Understanding behavioural drivers of iron and folic acid supplementation and vitamin A- and iron-rich food consumption among women and adolescent girls in Niger.

Objective: This study examined drivers and barriers to iron and folic acid supplementation and consumption of iron- and vitamin A-rich foods among women of reproductive age and adolescent girls in Niger.

Design: This was an exploratory qualitative study using focus group discussions and semi-structured interviews.

Setting: This study was conducted in the rural areas of three districts in Maradi and Zinder regions of southern Niger.

Feasibility of delivering vitamin A supplementation (VAS) and deworming through routine community health services in Siaya County, Kenya: A cross-sectional study.

Vitamin A deficiency and soil-transmitted helminth infection are serious public health problems in Kenya. The coverage of vitamin A supplementation and deworming medication (VASD) provided through mass campaigns is generally high, yet with a cost that is not sustainable, while coverage offered through routine health services is low. Alternative strategies are needed that achieve the recommended coverage of >80% of children twice annually and can be managed by health systems with limited resources.

Outcomes of a food voucher program and factors associated with the recovery rate of children with moderate acute malnutrition in Far North Cameroon.

Background: Research on moderate acute malnutrition (MAM) is limited, despite its high prevalence. This study examined outcomes of bi-weekly locally available foods provided via a food voucher program (FVP) on nutritional recovery [mid-upper arm circumference (MUAC) ≥ 125 mm] from MAM (defined as MUAC between 115 and 124 mm) and identified the factors associated with recovery rate in Kaélé health district, Far North Region of Cameroon.

Methods: This was a prospective study with 474 MAM children aged 6-59 months.

Adolescent Girls' Nutritional Status and Knowledge, Beliefs, Practices, and Access to Services: An Assessment to Guide Intervention Design in Nepal.

Background: Despite growing recognition of the importance of the adolescent period for health and nutritional well-being, scant evidence exists to inform interventions. Beyond limited understanding of adolescents' knowledge and practices, gaps in adolescent research also include limited understanding of how best to reach them with programs and policies and how the contexts in which they live present barriers and opportunities. Given that most studies on adolescent health and nutrition have used data from surveys of women of reproductive age, this study also sought to understand variation among younger and older adolescents and those who were already mothers.

Fostering CHANGE: Lessons from implementing a multi-country, multi-sector nutrition-sensitive agriculture project.

Using agriculture to improve nutrition is an approach growing in popularity, with programs becoming increasingly complex and multisectoral. While there is an active line of research assessing the impacts of such programs, little has been written about the process of successfully implementing them. As such, this paper uses a multisectoral nutrition-sensitive agriculture program implemented in four African countries as a case study to address key challenges in and lessons learned from implementation.

Use of the Essential Nutrition Actions framework improved child growth in Bangladesh.

The Essential Nutrition Actions (ENA) framework is an evidence-based set of cost-effective, integrated tools for training health and community workers to promote optimal nutrition practices for the first 1,000 days. This ENA pilot project (ENAPP) was implemented with United States Agency for International Development (USAID) funding from August 2008 to September 2009 in six unions of the working area of an existing USAID-funded, Title II programme in southern Bangladesh. ENAPP, which targeted governmental and non-governmental service providers, was intended to strengthen the behaviour change component of the nutrition strategy of this project.

Process evaluation improves delivery of a nutrition-sensitive agriculture programme in Burkina Faso.

Evidence is emerging from rigorous evaluations about the effectiveness of nutrition-sensitive agriculture programmes in improving nutritional outcomes. Additional evidence can elucidate how different programme components and pathways contribute and can be optimized for impact. The International Food Policy Research Institute, with Helen Keller International, designed a comprehensive framework to evaluate the delivery, utilization, and impact of Helen Keller International's enhanced homestead food production programme in Burkina Faso.

Using formative research to promote antenatal care attendance and iron folic acid supplementation in Zinder, Niger.

In Niger, use of antenatal care (ANC) and iron folic acid (IFA) supplements is suboptimal. The objectives of this paper are as follows: (a) to conduct formative research to understand barriers and beliefs among pregnant women related to ANC, IFA supplementation, and pregnancy outcomes; (b) assess the quality of currently provided ANC services; (c) use the findings to guide the development of programmatic interventions to improve coverage of ANC services and IFA supplementation of pregnant women. Structured in-home interviews (n = 72) and focus groups (n = 4) were conducted with pregnant women in 4 randomly selected villages in rural Zinder.

Institutionalizing community-focused maternal, newborn, and child health strategies to strengthen health systems: A new framework for the Sustainable Development Goal era.

Background: Stronger health systems, with an emphasis on community-based primary health care, are required to help accelerate the pace of ending preventable maternal and child deaths as well as contribute to the achievement of the Sustainable Development Goals (SDGs). The success of the SDGs will require unprecedented coordination across sectors, including partnerships between public, private, and non-governmental organizations (NGOs). To date, little attention has been paid to the distinct ways in which NGOs (both international and local) can partner with existing national government health systems to institutionalize community health strategies.

Combining Home Garden, Poultry, and Nutrition Education Program Targeted to Families With Young Children Improved Anemia Among Children and Anemia and Underweight Among Nonpregnant Women in Nepal.

Background: The impact of food-based interventions on child and maternal anthropometry and anemia has not been adequately studied.

Objective: This study tested the effect of an enhanced homestead food production (EHFP) program consisting of home garden, poultry raising, and nutrition education implemented over 2.5 years versus control (no intervention) on anthropometry and anemia among children (12-48 months) and their mothers.

Safety and Mortality Benefits of Delivering Vitamin A Supplementation at 6 Months of Age in Sub-Saharan Africa.

Background: Vitamin A supplementation (VAS) among children 6 to 59 months of age reduces vitamin A deficiency (VAD)-related mortality. Child health days (CHDs) only reach an estimated 16.7% of children at exactly 6 months, leaving uncovered children at risk of VAD-related mortality; similarly, VAS provided at 9 months of age with measles-containing vaccine leaves infants unprotected for 3 months.

Using Field Data and GIS-Derived Variables to Model Occurrence of Williamson's Sapsucker Nesting Habitat at Multiple Spatial Scales.

Williamson's sapsucker (Sphyrapicus thyroideus) is a migratory woodpecker that breeds in mixed coniferous forests in western North America. In Canada, the range of this woodpecker is restricted to three small populations in southern British Columbia, precipitating a national listing as 'Endangered' in 2005, and the need to characterize critical habitat for its survival and recovery. We compared habitat attributes between Williamson's sapsucker nest territories and random points without nests or detections of this sapsucker as part of a resource selection analysis to identify the habitat features that best explain the probability of nest occurrence in two separate geographic regions in British Columbia.

The increasing incidence of remote metastasis: a case report of metastatic hepatocellular carcinoma to the rectosigmoid.

As the fifth most common malignancy worldwide, survival rates of hepatocellular carcinoma (HCC) have only slightly improved over the years due to early-stage detection. HCC is well known to metastasize to the lung, lymph nodes, and musculoskeletal regions; however, only 0.5% to 6% of HCCs metastasize to the gastrointestinal tract.

Lymphocytic gastritis is not associated with active Helicobacter pylori infection.

Background: Lymphocytic gastritis (LG), characterized by marked intra-epithelial lymphocytosis in the gastric mucosa, has been frequently associated with both celiac disease (CD) and H. pylori gastritis. The aim of this study was to review and correlate the morphology of LG with the presence of CD and H.

The optimal number of biopsy fragments to establish a morphologic diagnosis of eosinophilic esophagitis.

Objectives: Eosinophilic esophagitis (EoE) is characterized clinically by dysphagia, chest pain, and food impaction, and morphologically by increased numbers of intraepithelial eosinophils and marked basal hyperplasia of the squamous mucosa. The consensus criteria for a diagnosis of EoE include the presence of ≥15 eosinophils/HPF in biopsies from both proximal and distal esophagus in the absence of other causes of esophageal eosinophilia, and the lack of clinical response to proton pump inhibitor therapy. Because of the variability in the distribution of intraepithelial eosinophils among biopsy fragments and the lack of standardized biopsy practices, we sought to determine the optimal number of esophageal biopsies from the mid and distal esophagus needed to reach the minimum morphologic criteria of ≥15 eosinophils/HPF.

Angiotensin-II inhibitor (olmesartan)-induced collagenous sprue with resolution following discontinuation of drug.

Collagenous sprue (CS) is a pattern of small-bowel injury characterized histologically by marked villous blunting, intraepithelial lymphocytes, and thickened sub-epithelial collagen table. Clinically, patients present with diarrhea, abdominal pain, malabsorption, and weight loss. Gluten intolerance is the most common cause of villous blunting in the duodenum; however, in a recent case series by the Mayo Clinic, it has been reported that olmesartan can have a similar effect.

Incidence of diagnostic change in colorectal polyp specimens after deeper sectioning at 2 different laboratories staffed by the same pathologists.

Objectives: To calculate the incidence of nondiagnostic (ND) colorectal (CR) polyp cases in which deeper tissue sectioning rendered new diagnostic information--particularly adenomas--in 2 laboratories staffed by the same pathologists.

Methods: After initial diagnosis, 100 ND CR polyps from each laboratory were reexamined with 3 deeper levels to establish rates of diagnostic conversion based on biopsy specimen location and original observation(s).

Results: Deeper sectioning rendered new diagnostic information in 43 (21.

Esophageal lichen planus: a case report and review of the literature.

Esophageal involvement by lichen planus (ELP), previously thought to be quite rare, is a disease much more common in women and frequently the initial manifestation of mucocutaneous lichen planus (LP). Considering that the symptoms of ELP do not present in a predictable manner, ELP is perhaps more under-recognized than rare. To date, four cases of squamous cell carcinoma in association with ELP have been reported, suggesting that timely and accurate diagnosis of ELP is of importance for appropriate follow-up.

Using formative research to design a context-specific behaviour change strategy to improve infant and young child feeding practices and nutrition in Nepal.

Global recommendations on strategies to improve infant feeding, care and nutrition are clear; however, there is limited literature that explains methods for tailoring these recommendations to the local context where programmes are implemented. This paper aims to: (1) highlight the individual, cultural and environmental factors revealed by formative research to affect infant and young child feeding and care practices in Baitadi district of Far Western Nepal; and (2) outline how both quantitative and qualitative research methods were used to design a context-specific behaviour change strategy to improve child nutrition. Quantitative data on 750 children aged 12-23 months and their families were collected via surveys administered to mothers.

Ecological transcriptomics of lake-type and riverine sockeye salmon (Oncorhynchus nerka).

Background: There are a growing number of genomes sequenced with tentative functions assigned to a large proportion of the individual genes. Model organisms in laboratory settings form the basis for the assignment of gene function, and the ecological context of gene function is lacking. This work addresses this shortcoming by investigating expressed genes of sockeye salmon (Oncorhynchus nerka) muscle tissue.

Recent ecological divergence despite migration in sockeye salmon (Oncorhynchus nerka).

Ecological divergence may result when populations experience different selection regimes, but there is considerable discussion about the role of migration at the beginning stages of divergence before reproductive isolating mechanisms have evolved. However, detection of past migration is difficult in current populations and tools to differentiate genetic similarities due to migration versus recent common ancestry are only recently available. Using past volcanic eruption times as a framework, we combine morphological analyses of traits important to reproduction with a coalescent-based genetic analysis of two proximate sockeye salmon (Oncorhynchus nerka) populations.

Interventions to improve diet and weight gain among pregnant adolescents and recommendations for future research.

Pregnant adolescents are at particular risk for both inadequate and excessive gestational weight gain and for inadequate intake of micronutrients that support healthy fetal development. This article reviews the available literature on prenatal nutrition interventions intended to address such risks to identify effective strategies and needs for further research. A medical model providing enhanced prenatal care aimed at improved birth weight predominated.

High gestational weight gain does not improve birth weight in a cohort of African American adolescents.

Background: Because pregnant African American women and teens are at risk of low birth weight, they are frequently counseled to strive for gestational weight gains at the upper limits of the Institute of Medicine's recommended ranges.

Objective: The objective was to examine whether such weight gains improve birth outcomes in a cohort of disadvantaged African American adolescents of low (<19.8), average (> or =19.

Caspofungin: the first in a new class of antifungal agents.

Caspofungin is the first approved agent from a new class of antifungals, the echinocandins. By targeting the fungal cell wall (as opposed to the fungal cell membrane), the echinocandins exhibit a unique mechanism of action relative to the other currently approved antifungal agents. Preclinical (in vitro and in vivo) studies have demonstrated activity for caspofungin against the most commonly encountered fungi in the hospital setting, namely Candida and Aspergillus species.