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Zotor F.B.,University of Health and Allied Sciences | Ellahi B.,University of Chester | Amuna P.,University of Greenwich | Amuna P.,Primary Health Care Corporation
Proceedings of the Nutrition Society | Year: 2015

Despite a rich and diverse ecosystem, and biodiversity, worldwide, more than 2 billion people suffer from micronutrient malnutrition or hidden hunger. Of major concern are a degradation of our ecosystems and agricultural systems which are thought to be unsustainable thereby posing a challenge for the future food and nutrition security. Despite these challenges, nutrition security and ensuring well balanced diets depend on sound knowledge and appropriate food choices in a complex world of plenty and want. We have previously reported on how the food multimix (FMM) concept, a food-based and dietary diversification approach can be applied to meet energy and micronutrient needs of vulnerable groups through an empirical process. Our objective in this paper is to examine how the concept can be applied to improve nutrition in a sustainable way in otherwise poor and hard-to-reach communities. We have reviewed over 100 FMM food recipes formulated from combinations of commonly consumed traditional candidate food ingredients; on average five per recipe, and packaged as per 100 g powders from different countries including Ghana, Kenya, Botswana, Zimbabawe and Southern Africa, India, Mexico, Malaysia and the UK; and for different age groups and conditions such as older infants and young children, pregnant women, HIV patients, diabetes and for nutrition rehabilitation. Candidate foods were examined for their nutrient strengths and nutrient content and nutrient density of recipes per 100 g were compared with reference nutrient intakes for the different population groups. We report on the nutrient profiles from our analysis of the pooled and age-matched data as well as sensory analysis and conclude that locally produced FMM foods can complement local diets and contribute significantly to meet nutrient needs among vulnerable groups in food-insecure environments. © The Authors 2015. Source

Donnelly T.T.,University of Calgary | Donnelly T.T.,Qatar University | Al Khater A.-H.,Hamad Medical Corporation | Al-Bader S.B.,Hamad Medical Corporation | And 6 more authors.
BMC Women's Health | Year: 2013

Background: Despite rising breast cancer incidence and mortality rates, breast cancer screening (BCS) rates among women in Qatar remain low. Previous studies indicate the need to better understand the many complex beliefs, values, and attitudes that influence Arab women's health seeking behavior for the development of culturally appropriate and effective intervention strategies to address breast cancer in the Middle East. This study investigates beliefs, attitudes, and BCS practices of Arabic-speaking women in Qatar. Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) Arabic-speaking female Qatari citizens and non-Qatari residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Associations between beliefs and BCS practice were estimated using chi-square tests and multivariate logistic regression analyses. Participants who adhered to BCS guidelines (BCS practice = Yes) were compared to those who did not (BCS practice = No). Results: In addition to low levels of awareness and low participation rates in BCS, one quarter of the participants stated their doctors talked to them about breast cancer, and less than half of the women interviewed believed breast cancer can be prevented. Women who engaged in BCS practice were more likely to have a doctor who talked to them about breast cancer, to believe they were in good-excellent health, that cancer can be prevented, or that cancer might be hereditary. The majority wanted to know if they had cancer and felt their health care needs were being met. The main reasons given for not planning BCS were lack of a doctor's recommendation, fear, and embarrassment. Conclusions: These findings indicate that a variety of channels (health care providers, media, breast cancer survivors, community leaders) should be utilized to create culturally appropriate breast cancer intervention programs and increased awareness of breast cancer, BCS, and the benefits of early detection of breast cancer. Employment of these measures will reduce breast cancer mortality rates among Arabic-speaking women living in the State of Qatar. © 2013 Donnelly et al.; licensee BioMed Central Ltd. Source

McClellan M.,Value Innovation | Kent J.,Boston Consulting Groups London office | Beales S.J.,Imperial College London | Cohen S.I.,University of Cambridge | And 4 more authors.
Health Affairs | Year: 2014

Accountable care-a way to align health care payments with patient-focused reform goals-is currently being pursued in the United States, but its principles are also being applied in many other countries. In this article we review experiences with such reforms to offer a globally applicable definition of an accountable care system and propose a conceptual framework for characterizing and assessing accountable care reforms. The framework consists of five components: population, outcomes, metrics and learning, payments and incentives, and coordinated delivery. We describe how the framework applies to accountable care reforms that are already being implemented in Spain and Singapore. We also describe how it can be used to map progress through increasingly sophisticated levels of reforms. We recommend that policy makers pursuing accountable care reforms emphasize the following steps: highlight population health and wellness instead of just treating illness; pay for outcomes instead of activities; create a more favorable environment for collaboration and coordinated care; and promote interoperable data systems. © 2014 by Project HOPE - The People-to-People Health Foundation, Inc. Source

Naja F.,American University of Beirut | Nasreddine L.,American University of Beirut | Al Thani A.A.,Supreme Council of Health | Yunis K.,American University of Beirut | And 12 more authors.
BMC Pregnancy and Childbirth | Year: 2016

Background: The Middle East and North Africa region harbors significant proportions of stunting and wasting coupled with surging rates of non-communicable diseases (NCDs). Recent evidence identified nutrition during the first 1000 days of life as a common denominator not only for optimal growth but also for curbing the risk of NCDs later in life. The main objective of this manuscript is to describe the protocol of the first cohort in the region to investigate the association of nutrition imbalances early in life with birth outcomes, growth patterns, as well as early determinants of non-communicable diseases. More specifically the cohort aims to1) examine the effects of maternal and early child nutrition and lifestyle characteristics on birth outcomes and growth patterns and 2) develop evidence-based nutrition and lifestyle guidelines for pregnant women and young children. Methods/design: A multidisciplinary team of researchers was established from governmental and private academic and health sectors in Lebanon and Qatar to launch the Mother and Infant Nutritional Assessment 3-year cohort study. Pregnant women (n = 250 from Beirut, n = 250 from Doha) in their first trimester are recruited from healthcare centers in Beirut, Lebanon and Doha, Qatar. Participants are interviewed three times during pregnancy (once every trimester) and seven times at and after delivery (when the child is 4, 6, 9, 12, 18, and 24 months old). Delivery and birth data is obtained from hospital records. Data collection includes maternal socio-demographic and lifestyle characteristics, dietary intake, anthropometric measurements, and household food security data. For biochemical assessment of various indicators of nutritional status, a blood sample is obtained from women during their first trimester. Breastfeeding and complementary feeding practices, dietary intake, as well as anthropometric measurements of children are also examined. The Delphi technique will be used for the development of the nutrition and lifestyle guidelines. Discussion: The Mother and Infant Nutritional Assessment study protocol provides a model for collaborations between countries of different socio-economic levels within the same region to improve research efficiency in the field of early nutrition thus potentially leading to healthier pregnancies, mothers, infants, and children. © 2016 Naja et al. Source

Al-Kohji S.,Health Care Service Corporation | Said H.A.,Primary Health Care Corporation | Selim N.A.,Primary Health Care Corporation
Saudi Medical Journal | Year: 2012

Objectives: To assess the breastfeeding practices of Arab mothers by measuring breastfeeding indicators, and to identify the related determinants that affect maternal practices in Qatar. Methods: Using interview administered questionnaires, we carried out this cross-sectional study with cluster sampling of 770 Arab mothers of children below 24 months of age attending primary health care centers in Qatar from June to October 2009. Results: Early initiation of breastfeeding was found in 57%, exclusive breastfeeding under 6 months in 18.9%, and continued breastfeeding at one year in 49.9% of mothers. Children ever breastfed comprised 97.9%, continued breastfeeding at 2 years old comprised 45.4%, and predominant breastfeeding 11.9%. The proportion of children who were appropriately breastfed was 29%. The 'rooming in' rate was 43.9%. Receiving breast milk substitutes, exposure to advertisements for artificial teats, and employment status showed a significant relation with both early initiation and exclusive breastfeeding. On demand feeding was related to exclusive breastfeeding, and 'rooming in' and mode of delivery was related to early initiation. Conclusion: Breastfeeding practice among Arab mothers in Qatar is not at an acceptable level. Core indicators, optional indicators, and health facility indicators for breastfeeding practice are not at the desired World Health Organization recommended levels. Source

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