BackgroundQuality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care.MethodsResponses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics.ResultsThe cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age.ConclusionCancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.

In Malawi, net forest cover loss over time is associated with reduced dietary diversity and consumption of vitamin A-rich foods among children. Greater forest cover is associated with reduced risk of diarrheal disease. These preliminary findings suggest that protection of natural ecosystems could play an important role in improving health outcomes.

Background: The widespread international use of the 26-item WHO Quality of Life Instrument (WHOQOL-Bref) necessitates the assessment of its factor structure across cultures. For, alternative factor models may provide a better explanation of the data than the WHO 4-and 6-domain models. The objectives of the study were: to assess the factor structure of the WHOQOL-Bref in a Sudanese general population sample; and use confirmatory factor analysis (CFA) and path analysis (PA) to see how well the model thus generated fits into the WHOQOL-Bref data of Sudanese psychiatric patients and their family caregivers.

Context:Bacterial pathogens in dental plaque are necessary for the development of periodontitis but this etiology alone does not explain all its clinicopathologic features. Researchers have proven the role of certain viruses like herpes virus in periodontal disease which implies that other viral agents like human papilloma virus may also be involved.Aims:This cross-sectional study was conducted to determine the proportion of patients with human papilloma virus (HPV-16) in marginal periodontium by analyzing DNA from the gingival tissue sample and to understand its association with periodontitis.Settings and Design:102 systemically healthy patients between the age group of 15 and 70 years reporting to the Department of Periodontology who required surgical intervention (flap surgery for patients with periodontitis and crown lengthening for healthy patients) with internal bevel gingivectomy were selected.Materials and Methods:After scaling and root planning, gingival tissue was collected during the respective surgical procedure. DNA was isolated and amplified using specific primers for HPV-16 by polymerase chain reaction (PCR). The amplified products were checked by agarose gel electrophoresis.Results:No HPV DNA was detected in the 102 samples analyzed.Conclusion:Marginal periodontium does not contain HPV in this study population and hence there was no association between HPV and periodontitis.

Fish living around the coral reefs in the Philippines provide livelihoods for more than a million local fishers and are an important source of protein for coastal communities. However, this rich resource is at risk from myriad threats, which consequently threaten human livelihoods, nutrition, and health. In this paper, we examine the degree to which marine protected areas (MPAs), which aim to conserve marine biodiversity, are associated with improved nutritional outcomes in children under age 5. This analysis, which uses data from the 2008 Philippines Demographic and Health Survey and MPA data from the Coastal Conservation and Education Fund, found a positive association between MPAs and children’s dietary diversity when the MPAs were located closer than 2 km to a child’s community. MPA characteristics such as age or type of management were not consistently associated with dietary diversity. These results suggest a positive association of proximity to MPAs with certain aspects of children’s diet.Electronic supplementary materialThe online version of this article (doi:10.1007/s11111-015-0240-9) contains supplementary material, which is available to authorized users.

Childhood undernutrition yearly kills 3.1 million children worldwide. For those who survive early life undernutrition, it can cause motor and cognitive development problems that translate into poor educational performance and limited work productivity later in life. It has been suggested that nutrition-specific interventions (e.g., micronutrient supplementation) that directly address the immediate determinants of undernutrition (e.g., nutrient intake) need to be complemented by nutrition-sensitive interventions that more broadly address the underlying determinants of undernutrition (e.g., food insecurity). Here, we argue that forest conservation represents a potentially important but overlooked nutrition-sensitive intervention. Forests can address a number of underlying determinants of undernutrition, including the supply of forest food products, income, habitat for pollinators, women's time allocation, diarrheal disease, and dietary diversity. We examine the effects of forests on stunting-a debilitating outcome of undernutrition-using a database of household surveys and environmental variables across 25 low-and middle-income countries. Our result indicates that exposure to forest significantly reduces child stunting (at least 7.11% points average reduction). The average magnitude of the reduction is at least near the median of the impacts of other known nutrition interventions. Forest conservation interventions typically cover large areas and are often implemented where people are vulnerable, and thus could be used to reach a large number of the world's undernourished communities that may have difficult access Rasolofoson et al. Forest Conservation: Potentially Nutrition-Sensitive to traditional nutrition programs. Forest conservation is therefore a potentially effective nutrition-sensitive intervention. Efforts are needed to integrate specific nutrition goals and actions into forest conservation interventions in order to unleash their potential to deliver nutritional benefits.

Environmental degradation has been associated with increased burden of diseases such as malaria, diarrhea, and malnutrition. As a result, some have argued that continuing ecosystem change could undermine successes in global health investments. Here we conduct an empirical study to investigate this concern. Child deaths due to diarrhea have more than halved since the year 2000, partly due to increased access to improved water, sanitation and hygiene (WASH). We examine how the effectiveness of a water quality treatment may vary as a function of upstream watershed condition. We use data on occurrence of diarrhea and point-of-use water treatment methods from the Demographic and Health Surveys for Haiti and Honduras. We integrate these data with a variable that reflects the influence of upstream tree cover on surface water quality. Point-of-use chlorination is significantly associated with 3.4 percentage points reduction in prevalence of diarrheal disease on average. However, we only detect a significant reduction in diarrheal prevalence when upstream watersheds are moderately forested. At low upstream tree coverage, point-of-use water chlorination does not have significant effects, suggesting that forest clearing could undermine its effectiveness at reducing childhood diarrhea. Our results suggest that forested watersheds may reduce water-borne sediments and contaminants, and thus improve raw water quality in ways that moderate the effectiveness of water quality treatment. Watershed protection should be considered in WASH investments, as deforested watersheds could undermine their effectiveness, particularly in parts of low-income countries where access to improved WASH services is challenging.

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