Investigating the Dimensions of Youth Wellbeing: An Exploratory Structural Equation Modelling Approach Applied to Palestine

This paper illustrates the “Sen-Nussbaum-type” capability approach to the measurement of youth wellbeing using the newly developed Exploratory Structural Equation Modelling (ESEM). It offers insights into how the capability to achieve wellbeing can be measured in a conflict-affected and resource-constrained setting. The methodology is applied to nationally representative data taken from the Palestinian Family Survey. The population of interest is youth aged 15 to 29. Three capability dimensions are identified: health awareness, knowledge and living conditions. Results show an interrelation between capability dimensions. It is especially important to note the effect of knowledge capabilities on both health awareness and living conditions indicators. Results also confirm the importance of some (exogenous) factors such as the education of the household head in the conversion of capabilities into achievements. Capabilities are shown to be highest in the West Bank for both knowledge and living conditions compared to the Gaza Strip.     

Assessing the Impact of Salt Reduction Initiatives on the Chronic Disease Burden of Singapore

Globally, many countries are facing an increasing burden of chronic disease due to ageing populations, of which cardiovascular disease forms a large proportion. Excess dietary sodium contributes to cardiovascular disease risk and requires intervention at a population level. This study aimed to quantify the impact of several salt reduction initiatives on population health over a 30-year horizon using GeoDEMOS, a population model from Singapore. Four interventions were modelled in four demographic groups in 2020 for a total of 16 intervention scenarios. The effect of 0.5, 2.0, and 4.0 g/day reductions in daily salt consumption, along with adherence to the World Health Organization guidelines of a maximum of 5.0 g of salt each day, was modelled in the entire population, including the overweight and obese, the elderly, and diabetics. In each scenario, the number of averted incident cases of acute myocardial infarction and stroke, along with the disability-adjusted life years up to 2050, was monitored. We found 4.0 g/day reductions in salt consumption were the most effective when implemented across the entire population, resulting in 24,000 averted incident cases of cardiovascular disease and 215,000 disability-adjusted life years over 30 years. This is a large figure when compared with the 29,200 projected annual incident cases of cardiovascular disease in 2050. When targeted at specific high-risk demographic groups, the largest effects were observed in the overweight and obese, with the same intervention yielding 10,500 averted incident cases of cardiovascular disease and 91,500 disability-adjusted life years. Quantifying the benefits of salt reduction initiatives revealed a significant impact when administered across the entire population or the overweight and obese. Health promotion efforts directed toward sustainably reducing salt consumption will help to lower the chronic disease burden on the healthcare system in years to come.     

Acute 'upside-down' visual inversion due to multiple sclerosis

In a 20-year-old male patient, a 180 degree inversion of visual image was found as a manifestation of multiple sclerosis. Upside down reversal of vision is not a well-known sign in multiple sclerosis. Exact mechanism is still unknown. Lesions involving cortical areas, mainly the parieto-occipital region, have occasionally been documented. To our knowledge this is the first report of upside-down reversal of vision in multiple sclerosis with cerebra lesion on MRI.     

HIV/AIDS: nutritional implications and impact on human development

HIV/AIDS is associated with biological and social factors that affect the individual's ability to consume and utilize food and to acquire food. These biological and social factors lead to poor nutritional status and weight loss, which are an important cause of morbidity in individuals infected with HIV, resulting in a poor quality of life; weight loss is an important predictor of death from AIDS. The links between nutrition and HIV/AIDS amplify the negative effects of HIV infection on human development at individual, household, community and national levels. For many developing countries the incidence of HIV/AIDS and malnutrition is impeding progress towards achieving the UN millennium development goals. Aggressive interventions to curb the spread of HIV continue to be needed. Concurrent efforts to improve nutrition for populations living with HIV/AIDS should also be given priority.     

Dimensions of internal jugular veins in Turkish children aged between 0 and 6 years in resting state and during Valsalva maneuver

OBJECTIVE: We aimed to establish the values of the internal jugular vein (IJV) sizes in Turkish children aged between 0 and 6 years. METHODS: Ninety-four normal children included in this study. All of the children were imaged by ultrasonography (USG) at the level of the cricoid cartilage. The maximal antero-posterior (AP) and transverse (T) diameters of the IJV were measured during regular breathing and Valsalva maneuver. RESULTS: The mean transverse diameter of the right and left IJV were 8.11+/-3.01 and 7.64+/-2.68 mm in resting state. These values changed to 12.57+/-4.34 and 10.82+/-3.80 mm in Valsalva state, respectively. The AP diameters were found to be 5.43+/-2.07 for the right and 5.86+/-4.53 mm for the left IJV at rest. During VM, these values changed to 8.70+/-2.40 and 8.30+/-2.90 mm for the right and left IJV, respectively. There was no significant difference on the evaluation of the relationship between the right and left diameters of the IJV. While there were significant differences in sizes between the resting and Valsalva states. Also, the T diameter of the right IJV during Valsalva state was greater than those of the left. There were significant correlations between the diameters of the IJV and the age, weight and height of the children. CONCLUSION: The results we obtained in this study may be important in an attempt of intravascular intervention to IJV. These values may also be important for the comparison with the IJV sizes of the patients who have phlebectasia.     

Constraints on the Use of Animal Source Foods for Young Children in Ghana: A Participatory Rapid Appraisal Approach

Micronutrient deficiencies limit child health and development. Although animal source foods (ASF) provide highly bioavailable micronutrients, Ghanaian preschoolers consume little. Participatory rapid appraisal methods identified constraints to the availability, accessibility, and utilization of ASF. Stakeholders working with or living in six communities in three agro-ecological zones reported constraints including low income, lack of access to technology and markets, inequitable household food allocation, inadequate knowledge, and beliefs. The least expensive ASF was fish, which was easy to preserve and consumed by all communities. Since ASF was primarily purchased, interventions that increase income may be most successful in improving Ghanaian children's diets.     

Plexiform neurofibroma of the tongue: a case report of a child

A three-year-old girl with a lingual plexiform neurofibroma treated by total excision is presented. Despite their occurrence in the head and neck region, neural sheath tumors are rarely encountered in the oral cavity. It is reported that 4-7% of patients affected by neurofibromatosis display oral manifestations. Neurofibromatosis is characterized by café-au-lait spots and cutaneous neurofibromas. Plexiform neurofibroma is said to be indicative of von Recklinghausen's disease (VRD) even though it may be the only manifestation of the disease. Generally, surgical resection represents the treatment of choice and the diagnosis can only be confirmed after histological examination. Affected patients need regular follow-up to detect malignant degeneration, an early recurrence or appearance of other manifestations of VRD.     

Neonatal brachial plexus palsy: obstetric factors associated with litigation

Objective: Our objective was to compare characteristics between neonatal brachial plexus palsy (NBPP) cases that were litigated versus those that were not.

Study design: From May to December 2012, the University of Michigan Interdisciplinary Brachial Plexus Program surveyed 51 consecutive families whose children were treated for NBPP. Obstetric data was self-reported. Unless NBPP resolved, children were followed for at least two years. Student’s t-test and Chi-square test with odds ratio and 95% confidence intervals were calculated.

Results: Among 51 families surveyed, obstetric data were available for 98% (n?=?50). Litigation was pursued by 48% (n?=?24). Comparing families that litigated versus those that did not, there were no differences in demographics, peripartum characteristics, operative versus spontaneous vaginal birth, shoulder dystocia in current pregnancy (65% versus 54%; p?=?0.56) or birth weight above 9 lbs. The number of children having brachial nerve surgery was significantly higher among families that litigated (46%) versus those that did not (8%; p?=?0.002).

Conclusion: Though there were no differences in peripartum events, almost 1 out of 2 children managed by interdisciplinary team had concomitant litigation. The only factor associated with litigation was having brachial nerve surgery. Efforts are warranted to avert NBPP and mitigate litigations.