Objective: While iron de®ciency is regarded as the major cause of nutritional anaemia, changes in vitamins A, B 12 , C and E, folic acid and ribo¯avin status have also been linked to its development and control. This paper provides a systematic review of vitamin supplementation trials relating to the control of nutritional anaemia. Methods: A MEDLINE search was used to ®nd reports of vitamin supplementation trials that reported changes in anaemia or iron status. Results: Vitamin A can improve haematological indicators and enhance the ef®cacy of iron supplementation. Both folate and vitamin B 12 can cure and prevent megaloblastic anaemia. Ribo¯avin enhances the haematological response to iron, and its de®ciency may account for a signi®cant proportion of anaemia in many populations. Vitamin C enhances the absorption of dietary iron, although population-based data showing its ef®cacy in reducing anaemia or iron de®ciency are lacking. Vitamin E supplementation given to preterm infants has not reduced the severity of the anaemia of prematurity. Vitamin B 6 effectively treats sideroblastic anaemia. Multivitamin supplementation may raise haemoglobin (Hb) concentration, but few studies have isolated the effect of multivitamins from iron on haematological status. Conclusions: In general, the public health impact of vitamin supplementation in controlling anaemia is not clear. Neither are the complex interactions involving multiple vitamins in haematopoiesis suf®ciently understood to explain the observed variability in haematological responses to vitamins by age, population, vitamin mixture and dosages. Further research is needed to understand the roles of individual and combined vitamin de®ciencies on anaemia to design appropriate micronutrient interventions to prevent anaemia.
This article explores psychological factors involved in terrorism and counterterrorism on individual, group, and organizational levels of analysis. On the individual level, we describe attempts to understand terrorist behavior as a form of psychopathology and/or as reflecting a unique constellation of personality traits. We also consider whether there exists a general motivational basis for participating in terrorism. On the group level of analysis, we address the process of shared reality construction, social influence involved in recruitment of new members to terrorist organization, their indoctrination into terrorist ideology, and the use of language in creating terrorism warranting norms. On the organizational level, we consider issues of training, logistics, and cost effectiveness as they apply to the decisions to launch or abstain from terrorist activities. We conclude by considering the implications of our analysis for possible ways and means for countering terrorism.
The current burden of childhood injuries in South Asia is unacceptably high and calls for efforts from all sectors involved in research, policy and funding to not only assess the impact of childhood injuries but to strengthen the health systems to stem this preventable loss of healthy life.
The 1976 outbreak of A/New Jersey/76 influenza in Fort Dix is a rare example of an influenza virus with documented human to human transmission that failed to spread widely. Despite extensive epidemiological investigation, no attempt has been made to quantify the transmissibility of this virus. The World Health Organization and the United States Government view containment of emerging influenza strains as central to combating pandemic influenza. Computational models predict that it may be possible to contain an emergent pandemic influenza if virus transmissibility is low. The A/New Jersey/76 outbreak at the United States Army Training Center at Fort Dix, New Jersey in January 1976 caused 13 hospitalizations, 1 death and an estimated 230 cases. To characterize viral transmission in this epidemic, we estimated the basic reproductive number and serial interval using deterministic epidemic models and stochastic simulations. We estimated the basic reproductive number for this outbreak to be 1.2 (supported interval 1.1-1.4), the serial interval to be 1.9 days (supported interval 1.6-3.8 days), and that the virus had at least six serial human to human transmissions. This places the transmissibility of A/New Jersey/76 virus at the lower end of circulating flu strains, well below the threshold for control.
The study focuses on children less than 5 years old and explores the epidemiological profile and correlates of drowning as a challenge to child survival in Bangladesh. Two data sources from Bangladesh, a cohort of 8,070 children followed for 2 years in a rural area and a nation-wide survey conducted in 1996-97 have been used. In addition, a systematic review of the literature has been conducted spanning the past two decades for analysis of drowning in children. Seventy drowning deaths were reported in the cohort and 726 deaths were reported in the national survey. Verbal autopsy and semi-structured interviews were conducted on all deaths. Drowning accounted for 43% of deaths in the cohort and 20% of deaths in 1-4-year-old children in the national survey. Most drowning deaths were in 12-23 month old children from falling into ditches and ponds. Communities provided valuable insights on possible interventions to reduce deaths due to drowning. Drowning is a newly recognized challenge for Bangladesh. Considerable research and programmatic work is required to understand the nature of the problem and develop appropriate interventions. This paper calls on aid agencies to create opportunities for drowning research and action in their work plans for the country.
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