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Cobalamin and folate status in women during early pregnancy in Bhaktapur, Nepal
- Catherine Schwinger, Shakun Sharma, Ram K. Chandyo, Mari Hysing, Ingrid Kvestad, Manjeswori Ulak, Suman Ranjitkar, Merina Shrestha, Laxman P. Shrestha, Adrian McCann, Per M. Ueland, Tor A. Strand
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- Journal:
- Journal of Nutritional Science / Volume 10 / 2021
- Published online by Cambridge University Press:
- 09 August 2021, e57
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- Article
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The demand for cobalamin (vitamin B12) and folate is increased during pregnancy, and deficiency during pregnancy may lead to complications and adverse outcomes. Yet, the status of these micronutrients is unknown in many populations. We assessed the concentration of cobalamin, folate and their functional biomarkers, total homocysteine (tHcy) and methylmalonic acid (MMA), in 561 pregnant women enrolled in a community-based randomised controlled trial in Bhaktapur, Nepal. Plasma concentrations of cobalamin, folate, tHcy and MMA were measured and a combined indicator of vitamin B12 status (3cB12) was calculated. We report mean or median concentrations and the prevalence of deficiency according to commonly used cut-offs, and assessed their association with indicators of socio-economic status, and maternal and dietary characteristics by linear regression. Among the women at gestational week less than 15, deficiencies of cobalamin and folate were seen in 24 and 1 %, respectively. Being a vegetarian was associated with lower plasma cobalamin, and a higher socio-economic status was associated with a better micronutrient status. We conclude that cobalamin deficiency defined by commonly used cut-offs was common in Nepalese women in early pregnancy. In contrast, folate deficiency was rare. As there is no consensus on cut-off points for vitamin B12 deficiency during pregnancy, future studies are needed to assess the potential functional consequences of these low values.
Chapter 23 - Policies for Energy Access
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- By Daniel H. Bouille, Bariloche Foundation, Hugo Altomonte, Economic Commission for Latin America and the Caribbean, Douglas F. Barnes, Energy for Development, Touria Dafrallah, Environment and Development Action in the Third World, Hu Gao, Energy Research Institute, Hector Pistonesi, Bariloche Foundation, Ram M. Shrestha, Asian Institute of Technology, Eugene Visagie, University of Cape Town, Jean Acquatella, Economic Commission for Latin America and the Caribbean, Suani T. Coelho, Brazilian Reference Center on Biomass, Sivanappan Kumar, Asian Institute of Technology, Debajit Palit, The Energy and Resources Institute, Gisela Prasad, University of Cape Town, Leena Srivastava, The Energy and Resources Institute
- Global Energy Assessment Writing Team
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- Book:
- Global Energy Assessment
- Published online:
- 05 September 2012
- Print publication:
- 27 August 2012, pp 1603-1664
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Summary
Executive Summary
A number of factors contribute to the lack of access to modern forms of energy. They include low income levels, unequal income distribution, inequitable distribution of modern forms of energy, a lack of financial resources to build the necessary infrastructure, weak institutional and legal frameworks, and a lack of political commitment to the scaling up of services. An absence of specific policies oriented to poverty alleviation often explains inequitable economic growth and, consequently, inequality in access to and use of energy. In recent years, several developing countries have defined targets aimed at improving access to electricity, but many developing countries still have no modern forms of energy access targets in place that address meeting basic energy services, including modern fuels for cooking and mechanical power.
As Chapter 2 argues, developing countries require adequate access to modern energy, especially among the poor, in order to meet the Millennium Development Goals (MDGs) as well as their own national development objectives. In line with GEA objectives, Chapter 17 pathways are designed to describe transformative changes toward a more sustainable future. A specific feature of the GEA energy transition pathways is that they simultaneously achieve normative goals related to all major energy challenges, including environmental impacts of energy conversion and use, as well as energy security and energy access. ‘Energy access’ refers to those challenges clearly described in Chapter 19, which will be addressed in this chapter.
Affordable and sustainable universal access to modern forms of energy depends on the evolution of income level and income distribution.
Chapter 18 - Urban Energy Systems
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- By Arnulf Grubler, International Institute for Applied Systems Analysis, Austria and Yale University, Xuemei Bai, Australian National University, Thomas Buettner, United Nations Department of Economic and Social Affairs, Shobhakar Dhakal, Global Carbon Project and National Institute for Environmental Studies, David J. Fisk, Imperial College London, Toshiaki Ichinose, National Institute for Environmental Studies, James E. Keirstead, Imperial College London, Gerd Sammer, University of Natural Resources and Applied Life Sciences, David Satterthwaite, International Institute for Environment and Development, Niels B. Schulz, International Institute for Applied Systems Analysis, Austria and Imperial College, Nilay Shah, Imperial College London, Julia Steinberger, The Institute of Social Ecology, Austria and University of Leeds, Helga Weisz, Potsdam Institute for Climate Impact Research, Gilbert Ahamer, University of Graz, Timothy Baynes, Commonwealth Scientific and Industrial Research Organisation, Daniel Curtis, Oxford University Centre for the Environment, Michael Doherty, Commonwealth Scientific and Industrial Research Organisation, Nick Eyre, Oxford University Centre for the Environment, Junichi Fujino, National Institute for Environmental Studies, Keisuke Hanaki, University of Tokyo, Mikiko Kainuma, National Institute for Environmental Studies, Shinji Kaneko, Hiroshima University, Manfred Lenzen, University of Sydney, Jacqui Meyers, Commonwealth Scientific and Industrial Research Organisation, Hitomi Nakanishi, University of Canberra, Victoria Novikova, Oxford University Centre for the Environment, Krishnan S. Rajan, International Institute of Information Technology, Seongwon Seo, Commonwealth Scientific and Industrial Research Organisation, Ram M. Shrestha, Asian Institute of Technology, Priyadarshi R. Shukla, Indian Institute of Management, Alice Sverdlik, International Institute for Environment and Development, Jayant Sathaye, Lawrence Berkeley National Laboratory
- Global Energy Assessment Writing Team
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- Book:
- Global Energy Assessment
- Published online:
- 05 September 2012
- Print publication:
- 27 August 2012, pp 1307-1400
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More than 50% of the global population already lives in urban settlements and urban areas are projected to absorb almost all the global population growth to 2050, amounting to some additional three billion people. Over the next decades the increase in rural population in many developing countries will be overshadowed by population flows to cities. Rural populations globally are expected to peak at a level of 3.5 billion people by around 2020 and decline thereafter, albeit with heterogeneous regional trends. This adds urgency in addressing rural energy access, but our common future will be predominantly urban. Most of urban growth will continue to occur in small-to medium-sized urban centers. Growth in these smaller cities poses serious policy challenges, especially in the developing world. In small cities, data and information to guide policy are largely absent, local resources to tackle development challenges are limited, and governance and institutional capacities are weak, requiring serious efforts in capacity building, novel applications of remote sensing, information, and decision support techniques, and new institutional partnerships. While ‘megacities’ with more than 10 million inhabitants have distinctive challenges, their contribution to global urban growth will remain comparatively small.
Energy-wise, the world is already predominantly urban. This assessment estimates that between 60–80% of final energy use globally is urban, with a central estimate of 75%. Applying national energy (or GHG inventory) reporting formats to the urban scale and to urban administrative boundaries is often referred to as a ‘production’ accounting approach and underlies the above GEA estimate.