Marine protected areas and children's dietary diversity in the Philippines.

Fish living around the coral reefs in the Philippines provide livelihoods for more than a million local fishers and are an important source of protein for coastal communities. However, this rich resource is at risk from myriad threats, which consequently threaten human livelihoods, nutrition, and health. In this paper, we examine the degree to which marine protected areas (MPAs), which aim to conserve marine biodiversity, are associated with improved nutritional outcomes in children under age 5. This analysis, which uses data from the 2008 Philippines Demographic and Health Survey and MPA data from the Coastal Conservation and Education Fund, found a positive association between MPAs and children's dietary diversity when the MPAs were located closer than 2 km to a child's community. MPA characteristics such as age or type of management were not consistently associated with dietary diversity. These results suggest a positive association of proximity to MPAs with certain aspects of children's diet.

Prevalence of human papilloma virus in marginal periodontium and its association with periodontitis: A cross sectional study.

CONTEXT: Bacterial pathogens in dental plaque are necessary for the development of periodontitis but this etiology alone does not explain all its clinicopathologic features. Researchers have proven the role of certain viruses like herpes virus in periodontal disease which implies that other viral agents like human papilloma virus may also be involved. AIMS: This cross-sectional study was conducted to determine the proportion of patients with human papilloma virus (HPV-16) in marginal periodontium by analyzing DNA from the gingival tissue sample and to understand its association with periodontitis. SETTINGS AND DESIGN: 102 systemically healthy patients between the age group of 15 and 70 years reporting to the Department of Periodontology who required surgical intervention (flap surgery for patients with periodontitis and crown lengthening for healthy patients) with internal bevel gingivectomy were selected. MATERIALS AND METHODS: After scaling and root planning, gingival tissue was collected during the respective surgical procedure. DNA was isolated and amplified using specific primers for HPV-16 by polymerase chain reaction (PCR). The amplified products were checked by agarose gel electrophoresis. RESULTS: No HPV DNA was detected in the 102 samples analyzed. CONCLUSION: Marginal periodontium does not contain HPV in this study population and hence there was no association between HPV and periodontitis.

Essential hypertension as a result of neurochemical changes at the rostral ventrolateral medulla.

Acute ischemia of the brainstem has been known to produce hypertension. After an initial review of central nervous system mechanisms contributing to systemic hypertension and the impact of the rostral ventrolateral medulla (RVLM) on arterial pressure, the authors propose that essential hypertension involves neurochemical changes at the level of the RVLM which are triggered by cerebral ischemia. Experimental and clinical data are presented to show that there is a link between ischemia of the brainstem and chronic hypertension. Atherosclerosis of the cerebral circulation leads to ischemia of the RVLM and other regions with autonomic function. This ischemic process results in increased availability of angiotensin II in the RVLM, which maintains the chronic hypertensive state via either direct stimulation of the RVLM or exacerbation of brainstem ischemia due to increased vasoconstriction.

Forest cover associated with improved child health and nutrition: evidence from the Malawi Demographic and Health Survey and satellite data.

Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P = .002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystem services of forests are important factors in improving human health and nutrition outcomes.

Confirmatory factor analytical study of the WHOQOL-Bref: experience with Sudanese general population and psychiatric samples.

BACKGROUND: The widespread international use of the 26-item WHO Quality of Life Instrument (WHOQOL-Bref) necessitates the assessment of its factor structure across cultures. For, alternative factor models may provide a better explanation of the data than the WHO 4- and 6-domain models. The objectives of the study were: to assess the factor structure of the WHOQOL-Bref in a Sudanese general population sample; and use confirmatory factor analysis (CFA) and path analysis (PA) to see how well the model thus generated fits into the WHOQOL-Bref data of Sudanese psychiatric patients and their family caregivers. METHOD: In exploratory factor analysis (FA) with all items, data from 623 general population subjects were used to generate a 5-domain model. In CFA and PA, the model was tested on the data of 300 psychiatric outpatients and their caregivers, using four goodness of fit (GOF) criteria in Analysis of Moment Structures (AMOS). In the path relationships for our model, the dependent variable was the item on overall QOL (OQOL). For the WHO 6-domain model, the general facet on health and QOL was the dependent variable. RESULTS: Two of the five factors ("personal relations" and "environment") from our FA were similar to the WHO's. In CFA, the four GOF criteria were met by our 5-domain model and WHO's 4-domain model on the psychiatric data. In PA, these two models met the GOF criteria on the general population data. The direct predictors of OQOL were our factors: "life satisfaction" and "sense of enjoyment". For the general facet, predictors were WHO domains: "environment", "physical health" and "independence'. CONCLUSION: The findings support the credentials of WHO's 4-domain model as a universal QOL construct; and the impression that analysis of WHOQOL-Bref could benefit from including all the items in FA and using OQOL as a dependent variable. The clinical significance is that by more of such studies, a combination of domains from the WHO models and the local models would be generated and used to develop rigorous definitions of QOL, from which primary targets for subjective QOL interventions could be delineated that would have cross-cultural relevance.

Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study.

BACKGROUND: Quality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care. METHODS: Responses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics. RESULTS: The cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age. CONCLUSION: Cancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.