Relationship of household food insecurity to anaemia in children aged 6-59 months among families in rural Indonesia.

BACKGROUND: Anaemia is a significant global public health problem in developing countries with adverse health effects on young children. Household food insecurity, which reflects a household's access, availability and utilisation of food, has not been well characterised in relation to anaemia in children. OBJECTIVE: To examine the relationship of household food insecurity with anaemia (Hb <11 g/dl) in children. METHODS: In a cross-sectional study of 4940 rural households participating in the Indonesian Nutrition Surveillance System, household food insecurity was measured using a modified 9-item food security questionnaire and related to anaemia in children aged 6-59 months. RESULTS: The proportion of households with an anaemic child was 56·6%. In households with and without anaemic children, the mean (SD) food insecurity score was 1·82 (1·72) vs 1·55 (1·54) (p<0·0001), respectively. In a multivariate logistic regression model, food insecurity score was related to anaemia in children (odds ratio 0·77, 95% confidence interval 0·63-0·95, p=0·01) when the highest quintile of food insecurity score was compared with the lowest quintile, adjusting for potential confounders. CONCLUSION: A higher household food insecurity score is associated with greater prevalence of anaemia in children in rural families in Indonesia.

Low dietary diversity is a predictor of child stunting in rural Bangladesh.

BACKGROUND/OBJECTIVES: Dietary diversity is associated with overall quality and nutrient adequacy of the diet in low-income countries. We determined the association between dietary diversity and stunting among children aged 6-59 months in rural Bangladesh. SUBJECTS/METHODS: In total, 165 111 under-fives who participated in the National Surveillance Project in 2003-2005 were included in the analysis. Dietary diversity score (DDS) was constructed through the summation of the number of days each of the nine food groups was consumed in the previous week. The association between stunting and DDS was determined adjusting for confounders using logistic regression models. All analyses were performed separately for children aged 6-11, 12-23 and 24-59 months. RESULTS: One-half of the children were stunted. In multivariate analyses, compared with low DDS, high dietary diversity was associated with a 15, 26 and 31% reduced odds of being stunted among children aged 6-11, 12-23 and 24-59 months, respectively, after adjusting for all potential confounders (odds ratio (OR)=0.85, 95% confidence interval (CI): 0.76-0.94; OR=0.74, 95% CI: 0.69-0.79; OR=0.69, 95% CI: 0.66-0.73). In all groups, children who were still breastfed were more likely to have limited diversity (OR=1.88, 95% CI: 1.32-2.67; OR=1.71, 95% CI: 1.52-1.92; OR=1.15, 95% CI: 1.11-1.19). Those having diarrhea in the past week and coming from families with low socioeconomic status were more likely to have decreased diversity (P<0.05). CONCLUSIONS: Reduced dietary diversity is a strong predictor of stunting in rural Bangladesh. The inclusion of a variety of food groups into complementary foods may be essential to improve child nutritional status.

Opinion of South African Pre- and Post-Menopausal Women on the Potential Menopause-Related Health Benefits of Soy and Soy products

The increased use of alternative treatment for menopausal symptoms is mainly due to women's changing opinions of conventional hormone replacement therapy (HRT). The objective of this study was to assess the opinion of preand post-menopausal South African women regarding the potential menopause-related health benefits of soy. The sample used for the study was a sub-dataset of 825 respondents; which included only pre- and post-menopausal women that had heard of soy before; selected from a representative sample of the adult South African metropolitan and rural populations. A structured questionnaire was used. Neither age nor racial groups differed practically significantly in opinion regarding any of the various statements. The study also shows that a practically significant lower proportion of women in the sub-population across both age and race groups had a positive opinion on the health benefits of soy as an alternative to HRT and reliever of menopausal symptoms than those who acknowledged its benefit for preventing cardiovascular disease and osteoporosis. Practically significantly more women who used soy than women who never used soy agreed that soy keeps bones strong. In addition; more women who were of opinion that soy has few or no health benefits disagreed that soy could be used as an alternative to HRT compared to women who held a positive opinion

Length of stay comparisons for private and public hospitals.

This analysis uses average length of stay as a proxy for efficiency, to compare the Australian private and public hospital sectors. We conclude that private hospitals are more efficient than public hospitals in providing the range of care provided by private hospitals. However, public hospitals are more efficient in handling the casemix of the public hospital sector. The picture is more complicated when particular types of care (such as obstetric and psychiatric) are excluded.

Future financial impact of the current health financing system.

Major political parties remain publicly committed to Medicare and community-rated voluntary health insurance. It is important to understand the future financial consequences of this policy in order to assist community debate about whether such a commitment is appropriate or some other policy should be developed. This paper describes development of, and results from, the APHA health financing model. It suggests that health expenditure would represent 12.9% of gross domestic product by 2021, compared to 8.5% in 1995. Increasing per capita expenditure is the major contributor to the growth, with demographic changes responsible for only 14.3%.

Preoperative skin traction for fractures of the proximal femur. A randomised prospective trial.

We report the results of a randomised trial to determine the effects of skin traction on 252 patients awaiting surgery for fractures of the proximal femur. They were allocated randomly to be nursed free in bed or to receive Hamilton-Russell skin traction. No differences were found between the groups in terms of pain suffered, analgesia required, frequency of pressure sores or ease of operation. The application of skin traction to patients with fractures of the upper femur is time-consuming and we recommend therefore that its routine use should be discontinued.