18 results
Risk factors for psychiatric readmission among inpatients with major depressive disorder: A patient-chart based study
- H. Al-Haboobi, M. Ioannou, M. Ben Saleh, A. E. Bakken Wold, S. Berg, S. Patraskovic, Z. Szabó, S. Steingrímsson
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S838-S839
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Major depressive disorder (MDD) is a common and severe mental disorder. Although inpatient care may be needed in some cases, little is known on which factors are associated with risk for readmission.
ObjectivesTo identify risk factors associated with an increased risk of readmission within 90 days, after being discharged from psychiatric inpatient care for depression.
MethodsA medical record review is ongoing based on consecutive inpatients admitted in 2019-2021 at Sahlgrenska University Hospital, in Sweden. Inclusion criteria are MDD-diagnosis, admission > 7 days, no admission during the past half-year. Exclusion criteria are blocked medical record, patients who expired within 90 days after discharge. Time to first readmission for discharged patients was examined within 90 days. Clinical and sociodemographic characteristics were compared between readmitted and no-readmitted patients.
ResultsTo date, 446 cases have been included with a readmission rate of 19.5%. In a subgroup of 182 patients (admitted between April 2020 and March 2021), psychotic subtype of depression seems to be protective to re-admission (p < .003) while comorbid eating (p < .017) and neurodevelopmental disorder (p < .029) seem to be associated with high risk. At the congress, results from the whole cohort will be presented.
ConclusionsMedical record reviews can give good clinically relevant data for prediction of readmission. Comorbidities and depression subtypes may affect the risk for readmission.
Disclosure of InterestNone Declared
FROM BEST FIT TECHNOLOGIES TO BEST FIT SCALING: INCORPORATING AND EVALUATING FACTORS AFFECTING THE ADOPTION OF GRAIN LEGUMES IN SUB-SAHARAN AFRICA
- ANDREW FARROW, ESTHER RONNER, GRETA J. VAN DEN BRAND, STEPHEN K. BOAHEN, WILSON LEONARDO, ENDALKACHEW WOLDE-MESKEL, SAMUEL ADJEI-NSIAH, REGIS CHIKOWO, FREDRICK BAIJUKYA, PETER EBANYAT, EMMANUEL A. SANGODELE, JEAN-MARIE SANGINGA, SPECIOSE KANTENGWA, LLOYD PHIPHIRA, PAUL WOOMER, THERESA AMPADU-BOAKYE, EDWARD BAARS, FRED KANAMPIU, BERNARD VANLAUWE, KENNETH E. GILLER
-
- Journal:
- Experimental Agriculture / Volume 55 / Issue S1 / June 2019
- Published online by Cambridge University Press:
- 22 December 2016, pp. 226-251
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
The success of scaling out depends on a clear understanding of the factors that affect adoption of grain legumes and account for the dynamism of those factors across heterogeneous contexts of sub-Saharan Africa. We reviewed literature on adoption of grain legumes and other technologies in sub-Saharan Africa and other developing countries. Our review enabled us to define broad factors affecting different components of the scaling out programme of N2Africa and the scales at which those factors were important. We identified three strategies for managing those factors in the N2Africa scaling out programme: (i) testing different technologies and practices; (ii) evaluating the performance of different technologies in different contexts; and (iii) monitoring factors that are difficult to predict. We incorporated the review lessons in a design to appropriately target and evaluate technologies in multiple contexts across scales from that of the farm to whole countries. Our implementation of this design has only been partially successful because of competing reasons for selecting activity sites. Nevertheless, we observe that grain legume species have been successfully targeted for multiple biophysical environments across sub-Saharan Africa, and to social and economic contexts within countries. Rhizobium inoculant and legume specific fertiliser blends have also been targeted to specific contexts, although not in all countries. Relatively fewer input and output marketing models have been tested due to public–private partnerships, which are a key mechanism for dissemination in the N2Africa project.
Contributors
-
- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
-
- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
-
- Chapter
- Export citation
Innovation in Basic Science: Stem Cells and their role in the treatment of Paediatric Cardiac Failure – Opportunities and Challenges
- Sunjay Kaushal, Jeffrey Phillip Jacobs, Jeffrey G. Gossett, Ann Steele, Peter Steele, Craig R. Davis, Elfriede Pahl, Kalpana Vijayan, Alfred Asante-Korang, Robert J. Boucek, Carl L. Backer, Loren E. Wold
-
- Journal:
- Cardiology in the Young / Volume 19 / Issue S2 / November 2009
- Published online by Cambridge University Press:
- 01 November 2009, pp. 74-84
-
- Article
- Export citation
-
Heart failure is a leading cause of death worldwide. Current therapies only delay progression of the cardiac disease or replace the diseased heart with cardiac transplantation. Stem cells represent a recently discovered novel approach to the treatment of cardiac failure that may facilitate the replacement of diseased cardiac tissue and subsequently lead to improved cardiac function and cardiac regeneration.
A stem cell is defined as a cell with the properties of being clonogenic, self-renewing, and multipotent. In response to intercellular signalling or environmental stimuli, stem cells differentiate into cells derived from any of the three primary germ layers: ectoderm, endoderm, and mesoderm, a powerful advantage for regenerative therapies. Meanwhile, a cardiac progenitor cell is a multipotent cell that can differentiate into cells of any of the cardiac lineages, including endothelial cells and cardiomyocytes.
Stem cells can be classified into three categories: (1) adult stem cells, (2) embryonic stem cells, and (3) induced pluripotential cells. Adult stem cells have been identified in numerous organs and tissues in adults, including bone-marrow, skeletal muscle, adipose tissue, and, as was recently discovered, the heart. Embryonic stem cells are derived from the inner cell mass of the blastocyst stage of the developing embryo. Finally through transcriptional reprogramming, somatic cells, such as fibroblasts, can be converted into induced pluripotential cells that resemble embryonic stem cells.
Four classes of stem cells that may lead to cardiac regeneration are: (1) Embryonic stem cells, (2) Bone Marrow derived stem cells, (3) Skeletal myoblasts, and (4) Cardiac stem cells and cardiac progenitor cells. Embryonic stem cells are problematic because of several reasons: (1) the formation of teratomas, (2) potential immunologic cellular rejection, (3) low efficiency of their differentiation into cardiomyocytes, typically 1% in culture, and (4) ethical and political issues. As of now, bone marrow derived stem cells have not been proven to differentiate reproducibly and reliably into cardiomyocytes. Skeletal myoblasts have created in vivo myotubes but have not electrically integrated with the myocardium. Cardiac stem cells and cardiac progenitor cells represent one of the most promising types of cellular therapy for children with cardiac failure.
Early nutrition and immunity – progress and perspectives
- Philip C. Calder, Susanne Krauss-Etschmann, Esther C. de Jong, Christophe Dupont, Julia-Stefanie Frick, Hanne Frokiaer, Joachim Heinrich, Holger Garn, Sibylle Koletzko, Gideon Lack, Gianluca Mattelio, Harald Renz, Per T. Sangild, Jürgen Schrezenmeir, Thomas M. Stulnig, Thomas Thymann, Agnes E. Wold, Berthold Koletzko
-
- Journal:
- British Journal of Nutrition / Volume 96 / Issue 4 / October 2006
- Published online by Cambridge University Press:
- 08 March 2007, pp. 774-790
- Print publication:
- October 2006
-
- Article
-
- You have access Access
- Export citation
-
The immune system exists to protect the host against pathogenic organisms and highly complex pathways of recognition, response, elimination and memory have evolved in order to fulfil this role. The immune system also acts to ensure tolerance to ‘self’, to food and other environmental components, and to commensal bacteria. A breakdown in the tolerogenic pathways can also lead to inflammatory diseases. The prevalence of inflammatory diseases, including atopic disorders, has increased over the last 60 years. The development of tolerance is the result of active immune mechanisms and both development and maintenance of tolerance are lifelong processes which start very early in life, even prenatally. Profound immunologic changes occur during pregnancy, involving a polarization of T helper (Th) cells towards a dominance of Th2 and regulatory T cell effector responses in both mother and fetus. This situation is important to maintain pregnancy through avoidance of the rejection of the immunologically incompatible fetus. During the third trimester of human pregnancy, fetal T cells are able to mount antigen-specific responses to environmental and food-derived antigens and antigen-specific T cells are detectable in cord blood in virtually all newborns indicating in utero sensitization. If the neonatal immune system is not able to down-regulate the pre-existing Th2 dominance effectively then an allergic phenotype may develop. Changes occur at, and soon after, birth in order that the immune system of the neonate becomes competent and functional and that the gut becomes colonized with bacteria. Exposure to bacteria during birth and from the mother's skin and the provision of immunologic factors in breast milk are amongst the key events that promote maturation of the infant's gut and gut-associated and systemic immune systems. The introduction of formula and of solid foods exposes the infant to novel food antigens and also affects the gut flora. Nutrition may be the source of antigens to which the immune system must become tolerant, provide factors, including nutrients, that themselves might modulate immune maturation and responses, and provide factors that influence intestinal flora, which in turn will affect antigen exposure, immune maturation and immune responses. Through these mechanisms it is possible that nutrition early in life might affect later immune competence, the ability to mount an appropriate immune response upon infection, the ability to develop a tolerogenic response to ‘self’ and to benign environmental antigens, and the development of immunologic disorders. A Workshop held in February 2006 considered recent findings in the areas of oral tolerance, routes of sensitization to allergens and factors affecting the development of atopic disease; factors influencing the maturation of dendritic cells and the development of regulatory T cells; the influence of gut microflora on immunity, allergic sensitization and infectious disease; the role of nutrition in preventing necrotizing enterocolitis in an animal model of preterm birth; and the role of PUFA of different classes in influencing immune responses and in shaping the development of atopic disease. This report summarizes the content of the lectures and the subsequent discussions.
Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia
- S. Blomhoff, T. T. Haug, K. Hellström, I. Holme, M. Humble, H. P. Madsbu, J. E. Wold
-
- Journal:
- The British Journal of Psychiatry / Volume 179 / Issue 1 / July 2001
- Published online by Cambridge University Press:
- 02 January 2018, pp. 23-30
- Print publication:
- July 2001
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Background
No controlled trial of treatment of generalised social phobia has been conducted in general practice.
AimsTo examine the efficacy of sertraline or exposure therapy, administered alone or in combination in this setting.
MethodStudy was of a randomised, double-blind design. Patients (n=387) received sertraline 50–150 mg or placebo for 24 weeks. Patients were additionally randomised to exposure therapy or general medical care.
ResultsSertraline-treated patients were significantly more improved than non-sertraline-treated patients (χ2=12.53, P<0.001; odds ratio=0.534; 95% CI 0.347–0.835). No significant difference was observed between exposure— and non-exposure-treated patients (χ2=2.18, P=0.140; odds ratio=0.732; 95% CI 0.475–1.134). In the pairwise comparisons, combined sertraline and exposure (χ2=12.32; P<0.001) and sertraline (χ2=10.13; P=0.002) were significantly superior to placebo.
ConclusionsSertraline is an effective treatment for generalised social phobia. Combined treatment with sertraline and exposure therapy, conducted by the general practitioner, may enhance the treatment efficacy in primary care.
P fimbriae and aerobactin as intestinal colonization factors for Escherichia coli in Pakistani infants
- F. NOWROUZIAN, A. E. WOLD, I. ADLERBERTH
-
- Journal:
- Epidemiology & Infection / Volume 126 / Issue 1 / February 2001
- Published online by Cambridge University Press:
- 09 April 2001, pp. 19-23
-
- Article
-
- You have access Access
- Export citation
-
The carriage rate of a range of virulence genes was compared between resident and transient Escherichia coli strains obtained from the rectal flora of 22 home-delivered Pakistani infants 0–6 months old. Genes for the following virulence factors were assessed using multiplex PCR: P, type 1 and S fimbriae, three P fimbrial adhesin varieties, Dr haemagglutinin, K1 and K5 capsule, haemolysin and aerobactin. The E. coli strains examined here differed from those previously obtained from hosts in Western Europe in a lower prevalence of genes for P, S and type 1 fimbriae, K1 capsule and haemolysin. Nevertheless, genes for P fimbriae, the class II variety of papG adhesin, and aerobactin were significantly more common among resident than transient strains, as previously observed in a Swedish study. The results suggest that P fimbriae and aerobactin, previously implicated as virulence factors for urinary tract infection, might contribute to persistence of E. coli in the normal intestinal microflora.
P fimbriae, capsule and aerobactin characterize colonic resident Escherichia coli
- F. NOWROUZIAN, I. ADLERBERTH, A. E. WOLD
-
- Journal:
- Epidemiology & Infection / Volume 126 / Issue 1 / February 2001
- Published online by Cambridge University Press:
- 09 April 2001, pp. 11-18
-
- Article
-
- You have access Access
- Export citation
-
Resident and transient Escherichia coli strains from the colonic microflora of 13 Swedish schoolgirls were analysed for carriage of genes encoding a range of adhesins (P, type 1 and S fimbriae, Dr haemagglutinin and three varieties of the P fimbrial papG adhesin) and other virulence traits (K1 and K5 capsule, haemolysin and aerobactin) using multiplex PCR. Forty-four percent of the resident clones carried genes for P fimbriae, K1 or K5 capsule, and aerobactin, compared with only 3% of transient clones (P<0·0001). The P-fimbriated clones most often had the class II variety of the P-fimbrial adhesin gene papG and this adhesin was significantly associated with persistence of a strain. S fimbriae and type 1 fimbriae were equally common in resident and transient strains. The results indicate that not only P fimbriae, but also, certain capsules and the ability to produce the siderophore aerobactin might contribute to persistence of E. coli in the large intestine.
Effect of work applied at different stages of lactation on milk production, reproduction and live-weight change of F1 crossbred dairy cows used for draught
- E. Zerbini, Alemu Gebre Wold
-
- Journal:
- Animal Science / Volume 69 / Issue 3 / December 1999
- Published online by Cambridge University Press:
- 18 August 2016, pp. 473-480
- Print publication:
- December 1999
-
- Article
- Export citation
-
This study examined whether work applied at different stages of lactation had any effect on reproduction of cows under two feeding regimes. Twenty-four F1 crossbred dairy cows (12 Friesian × Boran and 12 Simmental × Boran) were allocated one of two diets (H + 3: natural pasture hay + 3 kg concentrate per day; and H + 5: natural pasture hay + 5 kg concentrate per day) and one of three work treatments — starting 45 days (D45), 90 days (D90) and 135 days (D135) post partum — using a principal component analysis score based on milk yield, live weight, calving interval and parity. Cows pulled sledges for 50 days (pull = 108 N per 100 kg live weight). Over the experimental period of 315 days, cows on diet H + 5 travelled a similar distance and produced amounts of fat-corrected milk (FCM) similar to those of cows on diet H + 3. Total intake of dry matter per kg live weight 0·75 was higher for cows on diet H + 5 than for cows on diet H + 3 and was similar across work times. Hay dry-matter intake was greater for the H + 3 group than for the H + 5 group at 180 days post partum and thereafter. Cows on diet H + 5 lost less weight in early lactation and gained more in mid and late lactation than cows on diet H + 3. During the work period, live-weight change was similar across diets but it was different between work treatments D45 and D135. The interval from calving to conception decreased by 63 and 101 days when start of work was delayed from D45 to D90 and from D45 to D 135, respectively. Output/input ratios of metabolizable energy equivalents were 0·35 for H + 3 and 0·37 for H + 5 diet, and 0·34, 0·37 and 0·40 for work times D45, D90 and D135, respectively. These results indicate that work started in early lactation significantly increased days to conception and decreased overall productivity of lactating working cows. Farmers must weigh the relative importance and cost of delayed ploughing against those of delayed oestrus or against the cost of borrowing draught power.
P fimbriae and other adhesins enhance intestinal persistence of Escherichia coli in early infancy
- I. ADLERBERTH, C. SVANBORG, B. CARLSSON, L. MELLANDER, L.-Å. HANSON, F. JALIL, K. KHALIL, A. E. WOLD
-
- Journal:
- Epidemiology & Infection / Volume 121 / Issue 3 / December 1998
- Published online by Cambridge University Press:
- 01 December 1998, pp. 599-608
-
- Article
-
- You have access Access
- Export citation
-
Resident and transient Escherichia coli strains were identified in the rectal flora of 22 Pakistani infants followed from birth to 6 months of age. All strains were tested for O-antigen expression, adhesin specificity (P fimbriae, other mannose-resistant adhesins or type 1 fimbriae) and adherence to the colonic cell line HT-29. Resident strains displayed higher mannose- resistant adherence to HT-29 cells, and expressed P fimbriae (P=0·0036) as well as other mannose-resistant adhesins (P=0·012) more often than transient strains. In strains acquired during the first month of life, P fimbriae were 12 times more frequent in resident than in transient strains (P=0·0006). The O-antigen distribution did not differ between resident and transient strains, and none of the resident P-fimbriated strains belonged to previously recognized uropathogenic clones. The results suggest that adhesins mediating adherence to intestinal epithelial cells, especially P fimbriae, enhance the persistence of E. coli in the large intestine of infants.
High turnover rate of Escherichia coli strains in the intestinal flora of infants in Pakistan
- I. ADLERBERTH, F. JALIL, B. CARLSSON, L. MELLANDER, L. Å. HANSON, P. LARSSON, K. KHALIL, A. E. WOLD
-
- Journal:
- Epidemiology & Infection / Volume 121 / Issue 3 / December 1998
- Published online by Cambridge University Press:
- 01 December 1998, pp. 587-598
-
- Article
-
- You have access Access
- Export citation
-
The Escherichia coli flora of infants in developed countries is dominated by one or a few strains which persist for prolonged periods of time, but no longitudinal studies have been performed in developing countries. To this end, we studied the rectal enterobacterial flora in 22 home-delivered Pakistani infants during their first 6 months of life. Three colonies were isolated and species typed on each of 11 sampling occasions. E. coli isolates were strain typed using electromorphic typing of cytoplasmic enzymes, and their O serogroups were determined. There was a very rapid turnover of enterobacterial strains in the rectal flora of individual infants. On average, 8·5 different E. coli strains were found per infant, and several biotypes of other enterobacteria. Less than 50% of the infants were colonized with E. coli from their mothers, but strains of maternal origin were four times more likely to persists in the infants' flora than other E. coli strains. Enterobacteria other than E. coli were always of non-maternal origin, and Enterobacter cloacae and Klebsiella pneumoniae biotypes recovered from contaminated feeds were later identified in the infants' rectal flora. An early colonization with klebsiella or enterobacter was significantly associated with diarrhoea during the neonatal period, although these bacteria were not likely to be the cause of the disease. The results suggest that poor hygienic conditions result in an unstable and diverse enterobacterial flora, which may influence infant health.
Effect of draught force and diet on dry-matter intake, milk production and live-weight change in non-pregnant and pregnant cows
- E. Zerbini, A. G. Wold, D. Demissie
-
- Journal:
- Animal Science / Volume 62 / Issue 2 / April 1996
- Published online by Cambridge University Press:
- 02 September 2010, pp. 225-231
- Print publication:
- April 1996
-
- Article
- Export citation
-
Eighteen F1 crossbred dairy cows (Friesian × Boran and Simmental × Boran) were allocated to one of three diet groups (H: natural pasture hay; H+3: natural pasture hay + 3 kg concentrate; and H+5: natural pasture hay + 5 kg concentrate) using a stratified random sampling procedure, with parity, milk production genotype, body weight and body condition score as blocking variables. Cows on each diet were then allocated to three draught forces (7, 11 and 15 kg draught force per 100 kg live weight) in a cross-over design to investigate relationships between work output, live-weight changes, dry-matter intake (DMI) and milk yield. Each cow worked for 36 days in early lactation (from calving to 90 days) and for a further 36 days in late lactation (from 250 to 340 days post partum). Work output was similar for cows on each of the three diets. Cows on the H diet consumed more hay than cows on H+3 and H−5 diets. Hay and total DMI, milk yield and milk fat were similar across draught forces and during working and resting days when the cows were not pregnant. Similar results were obtained when cows were from 82 to 172 days pregnant. Pregnancy did not affect the ability of cows to perform work at different intensities. During working days cows lost live weight both when pregnant and when non-pregnant. During rest days, non-pregnant cows on diets H, H+3 and H+5 compensated proportionately 0·12, 0·59 and 0·59, respectively, of the live weight lost during working days. Pregnant cows on diet H+3 and H+5 compensated proportionately 0·95 and 1·77 live weight, respectively. Lower total live-weight losses during the pregnant period could be attributed partly to relatively greater DMIs and lower milk production, but also to gestation. Prediction of live-weight change from total DMI above maintenance, milk yield and work output during periods of 6 working days was poor (R2 = 0·18). However, the same parameters explained adequately changes in live weight for supplemented and non-supplemented working cows (R2 = 0·38 and 0·79, respectively) during a period of 90 days.
Effect of dietary repletion on reproductive activity in cows after a long anoestrous period
- E. Zerbini, A. G. Wold, T. Gemeda
-
- Journal:
- Animal Science / Volume 62 / Issue 2 / April 1996
- Published online by Cambridge University Press:
- 02 September 2010, pp. 217-223
- Print publication:
- April 1996
-
- Article
- Export citation
-
This study examined whether a prolonged anoestrus had any long-term effect on subsequent fertility of cows and estimated the relationship between repletion and resumption of reproductive activity. Twelve low body-condition, non-milking, non-cycling (depletion state) F1 crossbred dairy cows (Friesian × Boron and Simmental × Boran) were stratified to two diets (H: natural grass hay offered ad libitum and mineral lick +3 kg concentrate, and H + P: H + 7 h/day natural pasture grazing) according to parity, body weight, body condition score and calving intervals. Daily dry-matter intake was similar between cows on the two diets, but total intake of nitrogen was proportionately about 0·10 greater for cows with access to pasture. The calculated metabolizable energy intake was more than twice the estimated maintenance requirement for cows on both diets. Live weights increased from depletion to ovulation, to oestrus and to conception, but were not significantly different between cows on both diets. Body condition score increased from depletion time to first oestrus and to repletion and was greater for H + P than for H cows at first oestrus and at conception. After an average of 45 days of repletion, cows were already ovulating with no significant differences between cows on either diet. Days to onset of oestrus were 83 and 44 days for diet H and H + P, respectively. Time to conception was similar between coivs on both diets. Conception occurred when cows on H and H + P diets had recovered proportionately 0·51 and 0·58 of their live-weight and 0·84 and 1·27 of their body condition loss, respectively. Interval to repletion weight was 178 and 139 days for cows on the H and H + P diet, respectively. Cows subjected to an exceptionally long depletion period were able to resume ovarian cyclic activity and to conceive in less than 3 months when given twice maintenance requirements. These results have important management implication for on-farm situations in the tropics where fluctuations of food availability and quality occur.
Effect of draught work on performance and metabolism of crossbred cows 1. Effect of work and diet on body-weight change, body condition, lactation and productivity
- T. Gemeda, E. Zerbini, A. G. Wold, D. Demissie
-
- Journal:
- Animal Science / Volume 60 / Issue 3 / June 1995
- Published online by Cambridge University Press:
- 02 September 2010, pp. 361-367
- Print publication:
- June 1995
-
- Article
- Export citation
-
Forty pregnant F1 crossbred dairy cows (20 Friesian × Boran and 20 Simmental × Boran) were stratified in a 2 × 2 diet × work factorial experiment (not working-not supplemented, NWNS; not working-supplemented, NWS; working-not supplemented, WNS; and working-supplemented, WS). Working cows pulled sledges 100 days/year (pull = 350 to 450 N, 4 h/day, 4 days/week). Work output of supplemented and non-supplemented cows was similar over 1 and 2 years. Over all 3 years, dry-matter intake relative to metabolic body size (g/kg M0.75 was greater for working, compared with non-working cows. Body-weight changes and body condition score were similar for working and non-working cows. Non-supplemented cows lost weight throughout the first 2-year period, while supplemented cows tended to maintain or gain body weight over 1 and 3 years. Over 2 years, supplementation of working cows proportionately reduced live-weight loss by 0.73 and doubled the number of conceptions and parturitions. Days in milk, milk, milk fat and protein yields were similar for working and non-working cows, but were greater for supplemented, compared with non-supplemented, cows. Total conceptions and calves born in all 3 years tended to be greater for supplemented and non-working compared with non-supplemented and working cows. A productivity index (PI) that took into account food intake was calculated. The PI for supplemented cows over 2 years was greater than that for non-supplemented cows. Meanwhile the PI was similar for working and non-working cows over all periods considered. A similar PI for working and non-working cows under supplementation indicates potential of on-farm adoption of a cow traction technology that includes improved food production and ng strategies.
Effect of draught work on performance and metabolism of crossbred cows 2. Effect of work on roughage intake, digestion, digesta kinetics and plasma metabolites
- E. Zerbini, T. Gemeda, A. G. Wold, S. Nokoe, D. Demissie
-
- Journal:
- Animal Science / Volume 60 / Issue 3 / June 1995
- Published online by Cambridge University Press:
- 02 September 2010, pp. 369-378
- Print publication:
- June 1995
-
- Article
- Export citation
-
Forty pregnant F1 crossbred dairy cows (20 Friesian × Boran and 20 Simmental × Boran) were stratified in a 2 × 2 diet × work factorial arrangement (not working-not supplemented, NWNS; not working-supplemented, NWS; working-not supplemented, WNS; and working-supplemented, WS) were used to study the effect of work and diet supplementation on roughage intake, apparent digestibility of nutrients, digesta kinetics and plasma metabolites. Dry matter (DM) and organic matter (OM) intakes were greater for working than for non-working cows. Work and supplementation increased DM and OM in vivo apparent digestibility. This effect was particularly significant when comparing working cows at rest and at work. Passage rate and rumen mean retention of Cr-mordanted hay were similar for working and for nonworking cows. Liquid turn-over rate of Co-ethylene diamine tetra acetic acid (EDTA) was lower and rumen mean retention time of Co-EDTA was greater in working than in non-working cows whether supplemented or not. Working coios had lower plasma glucose during and immediately after working than non-working cows. Plasma non-esterified fatty acid (NEFA) was higher in working cows at the end of the working period and after rest between working hours. This effect was greater in non-supplemented than in supplemented cows. In working cows, β-hydroxybutyrate was lower at the end of working hours than in non-working cows. Lactate was greater in working than in non-working cows after the 3rd and 4th hours of work. Digesta kinetics could explain only partially the possible mechanisms responsible for greater roughage intake and apparent digestibility in working cows. The decrease of plasma glucose and the increase in NEFA during work indicates an increasing utilization of NEFA by muscle during consecutive working hours.
Reproductive performance of F1 crossbred dairy cows used for draught: effect of work and diet supplementation
- E. Zerbini, T. Gemeda, R. Franceschini, J. Sherington, A. G. Wold
-
- Journal:
- Animal Production / Volume 57 / Issue 3 / December 1993
- Published online by Cambridge University Press:
- 25 May 2016, pp. 361-368
- Print publication:
- December 1993
-
- Article
- Export citation
-
Forty pregnant F1 crossbred cows (20 Holstein-Friesian × Boran and 20 Simmental × Boran) were assigned to a 2 × 2 (work × diet) factorial experiment as follows: supplemented-non-working (SNW), supplemented-working (SW), non-supplemented-non-working (NSNW) and non-supplemented-working (NSW). Working cows pulled sledges 100 days/year (pull = 350 to 450 N, 4 h/day, 4 days/week). Conception and oestrus at fixed times (200 and 365 days post partum) were analysed using linear logistic models. Proportional hazard models were used for analysing ‘failure’ time data such as time to first oestrus or time to conception. Diet supplementation significantly decreased days to first oestrus and days to conception in non-working and working cows. SW cows had similar reproductive performance to NSNW cows. In supplemented cows, work significantly delayed days to conception. However, by 365 days post partum, conception rate was similar for SNW and SW cows. Body condition at calving significantly affected post-partum reproductive ability of non-working and working cows. Natural grass hay alone could not support potential reproductive ability of crossbred cows. Work output of supplemented cows may be associated with longer calving intervals. The economic trade-offs between longer calving intervals and work output should be examined in detail.
Interrelationship between vitamin A, iodine and iron status in schoolchildren in Shoa Region, Central Ethiopia
- Zewdie Wolde-Gebriel, Clive E. West, Haile Gebru, Amha-Selassie Tadesse, Tezera Fisseha, Petros Gabre, Chernet Aboye, Gonfa Ayana, Joseph G. A. J. Hautvast
-
- Journal:
- British Journal of Nutrition / Volume 70 / Issue 2 / September 1993
- Published online by Cambridge University Press:
- 09 March 2007, pp. 593-607
- Print publication:
- September 1993
-
- Article
-
- You have access Access
- Export citation
-
A total of 14740 schoolchildren in seven provinces of Shoa Administrative Region in Central Ethiopia were surveyed for the prevalence of goitre, xerophthalmia and anaemia. Haemoglobin and packed cell volume were assessed in 966 children in one province while an in-depth study was conducted on 344 children in the same province and two others. Goitre, xerophthalmia (Bitot's spots) and clinical anaemia were observed in 34·2, 0·91 and 18·6% respectively of the children. Most biochemical variables were within the normal range while those of haemoglobin (Hb), mean corpuscular Hb concentration (MCHC) and urinary I excretion were lower, and mean corpuscular volume, mean corpuscular Hb (MCH), and immunoglobulins G and M were higher. Hb was strongly correlated with retinol. ferritin, MCHC, MCH, packed cell volume and erythrocyte count while retinol formed a triad with transthyretin (TTR) and retinol-binding protein (RBP) which were all correlated with one another. Total and free thyroxin and total and free triiodothyronine were positively correlated as were the concentrations of the total and free hormones. Thyrotropin (TSH) was negatively correlated with total and free thyroxin and positively correlated with free triiodothyronine. Thyroxin and triiodothyronine in both free and combined forms were all correlated with thyroxin-binding globulin which in turn was negatively correlated with the triad retinol, RBP and TTR. The triad was also negatively correlated with C-reactive protein. Urinary I excretion was positively associated with total thyroxin and negatively associated with TSH. The anaemia found was not nutritional in origin but due to the effect of infestation with intestinal parasites and malaria.
Goitre in Ethiopia
- Zewdie Wolde-Gebriel, Teshome Demeke, Clive E. Westa, Frits Van Der Haar
-
- Journal:
- British Journal of Nutrition / Volume 69 / Issue 1 / January 1993
- Published online by Cambridge University Press:
- 09 March 2007, pp. 257-268
- Print publication:
- January 1993
-
- Article
-
- You have access Access
- Export citation
-
A stratified goitre survey was conducted on 35635 schoolchildren and 19158 household members in all Regions of Ethiopia except Eritrea and Tigrai. The gross goitre prevalence (mean of male and female values) among schoolchildren and household members was 30.6 and 18.7% respectively, while that of visible goitre was 1.6 and 3.2% respectively. Prevalence was higher in females (27.3% in household members and 36.1% in schoolchildren) than in males (10.1% in household members and 25.1% in schoolchildren) and increased with age more in females than in males. The prevalence rates at higher altitudes were higher than those at lower altitudes in both schoolchildren and household members. Using an epidemiological model the consequences of iodine deficiency, including cretinism and maternal wastage, have been estimated.