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Womens empowerment-related inequalities in complementary feeding practices among children aged 6-23 months in Indonesia: a decomposition analysis

Por: Nurokhmah · S. · Februhartanty · J. · Siscawati · M. · Hendarto · A.
Objective

To examine inequalities in complementary feeding among infants aged 6–23 months across three domains of women’s empowerment (social independence, attitude towards violence and decision-making) in Indonesia, and identify socioeconomic and demographic factors contributing to these inequalities.

Setting

This study used nationally and provincially representative data from the 2017 Indonesia Demographic and Health Survey, which included all 34 provinces and urban and rural areas.

Participants

Mothers of infants who met the following criteria: aged 6–23 months, last-born child, currently alive and residing with both parents.

Outcomes

Complementary feeding indicators: minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD).

Results

Overall, MDD, MMF and MAD were more concentrated among mothers with high empowerment levels. The greatest inequality was observed in MAD when ranked by social independence (Wagstaff Normalised Concentration Index, WCI 0.146; 95% CI 0.106 to 0.185), followed by MDD (WCI 0.144; 95% CI 0.108 to 0.181) and MMF (WCI 0.078; 95% CI 0.035 to 0.122) within the same domain. By decision-making, MMF was more disproportionately distributed (WCI 0.056; 95% CI 0.019 to 0.092) than MDD (WCI 0.048; 95% CI 0.016 to 0.080) and MAD (WCI 0.047; 95% CI 0.011 to 0.083). Evidence for the inequalities by attitude towards violence was statistically significant only for MDD. The main contributing factors to these inequalities were antenatal care, place of delivery, parents’ education, fathers’ occupation and women’s empowerment domains.

Conclusions

This study provides evidence of the women’s empowerment-related inequalities in complementary feeding, which were explained by disproportional distributions of mothers’ and fathers’ characteristics and behaviours. Interventions addressing poor complementary feeding practices should integrate key aspects of women’s empowerment—such as enhancing decision-making autonomy, promoting social independence and addressing attitudes towards violence—and should prioritise disadvantaged groups, particularly mothers with limited access to healthcare and low educational attainment.

Global prevalence of chronic kidney disease and associated risk factors in children and adolescents: protocol for a systematic review and meta-analysis

Por: Hedin · E. · Tungsanga · S. · Ye · F. · Kung · J. Y. · Okpechi · I. · Dart · A. B. · Thompson · S. · Morgan · C. · Erickson · R. · Chaturvedi · S. · Hariramani · V. K. · Crowshoe · H. · Bello · A. K.
Introduction

While chronic kidney disease (CKD) is well characterised in adults, less is known about the prevalence of CKD in children and adolescents, where it is rare and associated with unique characteristics and implications for long-term health outcomes. This study protocol outlines a systematic review to assess the global prevalence of CKD in children and adolescents along with causes and associated risk factors. This is warranted to better characterise prevalence and to identify at-risk groups that would benefit from screening efforts. We will explore the risk and burden of CKD and its variations by sociodemographic characteristics (age group, race, sex/gender) and geographical regions (country, International Society of Nephrology region and income groups based on World Bank country classifications).

Methods and analysis

We will conduct a systematic review of studies reporting on the prevalence of CKD in children and adolescents following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 (PRISMA-P-2015) and the PRISMA 2020 methodological guidelines (PRISMA 2020). Searches will be undertaken in the following databases with the date range from 2000 to date: Ovid MEDLINE, Ovid Embase, CINAHL, Cochrane Library, ProQuest Dissertations & Theses Citation Index (via Clarivate), Web of Science Core Collection, Google Scholar and grey literature sites (registries, government reports) to identify studies that report on the prevalence of CKD in children and adolescents from ages 0 to 18. The primary outcome will be the global prevalence of CKD in children and adolescents. Secondary outcomes will include the causes of and risk factors for CKD, and examining differences and temporal trends in CKD prevalence across countries, geographical regions, income levels and sociodemographic characteristics.

Ethics and dissemination

No direct involvement with patient data will be used in this systematic review, as data will be obtained from previously published reports. Ethical approval is therefore not required. Our findings will be published in an open-access peer-reviewed journal and presented at scientific conferences.

PROSPERO registration number

CRD42024547467.

Targeting osteosarcopenia and multimorbidity for frailty prevention through identification and deep phenotyping methods in healthy ageing and high-burden disease cohorts (OPTIMA-C): a longitudinal observational cohort study protocol for neuromusculoskelet

Por: Tay · M. R. J. · Kim · J. M. · Ong · P. L. · Khin · L. W. · Wong · C. J. · Kong · K. H. · Tan · B. Y. · Lee · E. S. · Sim · S. Z. · Lim · W. S. · Yam · M. G. J. · Chew · J. L. · Tan · A. W. K. · Sidarta · A. · Yee · E. · Chua · K. S. G.
Introduction

Sarcopenia and frailty have been identified as negative predictors of health outcomes. Patients with stroke, traumatic brain injury (TBI), knee osteoarthritis (OA) and breast cancer commonly experience low physical activity levels in the chronic phase of recovery. This prospective study aims to explore the feasibility of multimodal screening and longitudinal tracking of various biomarkers from the acute to chronic phase of disease to determine the relationship with frailty outcomes.

Methods and analysis

A prospective longitudinal observational cohort study involving Asian populations is planned over 3 years. Enrolled participants with index conditions of acute stroke, TBI, knee OA and breast cancer will be recruited from rehabilitation hospitals and clinics and followed longitudinally. Reference thresholds from the Asian Working Group on Sarcopenia will be used. Variables include self-reported questionnaires, disease and comorbidity characteristics, anthropometric measurements, appetite questionnaires, muscle ultrasound (MUS), muscle/bone mass, blood biomarkers and markerless gait motion systems. In particular, physical performance (short physical performance battery and hand grip strength), sarcopenia (SARC-F questionnaire) and frailty assessment (FRAIL score, clinical frailty scale), four-region MUS, body composition analysis, dual X-ray absorptiometry, bone mineral densitometry, physical activity levels (International Physical Activity Questionnaire for the elderly [IPAQ-E], fitness trackers) and health-related quality of life assessment (EuroQoL-5D questionnaire five level [EQ5D-5L]) will be used. Blood biomarkers measuring metabolic health (eg, glycated haemoglobin, cholesterol, fasting glucose and 25-OH vitamin D) and inflammation (eg, Tumor Necrosis Factor-alpha [TNF-α] and Monocyte Chemoattractant Protein-1 [MCP-1]) will be measured at baseline. Data collection will take place at postrecruitment baseline (hospital admission), 1, 6 months, 12 months and 2 years postrecruitment (inpatient) and at postrecruitment baseline, 6 months, 12 months and 2 years postrecruitment (outpatient).

Ethics and dissemination

Ethical approval has been obtained from the National Healthcare Group Domain Specific Review Board (2023/00105). Findings will be disseminated through conference presentations and publication in scientific journals.

Trial registeration number

NCT06073106.

Comparison of non-invasive and fluorescein tear film break-up time in a 65-year-old Norwegian population: a cross-sectional study

Por: Tashbayev · B. · Badian · R. A. · Chen · X. · Vitelli · V. · Lagali · N. · Dartt · D. · Hove · L. H. · Jensen · J. L. · Utheim · T. P.
Objectives

Measurement of tear film stability is central in dry eye disease (DED) diagnosis. In this study, we aimed to compare the performance of two methods of tear film stability measurement: non-invasive tear break-up time (NIBUT) and fluorescein tear film break-up time (FTBUT).

Design

Cross-sectional study.

Setting and participants

The study involved 132 subjects of 65-year-old inhabitants of the Oslo region who were not seeking ophthalmic care.

Interventions

The participants underwent a battery of DED tests, including NIBUT measured on Oculus Keratograph 5M and a traditional method using fluorescein drops (FTBUT). Oculus Keratograph 5M measures two types of NIBUT:; appearance time of the first dry spot (NIBUTFirst) and average NIBUTAvg.

Results

74 participants (56%) were female and 58 were male (44%). Subjects presented with varying degrees of DED signs and symptoms. Mean values of NIBUTFirst and FTBUT from all the participants were significantly different (6.2±4.9 s vs 8.6±6.2 s, pFirst and NIBUTAvg values (6.2±4.9 s vs 8.3±5.5 s, pAvg values (8.6±6.2 s vs 8.3±5.5 s, p=0.655). The receiver operating characteristic curve analysis was performed to compare NIBUT and FTBUT in regards to other clinical tests (Ocular Surface Disease Index, ocular surface staining, blink interval, eye redness, corneal sensitivity, lid debris, Schirmer I test, tear osmolarity, meibum quality, meibum expressibility, lid hyperemia, tear meniscus height. irregular lid margin, conjunctival hyperaemia, margin telangiectasia, lipid layer and meibomian gland drop-out). While FTBUT demonstrated results with area under the curve>0.6, neither NIBUTFirst nor NIBUTAvg showed significant results.

Conclusion

NIBUTFirst was shorter than FTBUT. Low correlation between NIBUT and FTBUT indicates that these diagnostic tests are not interchangeable. Other DED tests had correlation, though low, while NIBUT did not demonstrate correlation.

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