A measurement scale to assess responsive feeding among Cambodian young children.

The caregiver-child interaction during mealtime, which refers to responsive feeding (RF), influences child's dietary intake. In Cambodia, given the level of malnutrition, getting better knowledge of RF among young children is essential, but to do so, using an appropriate assessment tool is necessary. We aim to develop and to validate a measurement tool to assess RF in two different situations (before and after an intervention) among children 6-23 months old. This research is part of a larger trial assessing the impact of nutrition education combined or not with the provision of complementary foods on child nutritional status. The "Opportunistic Observation Form" from the Process for the Promotion of Child Feeding package was used to collect data on RF through direct observations of child's meal episodes. Data were used to define an initial scale composed of four constructs and 15 indicators. Confirmatory factor analyses (CFA) and Hancock and Mueller's H reliability indices were computed to assess the validity and reliability of the scale. The final tool was applied to baseline and endline data. At baseline, the sample included 243 pairs and, at endline, 248 pairs. The final scale included two latent constructs (RF and active feeding) that comprise three indicators for active feeding and five for RF. Criteria for fit indices of CFA were met for both constructs though better at baseline. Reliability coefficients were above 0.80 for each construct at baseline and endline. This research proposes a scale that could be used to assess active feeding and RF. Further validation is warranted in different contexts.

Determinants of Undernutrition among Young Children Living in Soth Nikum District, Siem Reap, Cambodia.

BACKGROUND: Child undernutrition is of public concern in Cambodia. An understanding of factors influencing child nutritional status is essential to design programs that will reduce undernutrition. Using the UNICEF conceptual framework of causes of malnutrition, our research investigates the relationship between nutritional status of children aged 6⁻23 months and its immediate and underlying determinants. METHODS: Baseline data from a cluster-randomized controlled trial aiming to assess the impact of the promotion of optimal feeding practices combined or not with the provision of local foods among 360 children 6⁻23 months of age were used. Anthropometry and biochemical measurements were performed at baseline. Data on each determinant of undernutrition were collected through interviews and direct observations. RESULTS: Our results show that the degree of satisfaction of proteins and zinc requirements as well as the access to improved water sources and sanitation were positively associated with length-for-age, while having a better health status and a higher degree of satisfaction of energy, protein, zinc, and iron requirements were associated to an improved weight-for-length. Only child health status was associated to ferritin. CONCLUSION: Our results reiterate the importance of improving child diet and health status, but also the access to a healthy environment to ensure an optimal nutritional status.

Mitigated Impact of Provision of Local Foods Combined with Nutrition Education and Counseling on Young Child Nutritional Status in Cambodia.

BACKGROUND: In Cambodia, stunting and wasting affect, respectively, 32% and 10% of children 0⁻59 months while 55% are anemic. Our research aims to assess the efficiency of two local foods combined with nutritional education and counseling (CEN) activities as compared to CEN alone on improving child nutritional status and dietary intake. METHODS: A cluster-randomized controlled trial was conducted in Soth Nikum area over a six-month period among children 6⁻23 months (n = 360) assigned to receive either moringa +CEN, cricket +CEN or CEN alone. Anthropometric measurements were performed and hemoglobin and ferritin levels assessed. RESULTS: Overall, no significant increase in the mean length/height-for-age z-score was observed, although a small increase of the weight-for-length/height was noted in intervention groups. Hemoglobin and ferritin mean values increased in all groups. The degree of satisfaction of energy, proteins, iron, and zinc requirements improved in all groups, but to a greater extent in the intervention groups and more children were healthy. CONCLUSION: Our research shows no significant impact of the provision of two local foods combined with CEN on the improvement of child nutritional status as compared to CEN alone. However, children consuming them better fulfilled their energy, iron, and zinc requirements and were healthier.

Molecular Epidemiology of Hemoglobinopathies in Cambodia.

Determining the magnitude of the thalassemia problem in a country is important for implementing a national prevention and control program. In order to acquire accurate thalassemia prevalence data, the gene frequency of α- and ß-thalassemia (α- and ß-thal) in different regions of a country should be determined. The molecular basis of thalassemia in Cambodia was performed by polymerase chain reaction (PCR)-based techniques in a community-based cross-sectional survey of 1631 unrelated individuals from three regions, Battambang, Preah Vihear and Phnom Penh. Thalassemia mutations were detected in 62.7% of the three studied population of Cambodia. Hb E (HBB: c.79G > A) was the most common ß-globin gene mutation with a frequency ranging from 0.139 to 0.331, while the most frequent α-globin gene mutation was the -α(3.7) (rightward) deletion (0.098-0.255). The other frequencies were 0.001-0.003 for ß-thal, 0.008-0.011 for α-thal-1 (- -(SEA)), 0.003-0.008 for α-thal-2 [-α(4.2) (leftward deletion)], 0.021-0.044 for Hb Constant Spring (Hb CS, HBA2: c.427T > C) and 0.009-0.036 for Hb Paksé (HBA2: c.429A > T). A regional specific thalassemia gene frequency was observed. Preah Vihear had the highest prevalence of Hb E (55.9%), α-thal-2 (24.0%) and nondeletional α-thal (15.1%), whereas Phnom Penh had the lowest frequency of thalassemia genes. Interestingly, in Preah Vihear, the frequency of Hb Paksé was extremely high (0.036), almost equivalent to that of Hb CS (0.044). Our results indicate the importance of micromapping and epidemiology studies of thalassemia, which will assist in establishing the national prevention and control program in Cambodia.

Thermal and hygric physiology of Australian burrowing mygalomorph spiders (Aganippe spp.).

This study investigated the standard metabolic rate (SMR) and evaporative water loss (EWL) responses of three Australian trapdoor-constructing mygalomorph spider species, two undescribed arid-zone species (Aganippe 'Tropicana A' and A. 'Tropicana B') and a mesic-dwelling species (A. rhaphiduca) to acute environmental regimes of temperature and relative humidity. There were significant effects of species, temperature, and relative humidity on SMR. SMR was lower for A. raphiduca than both A. 'Tropicana' spp. with no difference between the two A. 'Tropicana' spp. Metabolic rate increased at higher temperature and relative humidity for all three species. There were significant effects of species, temperature, and relative humidity on EWL. The mesic Aganippe species had a significantly higher EWL than either arid Tropicana species. EWL was significantly higher at lower relative humidity. Our results suggest an environmental effect on EWL but not SMR, and that mygalomorphs are so vulnerable to desiccation that the burrow provides a crucial refuge to ameliorate the effects of low environmental humidity. We conclude that mygalomorphs are highly susceptible to disturbance, and are of high conservation value as many are short-range endemics.

Genetic hemoglobin disorders, infection, and deficiencies of iron and vitamin A determine anemia in young Cambodian children.

In Cambodia, many factors may complicate the detection of iron deficiency. In a cross-sectional survey, we assessed the role of genetic hemoglobin (Hb) disorders, iron deficiency, vitamin A deficiency, infections, and other factors on Hb in young Cambodian children. Data on sociodemographic status, morbidity, and growth were collected from children (n = 3124) aged 6 to 59 mo selected from 3 rural provinces and Phnom Penh municipality. Blood samples were collected (n = 2695) for complete blood count, Hb type (by DNA analysis), ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP), C-reactive protein, and α(1)-acid glycoprotein (AGP). Genetic Hb disorders, anemia, and vitamin A deficiency were more common in rural than in urban provinces (P < 0.001): 60.0 vs. 40.0%, 58.2 vs. 32.7%, and 7.4 vs. 3.1%, respectively. Major determinants of Hb were age group, Hb type, ferritin, sTfR, RBP, AGP >1.0 g/L (P < 0.001), and rural setting (P < 0.05). Age group, Hb type, RBP, elevated AGP, and rural setting also influenced ferritin and sTfR (P < 0.02). Multiple factors affected anemia status, including the following: age groups 6-11.99 mo (OR: 6.1; 95% CI: 4.3, 8.7) and 12-23.99 mo (OR: 2.7; 95% CI: 2.1, 3.6); Hb type, notably Hb EE (OR: 18.5; 95% CI: 8.5, 40.4); low ferritin (OR: 3.2; 95% CI: 2.2, 4.7); elevated AGP (OR: 1.4; 95% CI: 1.2,1.7); rural setting (OR: 2.3; 95% CI: 1.7, 3.1); low RBP (OR: 3.6; 95% CI: 2.2, 5.9); and elevated sTfR (OR: 2.1; 95% CI: 1.7, 2.7). In Cambodia, where a high prevalence of genetic Hb disorders exists, ferritin and sTfR are of limited use for assessing the prevalence of iron deficiency. New low-cost methods for detecting genetic Hb disorders are urgently required.

Deep phylogeographic structuring of populations of the trapdoor spider Moggridgea tingle (Migidae) from southwestern Australia: evidence for long-term refugia within refugia.

Southwestern Australia has been recognized as a biodiversity hot spot of global significance, and it is particularly well known for its considerable diversity of flowering plant species. Questions of interest are how this region became so diverse and whether its fauna show similar diverse patterns of speciation. Here, we carried out a phylogeographic study of trapdoor spiders (Migidae: Moggridgea), a presumed Gondwanan lineage found in wet forest localities across southwestern Australia. Phylogenetic, molecular clock and population genetic analyses of mitochondrial (mtDNA) COI gene and ITS rRNA (internal transcribed spacer) data revealed considerable phylogeographic structuring of Moggridgea populations, with evidence for long-term (>3 million years) isolation of at least nine populations in different geographic locations, including upland regions of the Stirling and Porongurup Ranges. High levels of mtDNA divergence and no evidence of recent mitochondrial gene flow among valley populations of the Stirling Range suggest that individual valleys have acted as refugia for the spiders throughout the Pleistocene. Our findings support the hypothesis that climate change, particularly the aridification of Australia after the late Miocene, and the topography of the landscape, which allowed persistence of moist habitats, have been major drivers of speciation in southwestern Australia.

Predicting the post-fire responses of animal assemblages: testing a trait-based approach using spiders.

1. Developing a predictive understanding of how species assemblages respond to fire is a key conservation goal. In moving from solely describing patterns following fire to predicting changes, plant ecologists have successfully elucidated generalizations based on functional traits. Using species traits might also allow better predictions for fauna, but there are few empirical tests of this approach. 2. We examined whether species traits changed with post-fire age for spiders in 27 sites, representing a chronosequence of 0-20 years post-fire. We predicted a priori whether spiders with ten traits associated with survival, dispersal, reproduction, resource-utilization and microhabitat occupation would increase or decrease with post-fire age. We then tested these predictions using a direct (fourth-corner on individual traits and composite traits) and an indirect (emergent groups) approach, comparing the benefits of each and also examining the degree to which traits were intercorrelated. 3. For the seven individual traits that were significant, three followed predictions (body size, abundance of burrow ambushers and burrowers was greater in recently burnt sites); two were opposite (species with heavy sclerotisation of the cephalothorax and longer time to maturity were in greater abundance in long unburnt and recently burnt sites respectively); and two displayed response patterns more complex than predicted (abdominal scutes displayed a U-shaped response and dispersal ability a hump shaped curve). However, within a given trait, there were few significant differences among post-fire ages. 4. Several traits were intercorrelated and scores based on composite traits used in a fourth-corner analysis found significant patterns, but slightly different to those using individual traits. Changes in abundance with post-fire age were significant for three of the five emergent groups. The fourth-corner analysis yielded more detailed results, but overall we consider the two approaches complementary. 5. While we found significant differences in traits with post-fire age, our results suggest that a trait-based approach may not increase predictive power, at least for the assemblages of spiders we studied. That said, there are many refinements to faunal traits that could increase predictive power.

An adequacy evaluation of a 10-year, four-country nutrition and health programme.

BACKGROUND: Evaluations of large-scale health and nutrition programmes in developing countries are needed for determining the effectiveness of interventions. This article critically analyses a non-governmental organization (NGO)-led large-scale, multi-country, 10-year micronutrient and health (MICAH) programme with an 'adequacy evaluation', that is, a documentation of time trends in the expected direction. METHODS: MICAH was implemented from 1996 to 2005 in selected areas of Ethiopia, Ghana, Malawi and Tanzania, reaching >6 million people with numerous health and nutrition interventions. Coverage and impact were monitored through surveys at baseline, midpoint and end of funding. The data were subjected to post-hoc methods of quality determination, and, if of suitable quality, included in the adequacy evaluation. RESULTS: Most collected data were of moderate or high quality and therefore included in the adequacy evaluation. There were moderate to large improvements in vitamin A status in Ethiopian school-age children, children <5 years of age in Tanzania and Ghana and mothers in Ghana. Iodine status improved in Malawi and Tanzania. Anaemia rates and malaria prevalence decreased in women, pregnant women and pre-school children in Ghana, Malawi and Tanzania, but anaemia increased in Ethiopian women. Large increases were reported for rates of exclusive breastfeeding and immunization. Child growth improved to the maximum that would be predicted with the given interventions. CONCLUSIONS: Numerous nutrition and health impacts were observed in the intervention areas, often of a magnitude equal to or larger than observed in controlled interventions or trials. These results show the value of integrated long-term interventions.