, were reported. Animal-source foods, fruits, and vegetables were consumed by children, but frequency and/or volume of consumption was low, and it is among the probable causes of micronutrient deficiency among children under 5 years. The absence of reporting micronutrient intake in the national survey limited evidence to inform nutrition-related policies. The implementation of a national micronutrient survey will be beneficial in informing policy and practice aimed at reducing the prevalence of child malnutrition in line with national targets, through improvement in dietary intake.

2019 ◽  
Vol 30 (3) ◽  
pp. 405-413 ◽  
Author(s):  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Mundeep S. Bawa ◽  
Dil V. Patel ◽  
Harmeet S. Bawa ◽  
...  

OBJECTIVEThe Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to provide a standardized measure of clinical outcomes that is valid and reliable across a variety of patient populations. PROMIS has exhibited strong correlations with many legacy patient-reported outcome (PRO) measures. However, it is unclear to what extent PROMIS has been used within the spine literature. In this context, the purpose of this systematic review was to provide a comprehensive overview of the PROMIS literature for spine-specific populations that can be used to inform clinicians and guide future work. Specifically, the authors aimed to 1) evaluate publication trends of PROMIS in the spine literature, 2) assess how studies have used PROMIS, and 3) determine the correlations of PROMIS domains with legacy PROs as reported for spine populations.METHODSStudies reporting PROMIS scores among spine populations were identified from PubMed/MEDLINE and a review of reference lists from obtained studies. Articles were excluded if they did not report original results, or if the study population was not evaluated or treated for spine-related complaints. Characteristics of each study and journal in which it was published were recorded. Correlation of PROMIS to legacy PROs was reported with 0.1 ≤ |r| < 0.3, 0.3 ≤ |r| < 0.5, and |r| ≥ 0.5 indicating weak, moderate, and strong correlations, respectively.RESULTSTwenty-one articles were included in this analysis. Twelve studies assessed the validity of PROMIS whereas 9 used PROMIS as an outcome measure. The first study discussing PROMIS in patients with spine disorders was published in 2012, whereas the majority were published in 2017. The most common PROMIS domain used was Pain Interference. Assessments of PROMIS validity were most frequently performed with the Neck Disability Index. PROMIS domains demonstrated moderate to strong correlations with the legacy PROs that were evaluated. Studies assessing the validity of PROMIS exhibited substantial variability in PROMIS domains and legacy PROs used for comparisons.CONCLUSIONSThere has been a recent increase in the use of PROMIS within the spine literature. However, only a minority of studies have incorporated PROMIS for its intended use as an outcomes measure. Overall, PROMIS has exhibited moderate to strong correlations with a majority of legacy PROs used in the spine literature. These results suggest that PROMIS can be effective in the assessment and tracking of PROs among spine populations.


Author(s):  
Delaram Ghodsi ◽  
Nasrin Omidvar ◽  
Bahareh Nikooyeh ◽  
Roshanak Roustaee ◽  
Elham Shakibazadeh ◽  
...  

Childhood malnutrition remains an important public health and development problem in low- and middle-income countries. This study aimed to systematically review the community-based nutrition-specific interventions and their effectiveness and/or cost-effectiveness on the nutritional status of children under 5 years of age in the Eastern Mediterranean Region (EMR). A systematic literature search of the English electronic databases, including PubMed, Scopus, ISI Web of Knowledge, Ovid, EMBASE, as well as Persian databases (SID and Magiran) was performed up to May 2019. Studies regarding the effectiveness/cost-effectiveness of the community-based nutrition-specific programs and interventions targeted at under-five-year children in EMR countries were selected. The primary outcomes were mean of Weight-for-age z-score (WAZ), Height-for-Age z-score (HAZ), and Weight-for-Height z-score (WHZ) of children or prevalence of wasting, stunting, and/or underweight among the children. Meta-analysis was also performed on the selected articles and intervention effects (mean differences) were calculated for each outcome for each study and pooled using a weighted random effects model. Risk of bias (ROB) of each included study was assessed based on the Cochrane Handbook for Systematic Reviews. The study protocol was registered in PROSPERO (CRD42020172643). Of 1036 identified studies, eight met the inclusion criteria. Amongst these, seven were from Pakistan and one from Iran. Only one study conducted in Pakistan reported the cost-effectiveness of nutrition-specific interventions in the region. Nutrition education/consultation and cash-based interventions were the most common nutrition-specific strategies used for management of child malnutrition in the EMR countries. Out of these eight studies, four were included in the meta-analysis. When different interventions were pooled, they had resulted in a significant improvement in WHZ of children (MD: 0.26; 95% CI: 0.07 to 0.46, three studies, I2 82.40%). Considering the high prevalence of child malnutrition in a number of countries in the region, capacity building and investigation regarding the implementation of new approaches to improve nutritional status of children and their effect(s) and cost-effectiveness assessment are highly recommended.


Author(s):  
Liisa Andersen ◽  
Sus Sola Corazon ◽  
Ulrika Karlsson Stigsdotter

Given the drastic changes in our lifestyles and ecosystems worldwide, the potential health effects of natural environments have grown into a highly pervasive topic. Recent scientific findings suggest beneficial effects from nature exposure on human immune responses. This review aims at providing a comprehensive overview of literature published on immunomodulatory effects of nature exposure by inhalation of natural substances. A systematic database search was performed in SCOPUS and PubMed. The quality and potential bias of included studies (n = 33) were assessed by applying the EPHPP (Effective Public Health Practice Project) tool for human studies and the ARRIVE (Animal Research: Reporting of In Vivo Experiments) and SYRCLE (Systematic Review Centre for Laboratory Animal Experimentation) tools for animal studies. The synthesis of reviewed studies points to positive effects of nature exposure on immunological health parameters; such as anti-inflammatory, anti-allergic, anti-asthmatic effects or increased NK (natural killer) cell activity. Decreased expression of pro-inflammatory molecules, infiltration of leukocytes and release of cytotoxic mediators are outcomes that may serve as a baseline for further studies. However, partially weak study designs evoked uncertainties about outcome reproducibility and key questions remain open concerning effect sizes, duration of exposure and contributions of specific vegetation or ecosystem types.


Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes

AbstractGait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.


BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1872
Author(s):  
Justin Dela Cruz ◽  
David Kahan

Protein intake is an important factor for augmenting the response to resistance training in healthy individuals. Although food intake can help with anabolism during the day, the period of time during sleep is typically characterized by catabolism and other metabolic shifts. Research on the application of nighttime casein protein supplementation has introduced a new research paradigm related to protein timing. Pre-sleep casein supplementation has been attributed to improved adaptive response by skeletal muscle to resistance training through increases in muscle protein synthesis, muscle mass, and strength. However, it remains unclear what the effect of this nutritional strategy is on non-muscular parameters such as metabolism and appetite in both healthy and unhealthy populations. The purpose of this systematic review is to understand the effects of pre-sleep casein protein on energy expenditure, lipolysis, appetite, and food intake in both healthy and overweight or obese individuals. A systematic review following PRISMA guidelines was conducted in CINAHL, Cochrane, and SPORTDiscus during March 2021, and 11 studies met the inclusion criteria. A summary of the main findings shows limited to no effects on metabolism or appetite when ingesting 24–48 g of casein 30 min before sleep, but data are limited, and future research is needed to clarify the relationships observed.


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