Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

Background Peru has historically experienced high rural-to-urban migration. Despite large reductions in undernutrition, overweight is increasing. Elsewhere, internal migration has been associated with differences in children’s growth and nutritional health. We investigated how child growth and nutritional status in Peru varied over time and in association with maternal internal migration. Methods Using data from Demographic & Health Surveys from 1991 to 2017, we assessed trends in child growth (height-for-age [HAZ], weight-for-age [WAZ], weight-for-height [WHZ] z scores) and nutritional health (stunting, underweight, overweight) by maternal adult internal migration (urban [UNM] or rural non-migrant [RNM], or urban-urban [UUM], rural-urban [RUM], rural-rural [RRM], or urban-rural migrant [URM]). Using 2017 data, we ran regression analyses, adjusting for confounders, to investigate associations of maternal migration with child outcomes and the maternal and child double burden of malnutrition. We further stratified by timing of migration, child timing of birth and, for urban residents, type of area of residence. Results are given as adjusted predictive margins (mean z score or %) and associated regression p-values [p]. Results In 1991–2017, child growth improved, and undernutrition decreased, but large differences by maternal migration persisted. In 2017, within urban areas, being the child of a migrant woman was associated with lower WHZ (UUM = 0.6/RUM = 0.5 vs UNM = 0.7; p = 0.009 and p < 0.001 respectively) and overweight prevalence ((RUM 7% vs UNM = 11% [p = 0.002]). Results however varied both by child timing of birth (birth after migration meant greater overweight prevalence) and type of area of residence (better linear growth in children of migrants [vs non-migrants] in capital/large cities and towns but not small cities). In rural areas, compared to RNM, children of URM had higher HAZ (− 1.0 vs − 1.2; p < 0.001) and WAZ (− 0.3 vs − 0.4; p = 0.001) and lower stunting (14% vs 21%; [p < 0.001]). There were no differences by timing of birth in rural children, nor by time since migration across all children. The mother and child double burden of malnutrition was higher in rural than urban areas but no differences were found by maternal internal migration. Conclusions Migration creates a unique profile of child nutritional health that is not explained by maternal ethnic and early life factors, but which varies depending on the pathway of migration, the child timing of birth in relation to migration and, for urban dwellers, the size of the place of destination. Interventions to improve child nutritional health should take into consideration maternal health and migration history.

Towards Sustainable Shifts to Healthy Diets and Food Security in Sub-Saharan Africa with Climate-Resilient Crops in Bread-Type Products: A Food System Analysis

Massive urbanization and increasing disposable incomes favor a rapid transition in diets and lifestyle in sub-Saharan Africa (SSA). As a result, the SSA population is becoming increasingly vulnerable to the double burden of malnutrition and obesity. This, combined with the increasing pressure to produce sufficient food and provide employment for this growing population together with the threat of climate change-induced declining crop yields, requires urgent sustainable solutions. Can an increase in the cultivation of climate-resilient crops (CRCs) and their utilization to produce attractive, convenient and nutritious bread products contribute to climate change adaptation and healthy and sustainable diets? A food system analysis of the bread food value chain in SSA indicates that replacement of refined, mostly imported, wheat in attractive bread products could (1) improve food and nutrition security, (2) bring about a shift to more nutritionally balanced diets, (3) increase economic inclusiveness and equitable benefits, and (4) improve sustainability and resilience of the food system. The food system analysis also provided systematic insight into the challenges and hurdles that need to be overcome to increase the availability, affordability and uptake of CRCs. Proposed interventions include improving the agronomic yield of CRCs, food product technology, raising consumer awareness and directing policies. Overall, integrated programs involving all stakeholders in the food system are needed.

Prevalence of malnutrition among women and adolescent girls: impact of urbanization in rural–urban interface of Bangalore

PurposeIndia is facing a double burden of malnutrition, i.e. undernutrition and obesity. Women and adolescent health and nutrition are very relevant issues which have not received much attention it deserves in India, especially in the context of a girl child. Hence, the purpose of this study is to assess malnutrition among women and adolescent girls as well as the associated factors.Design/methodology/approachAn attempt was made to assess malnutrition among women and adolescent girls and associated factors. The required data was collected from the north (616) and south transects (659) sample households of Bangalore constituting a total sample size of 1,275. The data was analyzed by adopting multiple linear regression and multinomial logistic regression analysis using STATA software.FindingsThe effects of this study simply confirmed that, urbanization had an instantaneous effect on dietary repute of women and adolescent girls, while transferring throughout the gradient from rural to urban with the growing significance of weight problems and obese. In adolescent girls, about 31% were underweight followed by normal weight and overweight across rural–urban interface of Bangalore. The factors such as education, consumption of meat and animal products, a dummy for urban, diabetes and blood pressure were significantly and positively influencing the nutritional status (Body Mass Index) of women across rural–urban interface. While consumption of vegetables, wealth index and per capita income had a positive and significant influence on the nutritional status of adolescent girls.Originality/valueWith limited studies and data available in Karnataka, especially in Bengaluru, one of the fastest growing cities in the world. Against this backdrop, the study was conducted to assess the prevalence of malnutrition among women and adolescents and its association with various socio-economic variables.

Management of obesity with integrated Ayurveda and Yoga intervention: A case report

Obesity is the disease of nutritional deficiency which leads to abnormal growth of adipose tissue resulting in an increase in the body weight to the extent of 20% or more of standard weight for the person’s age, sex, and height. Obesity is one side of the double burden of malnutrition, and today more people are obese than underweight. In Ayurveda Obesity is classified under santarpanjanya rogas and ashtaninditiya purusha by Acharya Charaka. Ayurveda attributes concept of Dosha, dhatus and Mala in which any vikriti in any of dhatus, pramanatah or gunatah then it firmly affects both body and mind. Yoga and Ayurveda both spring as a greater part of spiritual and mental aspect of treatment. Considering all these factors this study is carried out to understand cause, cause effect relationship as well as treatment. In this case study patient was treated with Udwarthana, Shodhana and Shamana chikitsa, also advised Ahara (scheduled diet) and Vihara (life style modification) for the management of obesity. This showed a significant change in anthropometric measurement.

TIME ALLOCATION AND FEELINGS OF HAPPINESS OF SELF-EMPLOYED PERSONS – A GENDERED PERSPECTIVE

This article focuses on the division of the daily activities of self-employed persons on entrepreneurial activities, unpaid work, leisure time and other activities, and their interconnection to the feelings of happiness (as part of subjective well-being). Modified Time Use Survey (TUS) methodology was used to gather data on division of time and to identify SWB. The 13 groups of activities and 161 self-employed persons were included in the analysis. The results suggest that both self-employed men and women dedicate more than 8 hours per day for paid work. Daily activities during which the highest part of self-employed men and women feel the happiest belong to leisure activities. Unpaid work activities bring the highest feeling of happiness to 12.5 % of self-employed women. Feelings of happiness of self-employed women are more fluctuating during the paid work than feelings of happiness of self-employed men. In the evening, the feelings of happiness of the self-employed women decrease significantly, which could be caused by double burden of self-employed women.

Case Report : Mr. I 56 years old with Stroke Non Hemoragic

Stroke is one of the most common diseases that cause functional impairment and disability. Stroke is the second leading cause of death and the leading cause of disability worldwide. Its incidence is increasing as the population ages. In addition, more young people have strokes in low- and middle-income countries. Data in Indonesia shows that stroke is the third most common cause of death, followed by diabetes mellitus and hypertension with a mortality rate of 138,268 people or 9.7% of the total deaths. Indonesia has a double burden in dealing with health problems. Lacunar strokes, a type of ischemic stroke, are small and located in non-cortical areas. Lacunar infarctions are caused by occlusion of small branches penetrating within the cerebral vessels of the circle of Willis, including branches of the middle cerebral artery, anterior cerebral artery, posterior cerebral artery, or spinal cord. basilar artery. The principle of treatment for acute lacunar stroke is very similar to that of acute ischemic stroke. The initial goals of acute stage treatment are to ensure medical stability and determine candidacy for thrombolysis. Tissue plasminogen activator (TPA) improves outcomes for patients with ischemic stroke. Once intracerebral hemorrhage has been ruled out, intravenous thrombolysis is an important step in treatment. Acute lacunar infarction is efficiently treated with TPA. This case report discusses a 56 year old Mr I diagnosed with a non-hemorrhagic stroke.

Review of the Nutrition Situation in Jordan: Trends and Way Forward

Jordan is witnessing an escalating pace of nutrition transition, which may be associated with an increased burden of malnutrition and related non-communicable diseases. This review analyzes the nutrition situation in Jordan by exploring specific nutrition indicators, namely infant and young child feeding, low birthweight, micronutrient deficiencies, anthropometric indicators, and food consumption patterns. Results showed that although most children were ever breastfed and early initiation of breastfeeding had a two-fold increasing trend, rates of exclusive breastfeeding below 6 months of age and continued breastfeeding until two years of age were low. Complementary feeding indicators, particularly minimum diet diversity and minimum acceptable diet standards, were suboptimal. An overall low burden of stunting, wasting, and underweight among children under 5 years and remarkable progress in optimizing iodine status among school-aged children were reported. Conversely, the burden of low birthweight and overweight/obesity exacerbated, coexisting with anemia, vitamin A deficiency, and vitamin D deficiency. Overall, fruit and vegetable consumption were inadequate. The consumption of soft drinks and salt on the other hand was higher than recommended. This review acknowledges the double burden of malnutrition in Jordan and recommends the prioritization and evaluation of interventions towards improving the population’s nutritional status and achieving nutrition targets.

Stress Perception, Sleep Quality and Work Engagement of German Outpatient Nurses during the COVID-19 Pandemic

Since the outbreak of the COVID-19 pandemic, outpatient nurses have been exposed to a double burden of already known occupational and new pandemic-related stressors. Recent studies suggest that increased pandemic-related stress can affect mental health and promote the development of negative mental health outcomes for nurses. This includes a decrease in sleep quality and work engagement. In addition, certain groups appear to be particularly vulnerable to pandemic-related stress. The aim of this study was to investigate the stress perception of German outpatient nurses during the COVID-19 pandemic. The aim was to determine associations between their pandemic-related stress and variables such as sleep quality, work engagement, pandemic-related worries and concerns. For this purpose, a questionnaire was developed based on well-established measurement instruments such as the 10-item Perceived Stress Scale, the Pittsburgh Sleep Quality Index and the Copenhagen Psychosocial Questionnaire to conduct a cross-sectional online survey among outpatient nurses from Germany. Participants (n = 166) showed rather moderate overall pandemic-related stress levels, good sleep quality, high work engagement, and moderate pandemic-related worries and concerns. Pandemic-related stress proved to be a predictor of decreased sleep quality and work engagement of outpatient nurses with weak effect sizes. Despite the surprisingly moderate stress levels, the effects of pandemic-related stress on selected aspects of participants’ mental health could be demonstrated. Therefore, behavioural and organisational health promotion measures are recommended to support outpatient nurses during the pandemic. However, further research is needed to determine the causal relationships and long-term effects of pandemic-related stress on the mental health of outpatient caregivers.