Health Interventions Research Articles

The burden of lymphatic filariasis and its control strategies in Sierra Leone: A literature review

Lymphatic filariasis (LF) poses a significant health burden in Sierra Leone, with considerable socio-economic implications. LF, caused by parasitic worms transmitted through mosquito bites, leads to lymphedema, elephantiasis, and hydrocele, severely affecting individuals’ quality of life. Sierra Leone, with its tropical climate and inadequate healthcare infrastructure, faces unique challenges in combating lymphatic filariasis. This review explores the epidemiological landscape of LF in Sierra Leone, highlighting endemic regions, its impact, and control strategies. In 2005, epidemiological coverage of high-dose medications, like ivermectin and albendazole, exceeded 65% annually across 12 districts in Sierra Leone. By 2013, eight districts were eligible for transmission assessment surveys (TAS). After three additional rounds of mass drug administration (MDA), four districts became eligible for pre-TAS assessments in 2017. Despite efforts to control LF through mass drug administration (MDA) programs, challenges such as low treatment coverage, logistical constraints, and community resistance persist. Moreover, the impact of the Ebola outbreak on healthcare delivery has further impeded LF control efforts. This literature review adds to our understanding of LF control in Sierra Leone, providing valuable insights into the epidemiology, impact, challenges, and potential strategies for enhancing LF elimination efforts. It contributes to the broader discourse on neglected tropical diseases and public health interventions, emphasizing the need for context-specific approaches and interdisciplinary collaboration to achieve sustained progress towards LF elimination and improves public health outcomes.

Mobile Health Intervention Reduces Sedentary Time and Physical Inactivity in Patients with Cardiovascular Diseases after Discharge: Systematic Review and Meta-Analysis

Abstract Background: Long sedentary time and physical inactivity negatively impact patients with cardiovascular diseases (CVD). Although more and more studies are exploring the effects of mobile health (mHealth), whether an intervention using mHealth reduces sedentary time and physical inactivity is controversial. Objective: This systematic review aimed to investigate whether mHealth can reduce sedentary time and physical inactivity in patients with CVD via a comprehensive search and evaluation of relevant articles and review of the effects of mHealth on sedentary time and physical inactivity. Methods: We searched articles on three databases PubMed, Web of Science, and CiNii using “mHealth,” “CVD,” and “clinical trials” as keywords. All studies using mHealth to reduce sedentary time and physical inactivity were included. We assessed risk of bias in the included studies and conducted a meta-analysis using a random effects model. Results: After screening 502 articles, we included five randomized controlled trials. In one study, sedentary time was shorter in the intervention group than the control group by 61.5 min/day at 24 weeks. Three studies using physical inactivity as outcome measures were included in a meta-analysis, and the pooled odds ratio was 0.38 (95% confidence interval, 0.22–0.65), favoring the intervention group. All studies showed high risk of performance bias and low risk of selection bias and reporting bias. Conclusion: The mHealth intervention may remind patients with CVD of exercise training and help them reduce sedentary time and physical inactivity. Future studies need to show for how long mHealth can reduce sedentary time and clarify the cost-effectiveness of the mHealth intervention.

Multimodal digital health treatments for Chronic Migraine associated with Medication Overuse Headache: a literature appraisal and results of a single-arm open trial (the BE-HOME program).

Mindfulness-based treatments gained popularity for migraine treatment. In this manuscript we report the results of a single-arm open pilot study that evaluated the impact of a multimodal web-based intervention combining home-based medication withdrawal, patients' education, and online mindfulness-based interventions. We aimed to address whether our program had the ability to show a change in the observed parameters and the study should therefore be intended as an early phase trial. Consecutive patients with chronic migraine associated with medication overuse headache were enrolled, followed-up for 12months, in a program that included home-based medication withdrawal, education on the correct use of drugs and lifestyle issues, prescription of tailored pharmacological prophylaxis, and attendance to six online mindfulness-based sessions. We tested the effect of the program on improving headache frequency, medication intake, quality of life (QoL), headache impact, depression, self-efficacy, and pain catastrophizing. A total of 37 patients completed the study (10 dropped out). We observed a large improvement in headache frequency, medication intake, headache impact, and QoL, a moderate improvement in pain catastrophizing and a mild improvement in depression symptoms; 70% to 76% of patients achieved 50% or more reduction in headache frequency from baseline to each follow-up (p < .01). The results of our multimodal program showed significant improvements in headache frequency, medication intake, and patient-reported outcomes. Future studies are needed to better identify patients who might benefit most from Digital Health Interventions and to demonstrate at least an equivalence in outcome with in-person programs carried out in hospital settings.

Risk/benefit trade-off of habitual physical activity and air pollution on mortality: A large-scale prospective analysis in the UK Biobank

BackgroundPrevious observational studies have indicated associations of physical activity (PA) and air pollution with mortality. A few studies have evaluated air pollution and PA interactions for health. Still, the trade-off between the harmful effects of air pollution exposure and the protective effects of PA remains controversial and unclear. ObjectiveThis study aimed to investigate the joint association of air pollution and PA with mortality risks. MethodsThis prospective cohort study included 322,092 participants from 2006 to 2010 and followed up to 2021 in the UK Biobank study. The concentrations of air pollutants (2006–2010), including particulate matter (PM) with diameters <=2.5 mm (PM2.5), <=10 mm (PM10), and between 2.5 and 10 mm (PM2.5–10), and nitrogen oxides (NO2 and NOx) were obtained. Information on PA measured by the International Physical Activity Questionnaire short form (2006–2010) and wrist-worn accelerometer (2013–2015) were collected. All-cause and cause-specific mortalities were recorded. Cox proportional hazard models were used to investigate the associations of air pollution exposure and PA with mortality risks. The additive and multiplicative interactions were also examined. ResultsDuring a mean follow-up of 11.83 years, 16629 deaths were recorded. Compared with participants reporting low PA, higher PA was negatively associated with all-cause [hazard ratio (HR), 0.74; 95% CI, 0.71–0.78], cancer (HR, 0.85; 95% CI, 0.80–0.90), CVD (HR, 0.79; 95% CI, 0.71–0.87), and respiratory disease-specific mortality (HR, 0.51; 95% CI, 0.44–0.60). Exposure to PM2.5 (HR, 1.05; 95% CI, 1.00–1.09) and NOx (HR, 1.06; 95% CI, 1.02–1.10) was connected with increased all-cause mortality risk, and significant PM2.5-associated elevated risks for CVD mortality and NOx-associated elevated risks for respiratory disease mortality were observed. No obvious interaction between PA and PM2.5 or NOx exposure was detected. ConclusionsOur study provides additional evidence that higher PA and lower air pollutant levels are independently connected with reduced mortality risk. The benefits of PA are not significantly affected by long-term air pollution exposure, indicating PA can be recommended to prevent mortality regardless of air pollution levels. Our findings highlight the importance of public health policies and interventions facilitating PA and reducing air pollution in reducing mortality risks and maximizing health benefits. Future investigation is urgently needed to identify these findings in areas with severe air pollution conditions.

A Qualitative Study Into the Relative Stigmatization of Mental Illness by Mental Health Professionals.

Mental health professionals stigmatize mental illness, which has significant ramifications for public health and policy. Within this domain, there is a lack of comprehensive research on relative stigma, emotions, and behaviors and an absence of literature that can guide research on these topics. The current study sought to address these limitations. Unstructured interviews were conducted with 22 mental health professionals, and data were analyzed using a grounded theory approach. The current study identified a collection of mental disorders (e.g., borderline personality disorder), stereotypes (e.g., dangerousness), emotion-related responses (e.g., fear), and behaviors (e.g., helping) as being key to the relative stigmatization of mental illness by mental health professionals. The results also suggested that professional context and familiarity with mental illness decrease the stigmatization of mental illness by mental health professionals. These variables and constructs were combined to form a grounded theory of mental health professionals stigmatizing mental illness. The current study has implications for the direction of future research on the stigmatization of mental illness by mental health professionals and interventions that strive to mitigate this type of stigmatization.

Review on Pregnancy Progress Monitoring

This project outlines the creation of an innovative pregnancy progress monitoring system leveraging cutting-edge sensor technology and artificial intelligence (AI) models. This project presents an integrated system designed to revolutionize the monitoring of pregnancy progression through a sophisticated fusion of sensor technology and artificial intelligence (AI). The collaborative functionality of DS18B20 temperature sensors, heart beat sensor, and GSM modules establishes a seamless data collection and transmission framework. These sensors continuously capture vital parameters including body temperature, heart rate, and blood oxygen saturation, while the GSM module ensures secure and real-time transmission of this data to designated servers or caregivers’ devices. Leveraging AI-driven algorithms, the system interprets these multifaceted datasets, employing pattern recognition and anomaly detection to discern potential health irregularities. The intuitive user interface grants caregivers comprehensive access to visualized data, facilitating proactive monitoring and swift response through customizable alerts for critical health indicators. This innovative solution undergoes iterative development and validation, seeking to redefine prenatal care by enabling early identification of deviations and fostering informed decision-making among medical practitioners and expectant parents. By amalgamating sensor technology with AI capabilities, this system aspires to enhance the safety and well-being of both mother and fetus, marking a paradigm shift in prenatal health monitoring and intervention strategies.

Filipino seafarers’ experiences and perceptions of psychosocial interventions during the COVID-19 pandemic

This paper examines the mental health and psychosocial support (MHPSS) interventions provided to Filipino international merchant seafarers during the COVID-19 pandemic. Given the significant labor participation in seafaring of Filipinos, examining the MHPSS provided to them during a crisis is necessary because these services remain unexplored. Using an online survey, this paper raises two questions: (1) what MHPSS was provided to Filipino seafarers during the pandemic and (2) how did the seafarers perceive the importance of MHPSS interventions? Twenty-two MHPSS interventions are presented and analyzed, and policy recommendations for various Philippine-based stakeholders are offered.

Professionalising health technology assessment in South Africa

Health technology encompasses interventions developed to prevent, diagnose or treat medical conditions; promote health; provide rehabilitation or organise healthcare delivery. The intervention can be a test, device, medicine, vaccine, procedure, program or system.[1] Health technology assessment (HTA) is a multidisciplinary evaluation process that assesses the properties of health technologies and interventions. It uses specific methods to determine the value of a health technology at different points in its lifecycle. The purpose of the HTA is to inform decision-making to promote equitable, efficient and high-quality health and health care systems. [1,2] It bridges the gap between the realms of research, policy making and service delivery.

Identifying globally relevant learnings from Africa’s challenges and solutions to climate change and air pollution-related health impacts: a data science scoping review protocol

IntroductionLeveraging data science could significantly advance the understanding of the health impacts of climate change and air pollution to meet health systems’ needs and improve public health in Africa. This...

STUDY OF ANTIBIOTIC RESISTANCE AT REGIONAL LEVEL

The introduction of antibiotics revolutionized medicine, dramatically reducing deaths and illnesses caused by infections. However, decades of overuse have accelerated the evolution of microorganisms, leading to a critical challenge: antibiotic resistance. This research aims to investigate the regional risk factors contributing to antibiotic resistance among the Poltava region population. Materials and methods. 100 patients of the 2nd Municipal Clinical Hospital and the Regional (Republican) Center for Emergency Medical Aid and Disaster Medicine of Poltava were included in the study. Data collection was carried out from November 2023 to March 2024. Patients were offered a series of 11 questions. Research results. This study has revealed the following antibiotic usage patterns among the residents of the Poltava region. It has been found that 22% of respondents are currently undergoing treatment, 8% in the last month, 36% in the last year, and 34% of the respondents tool the treatment for more than a year. When using antibiotics without a prescription, 30% of patients consulted a pharmacy, 52% trusted the Internet, 10% chose the cheapest medicine, and 8% followed advertisements. For subsequent illnesses, 76% of respondents used antibiotics they had taken before: amoxicillin (42%), ciprofloxacin (28%), azithromycin (22%), and chloramphenicol (8%). While 80% reported following prescribed antibiotic regimens, 20% interrupted treatment prematurely due to perceived improvement. Despite 84% acknowledging the importance of completing antibiotic courses, a concerning 16% were unaware of this crucial practice. Interestingly, 11% reported using antibiotics for preventive purposes (before getting sick). However, a positive trend emerged: 85% of respondents confirmed undergoing testing for bacterial susceptibility before receiving antibiotics. Only 9% reported amoxicillin as ineffective. When antibiotics were ineffective, 46% of respondents consulted a doctor, 24% took no action and waited for the antibiotic to take effect, 21% stopped one antibiotic and started another, and 14% preferred intramuscular injections and self-medication. Conclusion. A significant number of patients (48%) take antibacterial drugs without a doctor's prescription and 52% search for information on the Internet. 76% of patients use the same drug for a recurrent disease. Amoxicillin is the most often preferred (42%), a smaller number of patients came to the pharmacy for ciprofloxacin (28%), 22% of respondents preferred azithromycin. This study underscores the necessity for public health interventions to tackle antibiotic misuse and misconceptions in the Poltava region. Promoting responsible usage, emphasizing the importance of completing treatment courses, and discouraging self-medication are crucial steps in combating the growing threat of antibiotic resistance.

Facilitators and Barriers to Adherence to Anti-Retroviral Treatment Among Pregnant or Breastfeeding Women Living with HIV and Perinatally Infected Infants: A Scoping Review.

In 2022, 54% of 1.5million children (age 0-14) living with HIV had access to anti-retroviral medication (ART). Adherence to ART for pregnant or breastfeeding HIV + women is critical for maintaining their personal health and to prevent mother-to-child-transmission (MTCT). For HIV + infants, adherence is essential to establish early viremic control and is contingent on caregiver administration. We conducted a scoping review to systematically identify and categorize the influences on ART adherence for pregnant or breastfeeding HIV + women and their HIV + infants. We searched databases in June 2023 and employed the Social-Ecological Model (SEM) to organize facilitators and barriers to adherence referenced in published articles. All articles published before 2016 were excluded due to updated guidelines from WHO on MTCT and ART. Our analysis included 52 articles. 50/52 took place in Africa and used cross-sectional and mixed-methods design. Barriers to adherence for pregnant or breastfeeding HIV + women included maternal education, self-efficacy, social support, and social/economic context. Barriers to infant adherence included development, nutrition, age of treatment initiation, disclosure, and ART side effects. Additional facilitators and barriers to adherence are presented at family, extra-familial, and socio-cultural SEM levels. Stigma was the most salient barrier referenced across the entire continuum of HIV care and all SEM levels. This review revealed a dearth of literature focusing on HIV + infants who are dependent on their caregivers for ART adherence and lack of a standard adherence measure. We identified multi-leveled influences on adherence impacting both the mother and infant and are amenable to public health intervention.

My Body, My Choice: An Adapted Sexual Health Intervention for Youth with Histories of Commercial Sexual Exploitation

Youth with commercial sexual exploitation (CSE) histories experience high rates of unplanned pregnancies and sexually transmitted infections, with few interventions targeting their needs. We therefore piloted an evidence-based sexual health education intervention tailored for CSE-impacted youth, My Body, My Choice (MBMC). MBMC was implemented in two rounds between March and October 2021 with a total of 37 youth who completed a baseline questionnaire, engaged in a 13 to 16-hour online course over two to three weeks, and then assessed the course’s likability and feasibility via a post-course evaluation survey. To measure sexual health knowledge retention and attitudes, follow-up questionnaires were administered at baseline, 1-month, and 3-months post-course. Descriptive and bivariate analyses examined demographic characteristics and differences between timepoints. Most participants identified as female (92%), and Latinx (57%) or Black (27%). Overall, youth had an improved understanding of sexual health concepts over time, with significantly increased knowledge regarding birth control methods such as IUDs and condoms. Youth expressed high rates of satisfaction with MBMC, with 93% seeking continued course access. Findings underscore the utility and acceptability of MBMC and may inform future interventions to reduce health disparities and improve sexual health outcomes among youth with CSE histories.

A theory of oral healthcare decision-making in Appalachia.

People make oral healthcare decisions regardless of having partial information, misinformation, sources that deliberately mislead, or information that is culturally influenced. This is particularly true in the Appalachian culture where oral healthcare decision-making practices are not well understood by researchers and dental professionals. Despite efforts to improve dental care utilization, the Appalachia region remains low in oral healthcare utilization. There is a need for a theory to identify concepts in decision-making when seeking oral healthcare. The theory could be useful in creating oral health interventions. The study objective is to develop a theory to identify concepts that influence oral healthcare decision-making in Appalachia (OHDA). The researchers used a grounded theory qualitative study design to explain data for a theory of OHDA. Participants from Appalachia, in 20-minute interviews, provided insights into concepts that influence OHDA from August 22, 2017 to May 26, 2022. Notes/memos were written during and after the interviews and coding was conducted after the interviews. Open coding categories emerged through constant comparison of responses. Five overarching concepts that embody OHDA were discovered: Affect (Level of Pain/Emotion/Stress involvement), Awareness, Trust/belief, Resources, and Risk Perception. All participants discussed the impact of social media toward these concepts. To influence a person's OHDA, public health officials and researchers need to address the person's affect, level of awareness, trust/belief, available resources, and risk perception. Social media is very important in awareness concerning oral health information. These factors are important to consider for similar research in oral healthcare utilization at the population level.

Erosion of the Capital City Advantage in Child Survival and Reproductive, Maternal, Newborn, and Child Health Intervention Coverage in Sub-Saharan Africa.

The place of residence is a major determinant of RMNCH outcomes, with rural areas often lagging in sub-Saharan Africa. This long-held pattern may be changing given differential progress across areas and increasing urbanization. We assessed inequalities in child mortality and RMNCH coverage across capital cities and other urban and rural areas. We analyzed mortality data from 163 DHS and MICS in 39 countries with the most recent survey conducted between 1990 and 2020 and RMNCH coverage data from 39 countries. We assessed inequality trends in neonatal and under-five mortality and in RMNCH coverage using multilevel linear regression models. Under-five mortality rates and RMNCH service coverage inequalities by place of residence have reduced substantially in sub-Saharan Africa, with rural areas experiencing faster progress than other areas. The absolute gap in child mortality between rural areas and capital cities and that between rural and other urban areas reduced respectively from 41 and 26 deaths per 1000 live births in 2000 to 23 and 15 by 2015. Capital cities are losing their primacy in child survival and RMNCH coverage over other urban areas and rural areas, especially in Eastern Africa where under-five mortality gap between capital cities and rural areas closed almost completely by 2015. While child mortality and RMNCH coverage inequalities are closing rapidly by place of residence, slower trends in capital cities and urban areas suggest gradual erosion of capital city and urban health advantage. Monitoring child mortality and RMNCH coverage trends in urban areas, especially among the urban poor, and addressing factors of within urban inequalities are urgently needed.

Ethnic representation within virtual reality: a co-design study in a forensic youth care setting

BackgroundVirtual reality (VR) is one of the most cutting-edge digital technologies currently used to extend and adapt mental health interventions. When designing therapeutic VR-applications, bias related to representational and behavioral features can be introduced. Specific bias, that could result from ethnic stereotyping, should be averted. However, structured debates and clear guidelines on how to deal with such bias are lacking.ObjectiveIn the current paper we describe our iterative, co-design process to develop an augmented version of a 360-degree VR-video that is used in the Street Temptations intervention. In this intervention, aimed at adolescents with disruptive behavior problems, the VR-video provides adolescents with an emotionally engaging situation and forms the basis of Street Temptations’ perspective-taking exercises. By presenting a detailed example of our VR developmental process, specifically focusing on ethnic representation in this virtual environment and related ethical aspects, we aim to positively contribute to the creation of ethically sound therapeutic VR-applications.MethodWe adopted an experience-based co-design approach. The process started by assembling professionals’ experiences with the original VR-video. Following, we conducted four co-design groups with adolescents, young adults, and professionals within the forensic youth care system, as experiential experts, to collaboratively develop an enhanced VR-scenario for the Street Temptations intervention. In total, ten adolescents, four young adults and four professionals participated. The co-design groups were alternated with sessions with a screenwriter, to reflect on the results of the co-design groups. In this way, we enabled continuous feedback on and design of the ameliorated scenario and let development and data collection reinforce each other.ResultsThe most important adjustments that were brought forward included explicit incorporation of diversity, establishing a clear storyline for the scenario, keeping the content close to reality, casting actors in a way to avoid obvious stigmatization, and using only names for the characters that are commonly used across different cultural and ethnic backgrounds.DiscussionBy presenting our developmental process, we give a detailed example of how to reflectively develop ethically sound therapeutic VR-content within a forensic youth care setting. We demonstrated that including stakeholders can help in preventing socially irresponsible and conceivably hurtful stereotypes. By describing the process in detail, we hope to contribute to the responsible use of technology within mental health care.

Spatio-temporal distributions and determinants of diarrhea among under-five children in Ethiopia

ObjectiveThe purpose of this study was to evaluate the spatio-temporal pattern of Ethiopia’s childhood diarrheal disease and identify its contributing factors.MethodsWe conducted analyses on secondary data from four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. Moran’s I was used to determine spatial dependence and spatial models were used to evaluate variables associated with diarrhea in under-five children at the zonal level.ResultsChildhood diarrhea showed spatial clustering in Ethiopia (Moran’s I; p &amp;lt; 0.05). The spatial regression model revealed significant factors at the zonal level: children born at home (eθ = 1.355, 95% CI: 1.052–1.544, p &amp;lt; 0.001), low birth weight (eθ = 1.18, 95% CI: 1.017–1.691, p &amp;lt; 0.05), and unimproved source of water (eθ = 0.8568, 95% CI: 0.671–1.086, p &amp;lt; 0.01).ConclusionThe prevalence of diarrhea among under-five children varied over time by zone, with the Assosa, Hundene, and Dire Diwa zones having the highest rates. Home births and low birth weight contributed to the prevalence of childhood diarrhea. In high-risk zones of Ethiopia, reducing childhood diarrhea requires integrated child health interventions and raising awareness about the potential hazards associated with unimproved water sources.

Factors influencing adoption of sexual and reproductive health intervention for adolescents in Ebonyi, Nigeria.

School and Community-embedded reproductive health interventions have been implemented in developing countries, with evidence that they led to improved sexual and reproductive health among adolescents. However, this type of intervention is rarely evaluated for its potential adoption and use. This study evaluated the constraints and enablers of the adoption of a school and community-embedded intervention that used community engagement, capacity building, partnerships and collaborations to deliver sexual and reproductive health services to adolescents. The intervention was implemented between 2019 and 2021 in six local government areas in Ebonyi State. The results on adoption presented here were collected four months into the mid-phase of the project, targeting adolescents, parents, adult family members, healthcare providers, local authorities, and community members. Sixteen in-depth interviews were conducted with policymakers, 14 with health service providers and 18 Focus Group Discussions (FGDs) with parents, community leaders and adolescents who were part of the implementation process. The coding reliability approach, a type of thematic data analysis was used, that involves early theme development and the identification of evidence for the themes. The adoption of school and community-embedded reproductive health intervention was strong among stakeholders at the early stages of the implementation process. Multi-stakeholder involvement and its multi-component approach made the intervention appealing, thereby enabling its adoption. However, at the later stage, the adoption was constrained by beliefs and norms about sexual and reproductive health (SRH) and the non-incentivisation of stakeholders who acted as advocates at the community level. The sustainability of the intervention may be threatened by the non-incentivisation of stakeholders and the irregular supply of materials and tools to facilitate SRH advocacy at the community level. The inclusive community-embedded reproductive health intervention was adopted by stakeholders because of the enablers which include timely stakeholder engagement. However, for it to be sustainable, implementers must address the non-incentivising of community-level advocates which serve as constraints.

Evaluation of Public Health Interventions in Reducing the Burden of Malaria Infection in Emohua Community, Rivers State, Nigeria.

Evaluation of Public Health Interventions in Reducing the Burden of Malaria Infection in Emohua Community, Rivers State, Nigeria.

How to plan and provide general anesthesia for a troop of 98 hamadryas baboons (Papio hamadryas) for contraceptive and preventative health interventions.

Present an approach to the safe and efficient provision of anesthesia and birth control measures to a large group of primates. 98 hamadryas baboons (Papio hamadryas) held in a German zoological institution. A group of 12 veterinarians, 2 zookeepers, and 6 volunteers anesthetized all animals within 2 days. The baboons were orally premedicated with midazolam (0.1 to 0.5 mg/kg) and anesthetized with medetomidine (40 to 60 µg/kg, IM) and ketamine (2 to 4 mg/kg, IM); isoflurane at rates of 1.5% to 2% was used for maintaining anesthesia if necessary. All animals received a physical examination, prophylactic medication, and tuberculin testing. For population management, the animals received a contraceptive implant (adult females), orchiectomy (young males), or vasectomy (breeding males). Young males received intratesticular blocks with lidocaine. All animals received atipamezole (125 to 150 µg/kg) before recovery. Premedication resulted in anxiolysis, which facilitated separating and darting. Median time from darting to access to the animal was 10 minutes. Mean anesthetic times were 25 minutes for females and 55 minutes for males. The depth of anesthesia was appropriate for the procedures. No fatalities were recorded. One animal was injured by other baboons but recovered after treatment. Health management and birth control measures are necessary in baboon troops under human care. Anesthesia and/or contraception of individual animals often leads to intraspecific aggression. This case series describes how to provide anesthesia and contraception to an entire troop as an alternative approach that can be adopted to future similar interventions.

Nutrition, Other Environmental Influences, and Genetics in the Determination of Human Stature.

Linear growth during three distinct stages of life determines attained stature in adulthood: namely, in utero, early postnatal life, and puberty and the adolescent period. Individual host factors, genetics, and the environment, including nutrition, influence attained human stature. Each period of physical growth has its specific biological and environmental considerations. Recent epidemiologic investigations reveal a strong influence of prenatal factors on linear size at birth that in turn influence the postnatal growth trajectory. Although average population height changes have been documented in high-income regions, stature as a complex human trait is not well understood or easily modified. This review summarizes the biology of linear growth and its major drivers including nutrition from a life-course perspective, the genetics of programmed growth patterns or height, and gene-environment interactions that determine human stature in toto over the life span. Implications for public health interventions and knowledge gaps are discussed.