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PubMed1987

Famine in Ethiopia 1983-1985: kwashiorkor and marasmus in four regions.

Parts of southern Ethiopia were form 1983 to 1985 affected by drought and famine. This study describes the prevalence of marasmus and kwashiorkor in four drought-affected regions: Bale, Sidamo, Gamu Gofa and southern Shoa. An analysis of 37,511 children in the 1-5 year age group representing 212 communities has been performed. The study demonstrates that both marasmus and kwashiorkor are facets of drought. The epidemiologies of kwashiorkor and marasmus differ: marasmus is the most common form of acute malnutrition in all areas, while kwashiorkor is found in a limited number of communities only. These latter communities have a subsistence farming economy, most often in ensete-growing areas. In the lowland semi-arid regions, which have an agro-pastoralist economy, kwashiorkor is virtually absent. These epidemiological findings are discussed in relation to different theories of the aetiology and pathogenesis of kwashiorkor.

Body Height↗
PubMedDate not supplied

The Irish Famine and its sequel: population structure changes in the Ards Peninsula, Co. Down, 1841-1911.

Using censal data, the population structure of the Ards Peninsula, Co. Down was investigated from 1841 to 1911. During the study period there were highly significant declines at townland level in the mean total population, population density, number and proportion of inhabited houses, household size and deviations in the male/female ratio. The potential genetic effects of the changes, mediated via reduced effective population sizes, were exacerbated by marked differences in the patterns of population structure variation by religion. It is suggested that the current high incidence of recessive genetic disorders in the Northern Irish can be ascribed, at least in part, to these post-Famine events.

Female↗
PubMed2005

Metabolic flux analysis of Escherichia coli in glucose-limited continuous culture. II. Dynamic response to famine and feast, activation of the methylglyoxal pathway and oscillatory behaviour.

The metabolic dynamics of the Escherichia coli K-12 strain TG1 to feast and famine were studied in glucose-limited steady-state cultures by up- and downshifts of the dilution rate, respectively. An uncoupling of anabolic and catabolic rates was observed upon dilution rate upshifts, apparent through immediately increased glucose uptake rates which were not accompanied by an immediate increase of the growth rate but instead resulted in the temporary excretion of methylglyoxal, D- and L-lactate, pyruvate and, after a delay, acetate. The energetic state of the cell during the transient was followed by measuring the adenylate energy charge, which increased within 2 min after the upshift and declined thereafter until a new steady-state level was reached. In the downshift experiment, the adenylate energy charge behaved inversely; no by-products were formed, indicating a tight coupling of anabolism and catabolism. Both dilution rate shifts were accompanied by an instantaneous increase of cAMP, presaging the subsequent changes in metabolic pathway utilization. Intracellular key metabolites of the Embden-Meyerhof-Parnas (EMP) pathway were measured to evaluate the metabolic perturbation during the upshift. Fructose 1,6-diphosphate (FDP) and dihydroxyacetone phosphate (DHAP) increased rapidly after the upshift, while glyceraldehyde 3-phosphate decreased. It is concluded that this imbalance at the branch-point of FDP induces the methylglyoxal (MG) pathway, a low-energy-yielding bypass of the lower EMP pathway, through the increasing level of DHAP. MG pathway activation after the upshift was simulated by restricting anabolic rates using a stoichiometry-based metabolic model. The metabolic model predicted that low-energy-yielding catabolic pathways are utilized preferentially in the transient after the upshift. Upon severe dilution rate upshifts, an oscillatory behaviour occurred, apparent through long-term oscillations of respiratory activity, which started when the cytotoxic compound MG reached a threshold concentration of 1.5 mg l(-1) in the medium.

Bacterial Proteins↗
PubMed2005

Modernizing UK health services: 'short-sharp-shock' reform, the NHS subsistence economy, and the spectre of health care famine.

Modernization is the trend for societies to grow functionally more complex, efficient and productive. Modernization usually occurs by increased specialization of function (e.g. division of labour, such as the proliferation of specialists in medicine), combined with increased organization in order to co-ordinate the numerous specialized functions (e.g. the increased size of hospitals and specialist teams, including the management of these large groups). There have been many attempts to modernize the National Health Service (NHS) over recent decades, but it seems that none have significantly enhanced either the efficiency or output of the health care system. The reason may be that reforms have been applied as a 'drip-drip' of central regulation, with the consequence that health care has become increasingly dominated by the political system. In contrast, a 'short-sharp-shock' of radical and rapid modernization seems to be a more successful strategy for reforming social systems - in-between waves of structural change the system is left to re-orientate towards its client group. An example was the Flexner-initiated reform of US medical education which resulted in the closure of nearly half the medical colleges, an immediate enhancement in quality and efficiency of the system and future growth based on best institutional practices. However, short-sharp-shock reforms would probably initiate an NHS 'health care famine' with acute shortages and a health care crisis, because the NHS constitutes a 'subsistence economy' without any significant surplus of health services. The UK health care system must grow to generate a surplus before it can adequately be modernized. Efficient and rapid growth in health services could most easily be generated by stimulating provision outside the NHS, using mainly staff trained abroad and needs-subsidized 'item-of-service'-type payment schemes. Once there is a surplus of critically vital health services (e.g. acute and emergency provision), then radical modernization should rapidly improve the health service by a cull of low-quality and inefficient health care providers.

Efficiency, Organizational↗
PubMed1994

Development of a computer workstation for famine early warning and food security.

Beginning in 1990, the University of Arizona, Arizona Remote Sensing Center (ARSC) has been involved in a collaborative effort with the Global Information and Early Warning System (GIEWS) and the Remote Sensing Center of the Food and Agriculture Organization (FAO) of the United Nations in designing and developing an integrated computer workstation for famine early warning. The goal of the project is to provide food security analysts with a set of computer tools to manage a very large and diverse set of data for predicting the onset of food security emergencies for every country on Earth. The initial stage of the project involved the conceptual definition of system elements and the development of overall system architecture. We are now developing an open, flexible, and portable system designed to significantly assist the work of the analysts. System architecture provides a task-specific and user-friendly graphic user interface (GUI) within a Windows environment that will link image processing, geographic information system (GIS), spreadsheet, text, and graphics software packages into a single operational environment. A relational database management system (RDBMS) is serving as the back-end of the workstation to facilitate data storage and retrieval and as a means to preserve analysis methodologies.

Computer Systems↗
PubMed1994

Timing in prenatal nutrition: a reprise of the Dutch Famine Study.

The array of results discussed in this paper is assembled by stage of gestation in the following table (Table 1). We must allow some uncertainty for some outcomes as to the precise stages of gestation in which they originate. For instance, with obesity, the effects of famine exposure may extend beyond the first trimester into the second. Yet, the table is perhaps sufficient in itself to support the point with which the paper opened, namely, that stage of development is crucial to the appreciation of the effects of prenatal nutrition.

Animals↗
PubMed1990

Diarrhoea of famine and malnutrition: investigations using a rat model. 1. Jejunal hypersecretion induced by starvation.

The effects of progressive starvation for up to three days on the secretory functions of the intestine were investigated using in vitro and in vivo preparations of rat jejunum and secretagogues whose action was either through cyclic AMP or Ca++. Initial starvation for 24 h (day 1) did not significantly alter the basal net electrogenic ion secretion measured in vitro as the short circuit current (Isc, muamps/cm2) or the change in electrogenic ion secretion (delta Isc) induced by the secretagogues. By day 2 of starvation, however, the maximum delta Isc transient induced by the cholinergic and other secretagogues (delta Isc = Isc max-basal Isc) was greatly increased (up to a maximum of 117%) compared with the fed controls on an area basis. The delta Isc were even greater on day 3 of starvation. If a tissue weight basis was used to normalise the data the increase became even more marked. The enhancement in secretion was not caused by a decrease in absorptive capacity as glucose, added mucosally, gave larger increases in absorptive currents in the starved than in the fed jejuna. Bethanecol dose-delta Isc response curves in fed and starved jejuna showed an increase in the maximum electrogenic secretion in the starved but no apparent change in the affinity of their cholinergic receptors mediating the enhanced secretion. The starvation-induced increase in secretion elicited by bethanecol was blocked by atropine, indicating that the receptors were muscarinic, but was unaffected by tetrodotoxin indicating that the enteric neural innervation was not essential for its expression. Noradrenaline released by tyramine was greater in the starved than the fed jejunum, suggesting that a decreased sympathetic tone was unlikely to be the major cause of the starvation induced secretory enhancement. Measurement of jejunal fluid movements in vivo showed that in fed controls and throughout the three days of starvation there was an unchanged net fluid absorption in the basal, unstimulated state. By day 2 and day 3 of starvation, however, bethanecol stimulated fluid secretion was very much greater than that of the fed controls. This increase in fluid secretion was concomitant with significant increases in the concentration of chloride in the lumenal fluid. Starvation thus appears to make the rat jejunum hypersensitive to cholinergic and other secretagogues, increasing the electrogenic secretion of chloride in vitro and that of chloride and fluid in vivo. These results obtained with the rat model give a new insight into possible mechanisms by which the diarrhoea of human famine and malnutrition may be expressed.

Animals↗
PubMed2003

Nursing shortage or nursing famine: looking beyond numbers?

There are numerous references in the nursing literature and in the popular press that offer description and commentary on the history, evolution, and future of the global nursing shortage. Authors express concerns about declining nursing numbers, nursing layoffs, diminishing student enrollments, faculty retirements, the aging workforce, and global recruitments. But what is missing in these articles and news alerts is a questioning about the substantive knowledge of nursing and what role this knowledge, or lack of, has in light of shrinking nursing resources. Of interest in this column are the meanings and messages that the nursing shortage has for nurses and for decision makers who will shape the direction of the nursing discipline. Issues connected with the global nursing shortage, or is it better thought of as a famine, are examined here in order to elucidate some points that may prove helpful for decisions of tomorrow.

Forecasting↗
PubMed1975

The Dutch famine, 1944-1945, and the reproductive process. II. Interrelations of caloric rations and six indices at birth.

Effects of maternal exposure to famine during the prenatal period were compared among six indices of reproduction by the use of Z scores. Maternal weight was affected soonest, then birthweight and placental weight. Length and head size at birth were affected relatively less and only after exposure to more severe nutritional deprivation. Path models were constructed of the interrelations of caloric rations, length of gestation, maternal weight, and fetal dimensions. Above a threshold value of 1,5000 Cal dialy average official food rations available to mothers in the third trimester, a model in whichthe placenta is treated as a fetal dimension (or organ) seemed most appropriate. Below the threshold value, a model in which the placenta is treated as a transmitter of nutrients seemed most appropirate.

Birth Weight↗
PubMed2005

Famine, social disruption, and involuntary fetal loss: evidence from Chinese survey data.

Relying on half a million pregnancy histories collected from Chinese women in the late 1980s, we studied nearly a quarter century of self-reported miscarriages and stillbirths in China. Our results suggest that these two forms of involuntary fetal loss are affected not only by biological and demographic factors, such as the mother's age, pregnancy order, and pregnancy history, but also by the mother's social characteristics and the larger social environment. In this article, we focus on how two social and economic crises--the Great Leap Forward famine and the Cultural Revolution--resulted in elevated risks of miscarriage and stillbirth in the Chinese population.

Abortion, Spontaneous↗
PubMed1997

Using multi-media to enhance history education: Glasgow, A Tale of Two Cities? and Tiree, Famine and Clearance 1840-1900.

Advances in information technology raise issues central to history education. Debates have focused on how pupils learn history by emphasising the development of critical thinking which in turn provides the basis of a theoretical framework for the use of IT in history. Martyn Wild identifies seven areas of teaching and learning enhanced through IT ranging from child-centered learning to pedagogy. James Schick argues that appropriate software brings out the absorbing, fascinating and enjoyable nature of history. This article discusses how multi-media computer programs, Glasgow, A Tale of Two Cities? and Tiree, Famine and Clearance 1840-1900 enhance the delivery of history in Scottish Primary and Secondary Schools within the criteria established by Martyn Wild. These programs relate to recent curricular changes in Scotland and help satisfy current demands for more Scottish history within overall history syllabuses. Moreover, it will be argued that appropriate software motivates pupils and enhances the central role of the classroom teacher.

Computer-Assisted Instruction↗
PubMed2003

Short report: assessing field vaccine efficacy for measles in famine-affected rural Ethiopia.

Measles is a major cause of mortality in complex emergencies. Both high vaccination coverage and vaccine efficacy are required to prevent major epidemics of measles in such situations. Evaluation of field vaccine efficacy is a critical but underutilized component of program monitoring in emergencies, and is particularly important in rural areas where the integrity of the cold chain is difficult to guarantee. In July 2000, we evaluated the field vaccine efficacy for measles vaccination by comparing the incidence of cases in vaccinated and unvaccinated groups during a two-stage cluster survey of 563 children in Ethiopia. Approximately 30% of the measles cases occurred in vaccinated children. Estimated field vaccine efficacy for measles was 66.9% in children 9-36 months old. The finding of a field vaccine efficacy for measles less than 80% warrants formal assessment of measles vaccine efficacy, particularly in famine emergencies where measles is associated with a high case fatality rate.

Age Factors↗
PubMed1995

Doctors in the Great Famine, 1845-1850.

The medical services, like most others in Ireland, were swamped by the massive demands of the Great Famine and its accompanying disruptions, diseases and epidemics. They were not, however, 'drowned', due largely to the fortitude of the individual doctors, the remarkable robustness of many of the medical institutions, and the vigorous if often unpopular steps taken by the central board of health whose most assiduous member was Dominic John Corrigan. There was a heavy price, mortality amongst doctors was very high (in 1847 alone, at least 123 died of 'fever' contracted in the course of duty), and a basic reform--most of the 'medical charities' came to be permanently administered through the Poor Law machinery.

Disasters↗
PubMed1990

Famine in southern Ethiopia 1985-1986. Malnutrition, diarrhoea and death.

During the 1985-86 famine children from two areas in Southern Ethiopia were studied to assess a possible association between malnutrition and diarrhoeal disease. Malnutrition did not increase the incidence of diarrhoeal disease. However, malnourished children were more severely affected by the infection. Nutritional rehabilitation reduced the demand for treatment of diarrhoea and probably contributed to a decrease in crude childhood mortality.

Child, Preschool↗
PubMed1997

Dispensaries in counties Armagh and Down in the pre-Famine years.

This paper traces the development of dispensaries in the counties of Armagh and Down in the decades prior to the Great Famine. It examines the number and distribution of dispensaries and discusses their management, finance and daily administration. The role of dispensary doctors, their conditions of employment and the diseases which they treated are also considered.

History, 19th Century↗