scholarly journals From Harvest to Health: Challenges for Developing Biofortified Staple Foods and Determining Their Impact on Micronutrient Status

2007 ◽  
Vol 28 (2_suppl2) ◽  
pp. S271-S279 ◽  
Author(s):  
Christine Hotz ◽  
Bonnie McClafferty
Keyword(s):  
Low Income ◽  
Micronutrient Deficiencies ◽  
Community Based ◽  
Target Populations ◽  
Vitamin A Status ◽  
Micronutrient Status ◽  
New Strategy ◽  
Staple Foods ◽  
Breeding Techniques

Background The use of conventional breeding techniques and biotechnology to improve the micronutrient quality of staple crops is a new strategy to address micronutrient deficiencies in developing countries. This strategy, referred to as “biofortification,” is being developed and implemented through the international alliance of HarvestPlus to improve iron, zinc, and vitamin A status in low-income populations. Objective The objective of this paper is to review the challenges faced by nutritionists to determine and demonstrate the ability of biofortified crops to have an impact on the nutritional and health status of target populations. Methods We reviewed available published and unpublished information that is needed to design and evaluate this strategy, including issues related to micronutrient retention in staple foods, micronutrient bioavailability from plant foods, and evidence for the efficacy of high-micronutrient-content staple foods to improve micronutrient status. Results Further information is needed on the retention of micronutrients in staple foods, in particular of provitamin A carotenoids, when stored and prepared under different conditions. The low bioavailability of iron from staple foods and the ability to demonstrate an impact on zinc status are specific challenges that need to be addressed. In target countries, infections and other micronutrient deficiencies may confound the ability to affect micronutrient status, and this must be taken into account in community-based studies. Conclusions Information to date suggests that biofortification has the potential to contribute to increased micronutrient intakes and improved micronutrient status. The success of this strategy will require the collaboration between health and agriculture sectors.

scholarly journals The role of a multidisciplinary student team in the community management of chronic obstructive pulmonary disease

2016 ◽  
Vol 17 (04) ◽  
pp. 415-420
Author(s):  
Herchel Clarke ◽  
Miranda Voss
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Health Literacy ◽  
Low Income ◽  
Chronic Obstructive ◽  
Community Based ◽  
Obstructive Pulmonary Disease ◽  
Home Based ◽  
Student Team

ObjectiveTo determine whether a community-based, multidisciplinary team consisting of home-based caregivers and supervised students could improve the functional status and quality of life of patients living with chronic obstructive pulmonary disease (COPD) in a low-income, peri-urban setting in South Africa.MethodsThis was a quasi-experimental study conducted over three months. Attention was paid to health literacy, inhaler technique, respiratory conditioning and nutrition.ResultsHealth literacy was poor and most patients were not using their inhalers correctly. Five of 12 patients found exercising challenging and withdrew from the study early. In the remaining seven patients, statistically significant improvements in FEV1%, and quality of life scores were seen at three months. Improvements in exercise tolerance and BODE prognostic index did not reach statistical significance.ConclusionA home-based multidisciplinary student team can improve the functional status and the quality of life in patients living with COPD in a low-income setting. This approach offers a suitable model for community-based service learning.

scholarly journals Micronutrients - a Global Perspective on Intake, Health Benefits and Economics

2012 ◽  
Vol 82 (5) ◽  
pp. 316-320 ◽  
Author(s):  
Birgit Hoeft ◽  
Peter Weber ◽  
Manfred Eggersdorfer
Keyword(s):  
Low Income ◽  
Health Care Systems ◽  
The Elderly ◽  
The United States ◽  
Global Perspective ◽  
Low Income Countries ◽  
Micronutrient Deficiencies ◽  
Micronutrient Status ◽  
Care Systems ◽  
Development And Aging

The link between a sufficient intake of vitamins and long term health, cognition, healthy development and aging is increasingly supported by experimental animal, human and epidemiology studies. In low income countries billions of people still suffer from the burden of malnutrition and micronutrient deficiencies. However, inadequate micronutrient status might also be an issue in industrialized countries. Recent results from nutritional surveys in countries like the United States, Germany, and Great Britain indicate that the recommended intake of micronutrients is not reached. This notably concerns certain vulnerable population groups, such as pregnant women, young children and the elderly, but also greatly influences the general healthcare costs. An overview is provided on the gap that exists between current vitamin intakes and requirements, even in countries where diverse foods are plentiful. Folic acid and vitamin D intake and status are evaluated in more detail, providing insight on health and potential impact on health care systems.

Health, Livelihoods, and Nutrition in Low-Income Rural Systems

2007 ◽  
Vol 28 (2_suppl2) ◽  
pp. S227-S236 ◽  
Author(s):  
Michael Joffe
Keyword(s):  
Low Income ◽  
Poverty Reduction ◽  
Rural Poverty ◽  
Educational Status ◽  
Child Growth ◽  
Main Element ◽  
World Population ◽  
Micronutrient Deficiencies ◽  
Absolute Poverty

Background Absolute poverty remains a major challenge: the proportion of the world population living with hunger, food insecurity, and undernutrition has fallen, but the absolute number remains stubbornly large. An even larger number of people have enough to eat but suffer from severe micronutrient deficiencies. Objectives To provide a conceptual framework showing the interdependence of hunger and poverty with ill health among the rural poor. Methods Review of the relevant health, nutrition, agriculture, and economics literature and organization of the findings into a systems framework. Results Economic growth is not a sufficient answer to rural poverty. The predicament of poor households can be represented in terms of a self-reinforcing cycle involving nutrition, health, and productivity. The degree of poverty limits the quantity and quality of food intake. Macro- and micronutrient deficiencies interfere with child growth and development and impair immune function, resulting in a predisposition to infectious diseases. Health status strongly influences the quantity and quality of labor and achieved educational status. The high risk of child mortality prevents households from going through the demographic transition to smaller families and better-educated children. The death of a working adult may be catastrophic for the household. This self-reinforcing cycle means that the beneficial effects of an intervention are propagated around the cycle, potentiating its impact. Each main element—nutrition, health, and productivity—also has numerous other determinants and can be influenced by interventions. Interventions that increase the carrying capacity of the household's environment are likely to be more sustainable than “technical fixes,” such as lifesaving medical treatment. Conclusions The self-reinforcing cycle is likely to be self-perpetuating without outside intervention. For any rural area where poverty reduction is planned, the key bottlenecks need to be identified. This can be done by using a causal diagram, as described in this paper.

E-Civic Engagement and the Youth

2012 ◽  
Vol 1 (3) ◽  
pp. 87-104 ◽  
Author(s):  
Kheir Al-Kodmany ◽  
John Betancur ◽  
Sanjeev Vidyarthi
Keyword(s):  
Civic Engagement ◽  
Low Income ◽  
New Technologies ◽  
After School ◽  
Lower Income ◽  
Community Based ◽  
Face To Face ◽  
Community Based Organizations ◽  
Wide Range

This article explores how community-based organizations working in low-income residential neighborhoods of U.S. cities employ e-tools and social networking platforms to engage the youth. The authors interviewed representatives of community organizations that work with young adults from lower-income groups in Chicago to comprehend their actual usages and perceptions of electronic tools. These organizations facilitate a wide-range of initiatives including political and after-school education, gang-free spaces, crime intervention and prevention, and arts and media. They found that the organizations have internalized the idea of employing e-Engagement techniques to enhance communication with their constituents but use new technologies and social media in multiple ways. Many respondents posit that the presently available e-tools enable certain forms of civic engagement but require sustained resources. Also stressed is the roles of face-to-face communication, offline-meetings, and other traditional means of interaction to ensure the commitment and quality of effective engagement in this age of e-participations.

A randomized controlled trial of the effect of a community-based intervention on patient activation, health-related quality of life, and acute care use.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 1-1
Author(s):  
Manali I. Patel ◽  
Sana Indravadan Khateeb ◽  
Ivana Krajcinovic ◽  
Deb Salava ◽  
Tumaini Coker
Keyword(s):  
Quality Of Life ◽  
Acute Care ◽  
Low Income ◽  
Cancer Care ◽  
Patient Activation ◽  
Health Related Quality ◽  
Community Based ◽  
Related Quality ◽  
Health Related

1 Background: Low-income and minority populations have disproportionately less activation in their cancer care, worse health-related quality of life (HrQOL), and greater acute care use than affluent and white populations. Community-based interventions are needed to improve patient experiences and quality of cancer care among these populations. We used community-based participatory methods to refine a previously tested intervention for use in Atlantic City NJ. The intervention, LEAPS, uses community health workers trained to activate patients to discuss advance care planning and their symptom burden with cancer clinicians and to connect patients with culturally-relevant community resources to overcome complications from social determinants of health. We conducted a randomized controlled trial of LEAPS in collaboration with a employer-union health fund. Members of the employer-union health fund with newly diagnosed with hematologic and solid tumor cancers were randomized to the 6-month intervention or to usual care. The objective was to determine if the intervention improved HrQOL at 4 months post-enrollment as compared to baseline more than usual care and secondarily the effect on change in patient activation at 4 months post-enrollment as compared to baseline and acute care use within 12 months post-enrollment. Methods: We conducted patient interviews to assess HrQOL and patient activation and obtained claims data for health care use. We used regression models to evaluate differences in health-related quality of life (validated Functional Assessment of Cancer Therapy-General) scores and patient activation (validated Patient Activation Measure) scores between groups over time and exact poisson regression adjusted for length of follow-up to compare emergency department and hospitalization utilization. Results: A total of 160 patients were consented and randomized into the study (80 intervention; 80 control). There were no differences in demographic or clinical factors across groups. The majority were non-white (74%), female (53%), mean age 57 years. The most common diagnoses were breast (31%) and lung (21%) cancer and the majority were diagnosed with stage 3 or 4 (63%). At 4 months, the intervention group had greater improvements in quality of life as compared to the control group (difference in difference: 9.56 p < 0.001), greater change in patient activation (difference in difference: 12.43 (p < 0.001)), and lower acute care use (hospital visits (1.10 (1.53) +/- 1.83 (1.31), p = 0.02) and emergency department use (1.2 (2.82) versus 3.47 (3.62) p = 0.03). Conclusions: Integration of community-based interventions into cancer care for low-income and minority populations may be a more effective and sustainable way to ensure equitable cancer care. Clinical trial information: NCT03699748.

scholarly journals Oral health-related quality of life outcomes in a randomized clinical trial to assess a community-based oral hygiene intervention among adults living in low-income senior housing

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Susan Reisine ◽  
Jean J. Schensul ◽  
Apoorva Salvi ◽  
James Grady ◽  
Toan Ha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Oral Health ◽  
Low Income ◽  
Oral Hygiene ◽  
Health Related Quality ◽  
Community Based ◽  
Related Quality ◽  
Health Related

Abstract Background Quality of life outcomes have been used frequently in clinical trials of oral health interventions. This study assessed the effects of a randomized trial on oral health related quality of life comparing an individual-based oral hygiene intervention to a community-based intervention. Methods Participants were recruited from six low-income senior housing residences. Buildings were randomly assigned to receive the individual-based intervention followed by the community-based intervention or to receive the community-based intervention followed by the individual intervention. Participants’ oral hygiene was assessed at baseline (T0), one month after the first intervention (T1) and one month after the second intervention (T2) and six months after the T2 assessment (T3). Oral hygiene was measured by the Gingival Index (GI) and Plaque scores (PS). Surveys collected data on beliefs, attitudes, behaviors and self-reported health status at T0, T1 and T2. Only oral hygiene and quality of life, measured by the General Oral Health Assessment Index (GOHAI), was assessed at all time points. general linear mixed models (GLMM) were used to assess changes in GOHAI over time, the interaction of condition by time and the contribution of psychosocial, behavioral, health status and background variables to changes in GOHAI. Results 331 people completed T0 assessments; 306 completed T1; 285 completed T2 and 268 completed T3. Scores on GOHAI at T0 ranged from 10 to 48 with a mean of 39.7 (sd = 7.8) and a median of 42. At T1, mean GOHAI was 40.7 (sd = 8.2), at T2 mean GOHAI was 41.1 (sd = 7.8) and at T3, GOHAI was 42.3 (sd = 8.2). GLMM showed that GOHAI improved significantly from T0 to T3 (p = 0.01) but the time by intervention interaction was not significant indicating that both interventions were effective in improving GOHAI but one intervention was not better than the other. Ethnicity, health status, worries, self-efficacy, number of missing teeth and symptoms of dry mouth were related to improvements in GOHAI. Neither GI nor PS were related to GOHAI. Conclusions The participants reported relatively good oral health related quality of life which improved significantly over time. Improvement occurred among all participants regardless of condition, suggesting that either intervention would be effective in future studies. Trial Registry: Clinicaltrials.gov, Clinical Trials ID #NCT02419144; Title: A Bi-level Intervention to Improve Older Adult Oral Health Status; Registered 04/07/2015 URL: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005H9X&selectaction=Edit&uid=U0000KBK&ts=2&cx=-rajj5q

scholarly journals Micronutrient Biofortification in Rice through New Breeding Techniques (NBTs): Bangladesh Perspective

2020 ◽  
Vol 01 ◽  
Author(s):  
Bishajit Sarkar ◽  
Fayza Akter ◽  
Fatema Tuz Johora ◽  
Md. Asad Ullah ◽  
Abdullah Mohammad Shohael
Keyword(s):  
Genetic Engineering ◽  
Genome Editing ◽  
Low Income ◽  
Rice Grain ◽  
Rice Cultivars ◽  
Micronutrient Deficiencies ◽  
Conventional Breeding ◽  
Vitamin B9 ◽  
New Breeding Techniques ◽  
Breeding Techniques

Background: Micronutrient deficiencies are serious health issues in developing countries of Asia and Africa, where millions of people are suffering from inadequate micronutrient intake. In Bangladesh, micronutrient deficiencies are found severe due to low income, food habits, and rice-based staple food consumption, (rice has an insufficiency of different types of vitamins and minerals). To lessen micronutrient malnutrition, supplementation has been employed but has not yet reached the goal. Agronomic and genetic biofortification has the potential to address micronutrient deficiencies. Biofortification in Rice grain is a convenient and affordable way to supply the desired micronutrients. The development of micronutrient-rich popular rice cultivars through conventional breeding is currently being harnessed for the limitation of natural resources of the related donor rice cultivars containing the required amount of micronutrients. To overcome these hurdles of conventional breeding, genetic engineering and genome editing have emerged as promising tools of micronutrient biofortification in rice. Methods: Identify the needs and explore the potential strategies by the search for relevant literature known to the authors was carried out to complete this review. Results: Highlighted here the sources, functions, and requirements of iron, zinc, vitamin A, vitamin B1, vitamin B9, and betanin in rice and their biofortification through conventional breeding, genetic engineering, and genome editing including their promises and hindrances. Conclusion: New breeding techniques are timely alternatives for developing nutrient-rich rice cultivars to eliminate hidden hunger and poverty in Bangladesh.

scholarly journals Improving Oral Health in Older Adults and People With Disabilities: Protocol for a Community-Based Clinical Trial (Good Oral Health) (Preprint)

2019 ◽  
Author(s):  
Jean Schensul ◽  
Susan Reisine ◽  
James Grady ◽  
Jianghong Li
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Low Income ◽  
Crossover Design ◽  
Health Campaigns ◽  
Community Based ◽  
Face To Face ◽  
Health Quality ◽  
Health Quality Of Life

BACKGROUND Low-income older adults experience disparities in oral health problems, including caries and periodontal disease, that can exacerbate already high levels of chronic and acute health problems. Behavioral interventions have been shown to improve oral health status but are typically administered in institutional rather than community settings. Furthermore, multiple simultaneous interventions at different levels in the locations where people live and work are likely to have more impact and sustainability than single interventions in clinical settings. OBJECTIVE This paper outlines a protocol for conducting a bilingual 5-year community-based trial of a bilevel intervention that addresses community norms, beliefs, intentions, and practices to improve oral health hygiene of vulnerable older adults living in publicly subsidized housing. The intervention utilizes (1) a face-to-face counseling approach (adapted motivational interviewing [AMI]) and (2) resident-run oral health campaigns in study buildings. METHODS The study’s modified fractional factorial crossover design randomizes 6 matched buildings into 2 conditions: AMI followed by campaign (AB) and campaign followed by AMI (BA). The total intervention cycle is approximately 18 months in duration. The design compares the 2 interventions alone (T0-T1), and in different sequences (T1-T2), using a self-reported survey and clinical assessment to measure Plaque Score (PS) and Gingival Index (GI) as outcomes. A final timepoint (T3), 6 months post T2, assesses sustainability of each sequence. The intervention is based on the Fishbein integrated model that includes both individual and contextual modifiers, norms and social influence, beliefs, attitudes, efficacy, and intention as predictors of improvements in PS, GI, and oral health quality of life. The cognitive and behavioral domains in the intervention constitute the mechanisms through which the intervention should have a positive effect. They are tailored through the AMI and targeted to building populations through the peer-facilitated oral health campaigns. The sample size is 360, 180 in each condition, with an attrition rate of 25%. The study is funded by National Institute of Dental and Craniofacial Research (NIDCR) and has been reviewed by University of Connecticut and NIDCR institutional review boards and NIDCR’s clinical trials review procedures. RESULTS When compared against each other, the face-to-face intervention is expected to have greater positive effects on clinical outcomes and oral health quality of life through the mediators. When sequences are compared, the results may be similar but affected by different mediators. The arm consisting of the BA is expected to have better sustainability. The protocol’s unique features include the comparative effectiveness crossover design; the introduction of new emotion-based mediators; the balancing of fidelity, tailoring, and targeting; and resident engagement in the intervention. CONCLUSIONS If successful, the evaluated interventions can be scaled up for implementation in other low-income congregate living and recreational settings with older adult collectives. CLINICALTRIAL ClinicalTrials.gov NCT02419144; https://clinicaltrials.gov/ct2/show/NCT02419144 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14555

Effects of the poverty alleviation relocation program on diet quality among low-income households

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Huanguang Qiu ◽  
Ganxiao Leng ◽  
Xiaolong Feng ◽  
Sansi Yang
Keyword(s):  
Selection Bias ◽  
Diet Quality ◽  
Low Income ◽  
Poverty Alleviation ◽  
Market Access ◽  
Content Type ◽  
Staple Foods ◽  
The Impact ◽  
Low Income Households

PurposeThis paper aims to examine impacts of the poverty alleviation relocation (PAR) program on diet quality of low-income households in China. We explore the impact mechanism of relocation on diet quality and the heterogeneous effects of different relocation modes.Design/methodology/approachA fixed effects model is constructed using panel data of 1126 low-income households collected over three years in eight provinces of China. The PAR program provides a natural experiment which dramatically changes the living conditions surrounding farmers. We are able to identify the causal effects of relocation on diet quality free from selection bias.FindingsThe empirical results show that the PAR program improves diet quality of low-income households and that better market access and increasing incomes induced by relocation play an important role in this improvement. Improved market access significantly reduces the over-consumption of staple foods, whereas higher income significantly reduces the intake divergences of non-staple foods. The impacts of different relocation modes on diet quality are highly heterogeneous.Practical implicationsOur findings indicate that the PAR program benefits diet quality of low-income households through greater market access and increases in total household income. Market improvements and food subsidies are conducive to improving the diet quality of the low income.Originality/valueDespite widespread evidences of healthy diets being associated with household environments and income, selection bias remains. This paper utilizes an exogenous program to explore the causal impacts of market access and family income on diet quality and to separate their different effects.

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