Lack Of Adequate Nutrition Research Articles

Carbon nanotubes: a novel innovation as food supplements and biosensing for food safety.

Recently, nanotechnology has emerged as an extensively growing field. Several important fabricated products including Carbon nanotubes (CNTs) are of great importance and hold significance in several industrial sectors, mainly food industry. Recent developments have come up with methodologies for the prevention of health complications like lack of adequate nutrition in our diet. This review delves deeper into the details of the food supplementation techniques and how CNTs function in this regard. This review includes the challenges in using CNTs for food applications and their future prospects in the industry. Food shortage has become a global issue and limiting food resources put an additional burden on the farmers for growing crops. Apart from quantity, quality should also be taken into consideration and new ways should be developed for increasing nutritional value of food items. Food supplementation has several complications due to the biologically active compounds and reaction in the in vivo environment, CNTs can play a crucial role in countering this problem through the supplementation of food by various processes including; nanoencapsulation and nanobiofortification thus stimulating crop growth and seed germination rates. CNTs also hold a key position in biosensing and diagnostic application for either the quality control of the food supplements or the detection of contagions like toxins, chemicals, dyes, pesticides, pathogens, additives, and preservatives. Detection such pathogens can help in attaining global food security goal and better production and provision of food resources. The data used in the current review was collected up to date as of March 31, 2024 and contains the best of our knowledge. Data collection was performed from various reliable and authentic literatures comprising PubMed database, Springer Link, Scopus, Wiley Online, Web of Science, ScienceDirect, and Google Scholar. Research related to commercially available CNTs has been added for the readers seeking additional information on the use of CNTs in various economic sectors.

Socialization of White Jack Bean Tempe Production as a Strategy to Reduce Stunting Rates in Gumantar Village, North Lombok Regency

Gumantar Village is in North Lombok Regency, West Nusa Tenggara. This village is classified as a developing village with many problems, including stunting. Stunting is caused by mothers and children's lack of adequate nutrition and nutrients, which impacts children's physical and mental growth as the nation's golden generation. Therefore, it is vital to prevent stunting in Gumantar Village, considering the village is the frontline in eradicating stunting. To prevent stunting, the KKN-PMD group of Mataram University initiated the utilization of white Jack bean (Canavalia ensiformis) as a raw material for making tempeh to replace soybeans to increase nutritious food and the economy in Gumantar Village. The activity was carried out from December 2023 to January 2024. This tempeh-making aimed to fulfill the community's nutritional intake through tempeh, which is rich in properties and nutrients and can become a community income to improve the economy. The method used through the work program to reduce stunting rates in Gumantar Village was healthy village socialization on stunting prevention, a stunting campaign through Posyandu, and nutritious food demonstrations to make tempeh from white Jack beans. Other activities carried out to prevent stunting were sexual education to children and socialization of early marriage to adolescents who are experiencing the puberty phase. The results of the socialization activities and demonstrations of processing white Jack beans as a primary ingredient for making tempeh were that the community had a better understanding of how to prevent stunting and how to make tempeh from white Jack beans—most of the community members like the tempeh both in terms of taste, shape, and texture. Participants well accepted sexual education and early marriage socialization.

Assessment of the Vitamin A supplementation protocol in primary health care settings: A case study of Mookgophong sub-district in South Africa

The Integrated Nutrition Programme in South Africa provides Vitamin A supplementation to targeted children. It began in 1994 when marginal vitamin A deficiency was 33 %. Since that time, malnutrition remains a serious problem in South Africa as one of the greatest contributors to childhood illness and death. It is estimated that about 27% of South African children are stunted from a lack of adequate nutrition in the early years of their lives. A poor intake of vitamin A is one of the cofactors in sight and contribute to blindness amongst children. In addition, it is required for cellular integrity. Furthermore, children with poor intake of vitamin A are underweight, fail to grow properly and are more likely to get infections and to die from them. The main purpose of this study was to assess the implementation process of the vitamin A supplementation protocol in primary health care institutions in the Mookgophong sub-district of Limpopo Province. The study design was descriptive and qualitative. All seven facilities, the clinics and the district hospital in the sub-district were purposefully selected. Data were collected from the seven health care facilities and 16 health care workers provided information on the implementation process of the Vitamin A programme, using a self-administered structured questionnaire. An observation questionnaire was also used by the researcher to validate some of the information and to check compliance with the protocol. The findings revealed poor availability of blue (100 000 IU), white (500 000 IU) and yellow (200 000 IU) capsules in stock (56.3%). Approximately half of the health care workers reported to know the preventative schedule, while most of them did not know the treatment schedule. There was generally good adherence to the implementation of preventative protocol. The health care workers complied with the Vitamin A protocol despite the lack of stock or resources in this low resource setting. Key words: Vitamin A supplementation protocol, health care workers, South Africa

Edukasi Tentang Gizi Seimbang Bagi Remaja Dalam Upaya Peningkatan Pengetahuan Mengenai Kebutuhan Gizi Di Wilayah Kerja Puskesmas Somba Opu

In human life, adolescence is a very important period. During this period, the initial process of maturation of the reproductive organs occurs. In this phase, adolescents will experience physical growth accompanied by mental, cognitive and psychological development. Lack of adequate nutrition during this period can cause disruption and obstacles in adolescent growth. One program that can be carried out to achieve and maintain normal nutritional status in adolescents is by implementing a balanced nutritional intake. This community service activity is carried out using nutrition education methods for teenagers. Through this service activity, it is hoped that there will be an increase in knowledge among teenagers regarding the importance of implementing a balanced nutritional intake for teenagers, which in turn is hoped that teenagers will be able to achieve and maintain normal nutritional status. This activity was attended by 23 teenagers in the working area of ​​the Somba Opu Health Center, Gowa Regency. The knowledge score results show that before being given counseling about balanced nutrition, the average knowledge score for teenagers was in the medium category, namely 60,8%. After following the counseling regarding balanced nutrition and carrying out a posttest, the results showed that the teenagers' knowledge scores increased to an average of 65,22% in the high category. This shows that there is an increase in knowledge among teenagers regarding balanced nutrition after attending this counseling.

Effect of a Nutrition Diet on Health Status of Physically Challenged Students at Ade Okubanjo Institute for the Blind, Ijebu-Igbo

ackground: The role of balanced diet in the life of an individual physically challenged or not cannot be overlooked. The condition of the physically challenged children attracts little or no attention. Several factors have been identified as causes of malnutrition in physically challenged persons. A nutritional diet is one of the factors that can help to reduce this phenomenon. The study was designed to examine the effect of a nutrition diet on health status of physically challenged students at Ade Okubanjo Institute for the Blind at Ijebu-Igbo.
 Method: This study used a descriptive survey research design and was conducted in 2022. 120 students were selected as the population of this study of which 100 were retuned valid. The research location was Ade Okubanjo Institute for the Blind, Ijebu-Igbo. A self-structured questionnaire was used to measure the nutrition diet of physically challenged students. To do so, 100 questionnaires were analyzed using a purposive sampling techniques method. Nutritional diet and health status questionnaire was the instrument used for this study and questions about physical performance, nutritional diet, lack of adequate nutrition and family/parental status questions were asked from the participants. Cronbach’s alpha of NHSQ was 0.72. The data analysis method included the descriptive statistics were analyzed using chi-square.
 Result: Findings revealed that physical activities performance will significantly influence the nutrition diet of physically challenged children (Cal. value = 125.748a,, p-value = .000.), Lack of adequate nutrition will significantly influence the nutrition diet of physically challenged children (Cal. value = 46.180a,, p-value = .000.) also mental health status significantly influence the nutrition diet of physically challenged children (Cal. value = 41.165a,, p-value = .000.), Family/parental status will significantly affect the nutritional diet intake of the physically challenged (Cal value = 41.165a, , p-value =.000.). 
 Conclusion: The findings concluded that Physical performance, Lack of adequate nutrition, Mental status and Family/parental status significantly affect the nutritional diet intake of the physically challenged students at Ade Okubanjo Institute for the Blind.

Prevalence and determinants of meeting minimum dietary diversity among children aged 6-23 months in three sub-Saharan African Countries: The Demographic and Health Surveys, 2019-2020.

BackgroundDietary diversity is an indicator of nutritional adequacy, which plays a significant role in child growth and development. Lack of adequate nutrition is associated with suboptimal brain development, lower school performance, and increased risk of mortality and chronic diseases. We aimed to determine the prevalence and determinants of meeting minimum dietary diversity (MDD), defined as consuming at least five out of eight basic food groups in the previous 24-h in three sub-Saharan African countries.MethodsA weighted population-based cross-sectional study was conducted using the most recent Demographic and Health Surveys (DHS). MDD data were available between 2019 and 2020 for three sub-Saharan African countries (Gambia, Liberia, and Rwanda). The study population included 5,832 children aged 6–23 months. A multivariable logistic regression model was developed to identify independent factors associated with meeting MDD.ResultsOverall, the weighted prevalence of children who met the MDD was 23.2% (95% CI: 21.7–24.8%), ranging from 8.6% in Liberia to 34.4% in Rwanda. Independent factors associated with meeting MDD were: age of the child (OR) = 1.96, 95% CI: 1.61, 2.39 for 12–17 months vs. 6–11 months], mothers from highest households' wealth status (OR = 1.86, 95% CI: 1.45–2.39) compared with the lowest, and mothers with secondary/higher education (OR = 1.69, 95% CI: 1.35–2.12) compared with those with no education. Mothers who were employed, had access to a radio, and those who visited a healthcare facility in the last 12 months were more likely to meet the MDD. There was no significant association between the child's sex and the odds of fulfilling the MDD.ConclusionsThere is substantial heterogeneity in the prevalence of MDD in these three sub-Saharan African countries. Lack of food availability or affordability may play a significant role in the low prevalence of MDD. The present analysis suggests that policies that will effectively increase the prevalence of meeting MDD should target poor households with appropriate materials or financial assistance and mothers with lower literacy. Public health interventions working with sectors such as education and radio stations to promote health education about the benefits of diverse diets is a critical step toward improving MDD in sub-Saharan Africa and preventing undernutrition.

Community optimized management for better eating after hospital sTay among geriatric patients of poor socio-economic status - The COMEAT study

In patients suffering from disease-related and socioeconomic malnutrition and being discharged from hospital, continuity of care is challenging. Lack of adequate nutrition may lead to increase in morbidity and mortality. The aim of this study was to overcome the handicap of limited nutrition access in this category of patients and to study its consequences on clinical outcome. Hospitalized patients screened to be at risk of malnutrition were approached and if diagnosed as suffering from malnutrition and from limited financial resources, they were randomized to receive a delivered daily dinner tray for 6 months and an assistance during the meal by a philanthropic association, or to regular food. At entry to the study, patients were assessed by indirect calorimetry, bioimpedance, Hospital Anxiety and Depression Scale (HADS), Functional independence measure (FIM) and SF 36 quality of life questionnaire. The latest questionnaires were reproduced after 3 and 6 months. Survival was followed at 6 months. The student t-test, the paired t-test, ANOVA were used. 180 days survival curves were expressed using the Kaplan-Meier method. 631 patients were screened and 60 patients were randomized. There was no difference between groups. Survival at 6 months was improved significantly in the intervention group (87%) compared to the control group (65%, p<005). HADS did significantly improve at 3 months and other parameters (FIM, SF 36) were not changed significantly. In hospitalized patients at nutritional risk, lunch home delivery, supported by a physical company after hospital discharge was associated with significantly lower mortality rates and improved depression and anxiety scores in elderly patients suffering from socioeconomic related malnutrition.

Aquaculture in Kenya: Present State and Development Trends

At present, about half of the total amount of fish and seafood consumed in the world is grown in artificial conditions, while in the early 2000s its share was 30%, and in the 1980s it did not exceed 7%. This trend is formed against the background of depletion of natural marine and freshwater bio-reserves. Overexploitation of some of their species, primarily fish, has actually reached the verge of sustainable reproduction or even exceeds this objective limit beyond which no production is possible without compromising the ecological state of the aquatic biological environment. At the same time, the population’s demand for products containing the most suitable balance of proteins, “right” fats, vitamins and amino acids is increasing more and more. One of their main sources is water bio-reserves. The shortage of these resources as a result of excessive demand (in the context of the actualization of the problem of preserving natural capital for future generations) is increasingly compensated by an increase in the supply of aquaculture products – that is, man-controlled artificial reproduction of commercial water reserves. Compared to other types of food, global aquaculture production is increasing at a faster rate of 10% per year. It is expected to exceed 100 million tons by 2030, compared to 82 million tons in 2018. The highest indicator, which is 48%, is estimated for Africa, which is no less affected by the growing deficit of natural water bioresources than other countries of the world. In addition, it exacerbates the still unresolved problems of food security in the countries of the continent and the lack of adequate nutrition of its population, especially its poorest strata, who are constantly experiencing protein and vitamin starvation. In many ways, this is why it is difficult to overestimate the importance of aquaculture for the African continent, although so far its share in global production is only 2.7%. This may indicate, in particular, a lack of attention to the industry by the leadership of a very large number of African states, which are still only at the beginning of the road. Among them was Kenya, which is currently in the middle of the list of top ten African countries that in recent years, according to the FAO, have made rather noticeable positive changes in this area of economic activity. The article discusses the main stages of development of various areas of aquaculture in Kenya. The main attention is paid to the state policy on turning this agricultural sub-sector into an important resource for increasing employment and well-being of the population in rural areas.

Review Article: Androgen Hormone and Male Infertility

Infertility, the inability to conceive after 1 year of unprotected intercourse. There are controversial studies about the factors that affect male fertility, the more prominent risky lifestyle influences such as cigarette smoke and consuming alcohol, the present research examined the possible implications of these observations behaviors about sperm genesis, human reproductive hormone, and oxidative profile of blood plasma. Male infertility is a reproductive health condition that arises worldwide as a severe medical and social challenge that affects the affected couples' heavy trauma, mental distress, and psychological stress. Males are confirmed to be the primary causative factor in 50% of the diagnosed cases of infertility. Male infertility may be measured by sperm cell content and quantities, as well as by structure. A description of a wide variety of factors responsible for male infertility is given in the current study. The primary causes are hormonal imbalances, developmental anomalies, physiological &amp; morphological genital disorders, sensitivity to contaminants &amp; pollutants, reactive oxygen species, and smoking. Besides, noise, changing habits, lack of adequate nutrition and diet, addictions, infections, drugs, diseases, and psychiatric issues can often lead to infertility problems that may impact the male reproductive system temporarily or permanently.

A Critical Review of the Association between Nutrition and Health in Modern Chinese Diet

Cardiovascular diseases (CVDs), obesity, diabetes, cancers and other chronic diseases are becoming main contributors to the global burden of disease, even as nutritional deficiencies are receding as leading contributors to mortality and disability. Diet is closely related to nutrition and health, which has been extensively investigated as risk factors for major chronic diseases. The past two decades have witnessed rapid changes in dietary pattern in China. However, a critical thinking of Chinese diet behind these changes is less emphasized. Given the causal relationship between nutrition and disease, lack of adequate nutrition and unhealthy diet habits might be responsible for the high incidence of chronic diseases in China in recent years. To this end, we will critically review some open problems in current diet compositions and the importance of regular mealtimes. The intake level of dietary supplements in China will also be discussed.

Migrant health situation when detained in European immigration detention centres: a synthesis of extant qualitative literature.

Many migrants are detained in Europe not because they have committed a crime but because of lack of certainty over their immigration status. Although generally in good physical health on entry to Europe, migrant detainees have complex health needs, often related to mental health. Very little is known about the current health situation and health care needs of migrants when detained in European immigration detention settings. The review aims to synthesize the qualitative literature available on this issue from the perspectives of staff and migrants. The authors undertook a synthesis of extant qualitative literature on migrant health experience and health situation when detained in European immigration detention settings; retrieved as part of a large-scale scoping review. Included records (n = 4) from Sweden and the UK representing both detainee and staff experiences were charted, synthesised and thematically analysed. Three themes emerged from the analysis, namely, conditions in immigration detention settings, uncertainties and communication barriers and considerations of migrant detainee health. Conditions were described as inhumane, resembling prison and underpinned by communication difficulties, lack of adequate nutrition and responsive health care. It is crucial that the experiences underpinning migration are understood to respond to the health needs of migrants, uphold their health rights and to ensure equitable access to health care in immigration detention settings. There is a dearth of qualitative research in this area because of the difficulty of access to immigration detention settings for migrants. The authors highlight the critical need for further investigation of migrant health needs, so as to inform appropriate staff support and health service responses.

Facilitators and Barriers to Adherence to Antiretroviral Therapy and Retention in Care Among Adolescents Living with HIV/AIDS in Zambia: A Mixed Methods Study.

Little is known about the factors that contribute to the losses during stages of the HIV continuum of care (CoC) and specifically during the latter stages of antiretroviral (ART) adherence and retention in HIV care among adolescents living with HIV/AIDS (ALHA) in sub-Saharan Africa. We conducted a mixed-methods study: six focus group discussions with 43 ALHA (age 17-19); in-depth interviews with four (age 18-19): and survey-based interviews with 330 ALHA (age 18-19) to identify, understand, and describe factors contributing to the losses in the latter stages of the CoC among ALHA in Zambia. Through focus group discussions and in-depth interviews, ALHA identified barriers at the intrapersonal level (e.g., poverty; lack of adequate nutrition; fear of stigma), interpersonal level (e.g., stigma; disrespectful treatment by providers), institutional/facility level (e.g., lack of adolescent specific services), and community level (e.g., lack of collaboration among organizations; social norms). In quantitative interviews, we found that 46% (101/220) of ALHA reported missing any clinic appointments in the past three months, and about 19% (41/221) reporting missing one or more doses of ART in the last week. Logistic regressions indicate that walking to the site of appointment and being currently employed were predictive of missed visits. Findings highlight the complexity of the multiple factors that are unique to ALHA in Zambia, which should be addressed to improve adherence to ART and retention in HIV.

Clinical one health: A novel healthcare solution for underserved communities

Limited access to healthcare is a symptom of poverty worldwide. In Knights Landing, California, USA, an economically underserved, agricultural community, advocates recognized that integration of human and animal healthcare could provide a less intimidating gateway to services and facilitate assessments of individuals' health, not just in moments in time, but within the context of the complex interactions with other humans, animals, and their encompassing environment. Humans and animals share diseases resulting from common exposure to environmental pollutants and disease hosts and lack of adequate nutrition. Thus, a One Health-based clinic was established using an interdisciplinary approach to individual and community health. Interprofessional proximity allows veterinarians and physicians to help each other develop the full community-health picture, allowing sentinel cases to come to the forefront. With a collaborative One Health approach and clinicians adaptable to the changing needs of the population, the provision of community-centered healthcare has become more tenable.

Deep neck space infection - A retrospective study of 270 cases at tertiary care center.

ObjectiveTo review the clinical findings in deep neck infections and identification predisposing factors of these complications.MethodsIn this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016.ResultsAnalysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated.ConclusionDNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.

The biological side of social determinants: Neural costs of childhood poverty

Interdisciplinary efforts to foster the development and education of children living in poverty require a comprehensive concept of multiple dimensions, within a systemic approach involving ecological and transactional perspectives. Constructing a common interdisciplinary language dealing with child development in ecological terms is a necessary first step toward building networks that can guide us in designing and implementing comprehensive, coherent actions. In this context, studies of how social determinants influence brain development include critical and sensitive growth periods for different neural systems, modulation of brain development by epigenetics mechanisms, influences of environmental toxins, lack of adequate nutrition, and stress and self-regulatory mechanisms. This neuroscientific agenda pioneers these explorations concerning the elemental components that bear on different levels of organization. Ecological considerations about how poverty shapes child neurocognitive development and its biological and social determinants should identify different protective and risk factors—as well as mediation mechanisms—that could help us better understand poverty’s effects and should guide us in designing actions to optimize children’s emotional, cognitive, and learning development.

Regional research priorities in brain and nervous system disorders.

The characteristics of neurological, psychiatric, developmental and substance-use disorders in low- and middle-income countries are unique and the burden that they have will be different from country to country. Many of the differences are explained by the wide variation in population demographics and size, poverty, conflict, culture, land area and quality, and genetics. Neurological, psychiatric, developmental and substance-use disorders that result from, or are worsened by, a lack of adequate nutrition and infectious disease still afflict much of sub-Saharan Africa, although disorders related to increasing longevity, such as stroke, are on the rise. In the Middle East and North Africa, major depressive disorders and post-traumatic stress disorder are a primary concern because of the conflict-ridden environment. Consanguinity is a serious concern that leads to the high prevalence of recessive disorders in the Middle East and North Africa and possibly other regions. The burden of these disorders in Latin American and Asian countries largely surrounds stroke and vascular disease, dementia and lifestyle factors that are influenced by genetics. Although much knowledge has been gained over the past 10 years, the epidemiology of the conditions in low- and middle-income countries still needs more research. Prevention and treatments could be better informed with more longitudinal studies of risk factors. Challenges and opportunities for ameliorating nervous-system disorders can benefit from both local and regional research collaborations. The lack of resources and infrastructure for health-care and related research, both in terms of personnel and equipment, along with the stigma associated with the physical or behavioural manifestations of some disorders have hampered progress in understanding the disease burden and improving brain health. Individual countries, and regions within countries, have specific needs in terms of research priorities.

Study on IC Reactor Treating Straw-Washing Wastewater and Changes of Sludge Bed

In this paper, we utilized IC reactor to treat straw-washing wastewater of straw pulping and papermaking. The removal rate of COD in normal operation is 28.14%, which is much lower than the value of wake-up stage and acclimation stage; gas production rate in the whole normal operation phase kept a lower level, and the average is 12.36L/h; so straw-washing water is not suitable for advanced anaerobic treatment. While COD removal rate is 28.14%, SCOD removal rate is only 6.96%; added the effluent VFA concentration which is 692~1211mg/L is greatly exceed normal control level, we can know that when treating straw-washing water the biological system was under acidification phase of the anaerobic process. Thus the straw-washing water is suitable for hydrolysis-acidification Process. Granular size of seed sludge was 3~5mm, 100 days later it became 1.5~3mm, and 120 days later it was 1~2.5mm mainly, With the acidification occurring, the mass proportion of the granular sludge to total sludge was reduced, the proportions of 2# and 3# sampling ports are decreasing from 70~85% to 30~50%. Because of lack of adequate nutrition and appropriate loading conditions, straw-washing water can’t support the cultivation and maintenance of granular sludge.

Improving Carcass Quality of Indigenous Cattle of West Sumatera Fed Local Feed Resources

Lack of adequate nutrition all year round is one of the major causes of the low productivity of ruminants. An operational policy announced by the Indonesian government to achieve the target to be self sufficient on meat demand 2010 is to develop feed and ration for beef industry based on agricultural and industrial-wastes besides exploiting biodiversity that has not been fully implemented by the farmers. A feeding trial with 12 Pesisir cattle, indigenous cattle of West Sumatera weighed 120-150 kg aged 2-3 yrs old were carried out to investigate the effect of feeding local feed resources on their growth performance and carcass characteristics; dressing percentage, rib eye area, lean and fat percentage. Animals were divided into two equal groups of similar average body weight, assigned to Completely Randomized Design and were individually fed for 90 days. The first group was offered control feed as practiced by farmer and the second group was offered treatment diet based on ammoniated rice straw and chipped cassava. This feeding trial was followed by a slaughter experiment on one animal from each group to study of carcass traits. Cattle receiving a treatment diet performed better (p 0.05) observed between the two groups with regard to Average Total Body Weight Gain (ATG) and Average Daily Body Weight Gain (ADG) 0.20 kg/d to 0.68 kg/d respectively. Dressing percentage was significantly higher in treatment diet (52.59%) than in control diet (50.82%). The rib eye area, lean and fat percentage was significantly higher in treatment diet than in control diet. It was concluded that feeding improved low quality local feed resources could have a positive effects on growth performance and carcass traits of indigenous cattle.

Homelessness and Hiv/Aids in Johannesburg

This paper contends that the peculiar, chronic, itinerant lifestyles and precarious spaces occupied by the homeless enhance their risk and vulnerability to HIV/AIDS. These spaces, including the streets, shacks and cardboard boxes, mine dumps and unorganised shelters, expose them to indecent lifestyles, poor choices and greater risk of HIV, as well as Tuberculosis (TB) and Sexually Transmitted Infections (STIs). This study was conducted amongst street homeless people, shack and hostel dwellers in informal settlements in various locations in Johannesburg. Inferences were drawn from the personal experiences of homeless people, and inputs from individuals and organisations that are engaged and work in the field of homelessness. Types of dwellings, overcrowding, livelihoods, knowledge of HIV/AIDS and survival sex are among the issues examined. Preliminary findings indicate that, firstly, poverty is a leading cause of precarious housing among the homeless. Secondly, behavioural practices, especially survival sex, make homeless people vulnerable to HIV. As a result, there is an increase in mortality rates from both HIV and AIDS amongst this group of people. Thirdly, the difficulties homeless people experience in gaining access to water, sanitation and health care services also compromises the care of those who are infected or affected by HIV/AIDS. Finally, other barriers to care and determinants of vulnerability to HIV/AIDS are the lack of knowledge, judgemental attitudes of the care providers overcrowding and lack of adequate nutrition amongst the homeless.

Neonatal Gastrointestinal Innate Immunity

After completing this article, readers should be able to: 1. Describe the largest surface area of the body that separates the external from the internal environment and the first line of defense that prevents breakdown of this barrier. 2. Delineate the components of the innate immune system. 3. Characterize some of the agents that mediate interplay between the innate and adaptive immune systems. 4. Describe how the integrity of the gastrointestinal innate immune system may relate to specific autoimmune diseases. Evidence is accumulating that the defense mechanisms in the newborn that normally maintain a healthy balance in the intestine (both immune and nonimmune) may be inadequate or at least not functioning at levels observed in adults. Infants, particularly undernourished infants, may be at an increased risk for luminal proliferation of and mucosal invasion by microbial pathogens and intact dietary antigens. The gastrointestinal (GI) tract presents the largest surface area of the body to which antigens and microbes are exposed. The intestine, therefore, must have intricate mechanisms to allow entry of nutrients and other beneficial molecules while preventing potentially harmful microbes and other agents from gaining entry into the inner milieu. Several factors lead to a hostile GI environment that predisposes the preterm infant to disease. These include the introduction of feeding tubes into the stomach or more distal intestine, the routine use of broad-spectrum antibiotics that select for resistant pathogens that thrive in the unusual microbial environment of the neonatal intensive care unit, intrinsic immaturities of the infant GI tract, and the lack of adequate nutrition. Intestinal defenses may be broadly divided into immune and nonimmune categories. The nonimmune system sometimes also is referred to as the innate immune system (Fig. 1). Although there is considerable overlap between the immune and nonimmune systems, this review focuses primarily on the innate arm of the intestinal …