BackgroundBangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government’s post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis.DiscussionA series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action.SummaryIn response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it could be adapted so that women and the poor are actively sought out and provided for. After training, these services could be run by Bangladesh’s pre-existing 50,000-strong Cyclone Preparedness Programme workforce, alongside the country’s extensive network of community-based health workers.

Background: Anemia causes fetal growth disorders that affect birth weight. Antenatal care (ANC) coverage and provision of high Fe if not followed by a decrease in the incidence of anemia can result indirectly in the risk of low birth weight. Supplementary feeding is expected to resolve the issue.Objective: To assess the effect of supplementary feeding on the third trimester of pregnancy on birth weight.Method: This was a quantitative study with a study design of quasi-experiment and non-equivalent control group. The given intervention was fish-processed feeding for 30 days. The study population was pregnant women in the third trimester in all health centers in the City of Yogyakarta and the samples were 104 pregnant women in some health centers with convenience sampling technique. The subjects were divided into two, namely the treatment group (PMT) and the comparison group (non-PMT). Birth weight was weighed immediately after the baby was born. Statistical analysis used t-test and logistic regression. Results: The mean birth weight of infants in the treatment group and the comparison group was 3248 g and 2974 g, respectively, so that the difference in the mean birth weight of both groups was 274 g (p=0.0002; 95%C:131-416). Thus, supplementary feeding was shown significantly affect the birth weight. The extraneous variables that significantly influenced birth weight were pregnancy interval. Other extraneous variables were age, mid-upper-arm circumference (MUAC), education, occupation, economic status, parity, protein intake, compliance of Fe tablet intake, antenatal care, gestational age at delivery and anemia status were not proven statistically significant to affect birth weight. Conclusion: Supplementary feeding effect on birth weight.

Purpose Stunting and being underweight in children are major nutritional problems especially in developing countries. The purpose of this study is to evaluate the effect of egg supplementation on a vitamin and mineral fortification program for growth, cognitive development and hemoglobin in underweight and stunted children. Design/methodology/approach This was an experimental study using a crossover design conducted in Yogyakarta province, Indonesia. A total of 39 subjects were randomly selected from two community health centers and provided with two types of intervention: vitamin and mineral fortification sprinkle (Taburia) and Taburia with egg supplementation (Taburia PLUS). Each intervention was conducted for three months with one-month of washout period in between interventions. Findings There were no changes in weight-for-age Z-score in Taburia and Taburia PLUS (all p > 0.05). The height-for-age Z-score was increased in Taburia PLUS (p = 0.022) but not in Taburia (p > 0.05). Hemoglobin level was significantly increased in Taburia (p = 0.039) but not in Taburia PLUS (p > 0.05). There were no significant changes in visual motoric score in Taburia, but there were slight increases in Taburia PLUS (all p > 0.05). Originality/value The authors concluded that egg supplementation combined with multivitamins and minerals fortification program, Taburia PLUS, is beneficial to improve linear growth but not hemoglobin in stunted and underweight children.

Backgrounds: The immune system changing affects the fitness. Exercise induces the immune responses, oxidative stress and tissue damage that alters leukocyte counts. Maltodextrin supplies higher energy reserves, that can improve the immune system profiles. Vitamin C as an antioxidant against tissue damage.Objective: This study aims to assess the effectiveness of a maltodextrin and vitamin C combination drink on leukocyte differential count after exercise.Method: This study was quasi-experimental with the within-subject design. Subjects were 14 collegiate football players of the State University of Yogyakarta and fulfilled the inclusion and exclusion criteria. Subjects were selected with a purposive sampling. Subjects received a combination of 15% maltodextrin and 250 mg of vitamin C beverage, 300 mL. Subjects did wash out for 6 days, then received placebo beverage (300 mL plain water). Subjects drank 30 minutes before and 5 minutes after physical exercise. Exercise loads were yoyo intermittent test and run gradually until 80 HRmaks. Blood samples were taken immediately and 30 minutes after exercise.Results: In the administration of intervention beverage, immediately to 30 minutes after exercise neutrophils increased (p=0,006); lymphocytes decreased (p=0.015); monocytes decreased (p=0.000); and eosinophils decreased (p=0.613). In the administration of placebo beverage, immediately to 30 minutes after exercise, neutrophils increased (p=0.359); lymphocytes decreased (p=0.257); monocytes decreased (p=0.146); and eosinophils increased (p=0.549). Neutrophils (p=0.003) and monocyte (p=0.003) had significant difference between both administration drink at 30 minutes after exercise. Lymphocyte and monocyte significantly decrease (p<0.05) at intervention than placebo.Conclusion: Maltodextrin and vitamin C combination drink effect on the decreasing of lymphocyte and monocyte 30 minutes after exercise.

Background: Overweight or obesity during childhood and adolescence are important risk factors for the presence of adult overweight or obesity. Eating habits in childhood and adolescence influence their healthy condition. Prospective studies of breakfast habits and nutritional status suggest an inverse (protective) association between the frequency of eating breakfast and the risk for overweight and obesity and relationships between no breakfast and increasing body weight.Objective: To examine risk factor of breakfast and snacking related to overweight status in adolescents.Method: This was the observational study with case control design. The first step of the study was screening to have a prevalence of overweight in adolescents. The second step was case control study participated by 100 overweight adolescents and 100 normal weight adolescents in senior high school matched in sex, age, and school. Data collected were weight and height measurements for nutritional status, respondent identity and characteristic, breakfast dan snacking habits and physical activity. Statistical analysis used Chi-Square statistics and multivariable logistic regression analysis.Results: Prevalence of overweight in adolescents were 16,8%. There was significant association between breakfast with overweight (p<0,05; OR=3.1; 95% CI=1.4-7.47). There was no association between snacking and overweight, but there was significant association between frequency of snacking (OR=1.9; 95% CI=1.05-3.50), the energy of snacking (OR=2.1; 95% CI=1.13-4.02), and carbohydrate of snacking (OR=4.5; 95% CI=1.94-11.50) with overweight. In the multivariate model, breakfast habits, carbohydrate of snacking and physical activity had a significant association with overweight.Conclusion: Skipping breakfast was a risk factor for overweight in adolescence. Adolescents who had to snack more than twice a day were having the greater risk factor for overweight.