Consumption of Vitamin-A-Rich Foods and Vitamin A Supplementation for Children under Two Years Old in 51 Low- and Middle-Income Countries

Vitamin A supplementation for children 6–59 months old is an important intervention that boosts immune function, especially where children do not consume enough vitamin-A-rich foods. However, the low coverage of vitamin A supplementation is a persistent problem in low- and middle-income countries. We first estimated the percentage of children 6–23 months old receiving the minimum dietary diversity, vitamin-A-rich foods, and vitamin A supplementation, and second, the difference in the percentage receiving vitamin A supplementation between children 6–23 months old and children 24–59 months old using nationally representative cross-sectional household surveys, namely, the Demographic and Health Surveys, conducted from 2010 to 2019 in 51 low- and middle-income countries. Overall, 22% (95% CI: 22, 23) of children received the minimum dietary diversity, 55% (95% CI: 54, 55) received vitamin-A-rich foods, 59% (95% CI: 58, 59) received vitamin A supplementation, and 78% (95% CI: 78, 79) received either vitamin-A-rich foods or supplementation. A wide variation across countries was observed; for example, the percentage of children that received either vitamin-A-rich foods or supplementation ranged from 53% (95% CI: 49, 57) in Guinea to 96% (95% CI: 95, 97) in Burundi. The coverage of vitamin A supplementation should be improved, especially for children 6–23 months old, in most countries, particularly where the consumption of vitamin-A-rich foods is inadequate.

Democracy: Maybe Less Is More

In any functional democratic system, some decisions are left to experts (who may be overseen indirectly by the people), while others are directly in the hands of the people. How to allocate these decision rights is a persistent problem in democratic theory. This chapter argues that competence is a crucial criterion in deciding the question of who decides. Further, part of the solution to the persistent pathologies of democracy is to reduce the sphere of politics and also the sphere of political control. Certain issues, such as trade policy, immigration policy, central banking interest rates, who serves as district attorney or judge, and various kinds of regulation, should be kept out of democracy’s hands—for everybody’s own good.

Bacterial-Based Cancer Therapy (BBCT): Recent Advances, Current Challenges, and Future Prospects for Cancer Immunotherapy

Currently approximately 10 million people die each year due to cancer, and cancer is the cause of every sixth death worldwide. Tremendous efforts and progress have been made towards finding a cure for cancer. However, numerous challenges have been faced due to adverse effects of chemotherapy, radiotherapy, and alternative cancer therapies, including toxicity to non-cancerous cells, the inability of drugs to reach deep tumor tissue, and the persistent problem of increasing drug resistance in tumor cells. These challenges have increased the demand for the development of alternative approaches with greater selectivity and effectiveness against tumor cells. Cancer immunotherapy has made significant advancements towards eliminating cancer. Our understanding of cancer-directed immune responses and the mechanisms through which immune cells invade tumors have extensively helped us in the development of new therapies. Among immunotherapies, the application of bacteria and bacterial-based products has promising potential to be used as treatments that combat cancer. Bacterial targeting of tumors has been developed as a unique therapeutic option that meets the ongoing challenges of cancer treatment. In comparison with other cancer therapeutics, bacterial-based therapies have capabilities for suppressing cancer. Bacteria are known to accumulate and proliferate in the tumor microenvironment and initiate antitumor immune responses. We are currently well-informed regarding various methods by which bacteria can be manipulated by simple genetic engineering or synthetic bioengineering to induce the production of anti-cancer drugs. Further, bacterial-based cancer therapy (BBCT) can be either used as a monotherapy or in combination with other anticancer therapies for better clinical outcomes. Here, we review recent advances, current challenges, and prospects of bacteria and bacterial products in the development of BBCTs.

The Power of Inquiry in Equity-Oriented Teacher Education

The international problem of differential achievement between groups of students has particular significance for New Zealand given its persistent problem of inequitable outcomes for Māori and Pasifika students, and those from poor communities. This qualitative study investigated how engagement in teacher inquiry supported student teachers’ understandings of, and practice for, equity. The 28 participants were in a one-year, equity-oriented Master’s initial teacher education programme. The data set comprised 84 research-related assignments participants completed for their teacher inquiry course. Thematic data analysis showed that the structured inquiry process supported participants to challenge inequity by problematizing student engagement and to address this by using a range of evidence to enhance their teaching. Overall, the study suggests that inquiry as research process and stance, along with the application of the Facets equity framework in authentic teaching and learning contexts, is a powerful source of student teacher equity-focused professional learning and practice.

Response—Corruption, Trust, and Professional Regulation

In their 2018 article in the Cambridge Quarterly of Healthcare Ethics, Little, Lipworth, and Kerridge unpack the concept of corruption and clarify the mechanisms that foster corruption and allow it to persist, noting that organizations are “corruptogenic.” To address the “so-what” question, I draw on research about trust and trustworthiness, emphasizing that a person’s well-being and sense of security require trust to be present at both the individual and organizational levels—which is not possible in an environment where corruption and misconduct prevail. I highlight similarities in Little et al.’s framing of corruption to the persistent problem of scientific misconduct in research and publishing. I acknowledge the challenges in stemming corruption in science and medicine and conclude with a discussion about the need to reinvigorate a web of stakeholders to actively engage in professional regulation.

Disparities in Disease-Specific Remaining Life Expectancy Among Medicare Beneficiaries in the United States

Racial and geographic disparities in life expectancy (LE) in the US are a persistent problem. We used 5% Medicare Claims for 2000-2017 to investigate the patterns of remaining LE (RLE) in the U.S. with the highest and the lowest LE. RLEs in race-/ethnicity specific populations aged 65+ were calculated in patients with specific diseases and in the total population using the area under the Kaplan-Meier estimator. The Cox model was used to investigate the effect of state-specific residence on total LE and RLE. Between-the-states differences in RLE were most pronounced for cerebrovascular disease, atherosclerotic heart disease, breast and prostate cancer. RLE was the lowest for lung cancer and sepsis, followed by Alzheimer’s disease, dementia, pneumonia, and heart failure. RLE for myocardial infarction and cerebrovascular disease decreased over time, while for renal failure, diabetes, atherosclerotic heart disease, and cancers of breast and prostate RLE increased.

Relying on Myself: The Lived Experience of Being at Risk for Falling in the Hospital Among Older Adults

Inpatient falls are a persistent problem and despite research efforts during the last decade, inpatient fall rates have not significantly decreased. Older adults have an estimated 50% greater inpatient fall rate than younger adults. How older adults perceive their own fall risk affects their adherence to fall prevention recommendations. The aim of this phenomenological study was to gain a deeper understanding of the lived experiences of being at risk for falling in the hospital among older adults aged 65 years and older (N=9). Participants (female=55%, age range=67 – 86) were interviewed twice using video conferencing within two weeks of hospital discharge. The audio-recorded interviews were transcribed, and then analyzed using van Manen’s interpretive phenomenological method. The Health Belief Model expanded with the concepts of independence, fear of falling, embarrassment, dignity, and positivity effect served as the theoretical framework. Five major interpretive themes emerged: Relying on Myself, Managing Balance Problems in an Unfamiliar Environment, Struggling to Maintain Identity, Following the Hospital Rules, and Maintaining Dignity in the Relationships with Nursing Staff. These themes describe how the participants thoughtfully planned their mobilization to avoid falls. This process was influenced by their struggling to remain independent, following the hospital fall prevention rules out of politeness, and experiencing both positive and negative relationships with nursing staff. Hospitalized older adults employed their self-efficacy to manage balance problems in the hospital. These findings have not been previously documented in the literature. Fall prevention interventions supporting hospitalized older adults’ self-management of fall risk are needed.

Corruption practices and government effectiveness on human capital development in Nigeria

The study assessed the impact of corruption practices and government effectiveness (GE) on human capital development (HCD) in Nigeria between the years 2003 and 2020, Panel data from 2003 to 2020 were obtained from the database of United Nations Development Programme, World Development Indicators and CIP and were analysed using the ordinary least square method which is suitable for the dataset. The study found that corruption has a significant relationship with HCD in Nigeria while the relationship between GE and HCD is not significant. The research implication is that the persistent problem of slow and sometimes stagnant HCD and growth in Nigeria can be reversed by improving GE and by reducing corrupt practices in the country. The paper concluded that corruption practices have a very strong influence on HCD in Nigeria, while the relationship between GE and HCD is insignificant. It was recommended that Nigeria should institute stiffer punishments for offenses bothering on corruption practices. Keywords: Corruption, human capital, development, government effectiveness, Nigeria.

Unmanned Aerial System-Based Weed Mapping in Sod Production Using a Convolutional Neural Network

Weeds are a persistent problem on sod farms, and herbicides to control different weed species are one of the largest chemical inputs. Recent advances in unmanned aerial systems (UAS) and artificial intelligence provide opportunities for weed mapping on sod farms. This study investigates the weed type composition and area through both ground and UAS-based weed surveys and trains a convolutional neural network (CNN) for identifying and mapping weeds in sod fields using UAS-based imagery and a high-level application programming interface (API) implementation (Fastai) of the PyTorch deep learning library. The performance of the CNN was overall similar to, and in some classes (broadleaf and spurge) better than, human eyes indicated by the metric recall. In general, the CNN detected broadleaf, grass weeds, spurge, sedge, and no weeds at a precision between 0.68 and 0.87, 0.57 and 0.82, 0.68 and 0.83, 0.66 and 0.90, and 0.80 and 0.88, respectively, when using UAS images at 0.57 cm–1.28 cm pixel–1 resolution. Recall ranges for the five classes were 0.78–0.93, 0.65–0.87, 0.82–0.93, 0.52–0.79, and 0.94–0.99. Additionally, this study demonstrates that a CNN can achieve precision and recall above 0.9 at detecting different types of weeds during turf establishment when the weeds are mature. The CNN is limited by the image resolution, and more than one model may be needed in practice to improve the overall performance of weed mapping.