Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2017-07-06T13:31:56Z No. of bitstreams: 1 arquivototal.pdf: 3483112 bytes, checksum: 875c98f02b865d33871e8bf6439b7afc (MD5) / Made available in DSpace on 2017-07-06T13:31:56Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 3483112 bytes, checksum: 875c98f02b865d33871e8bf6439b7afc (MD5) Previous issue date: 2016-11-29 / A significant number of people are living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (Aids) in the world, currently. With the increased survival rate provided by antiretroviral therapy, HIV-infected people now have concerns about their quality of life (QOL). Food insecurity corroborates with the socio-economic impacts arising from the disease while the HIV infection tends to aggravate the situation of food insecurity by the fact that it reduces work capacity and productivity of affected individuals. Nutrition intervention studies have demonstrated that the nutritional assistance promotes good responses to treatment and improves quality of life of people with HIV. In this context, the present thesis has as main objective to meet the conditions of life and health of people living with HIV and Aids (PLWHA) in the light of the situation of food insecurity, quality of life and nutritional status. This is a cross-sectional analytic study, involving 481 PLWHA answered in a reference service of the State of Paraiba-Brazil, held between the months of September and December 2015. Food insecurity was assessed using the Brazilian range of food insecurity and the quality of life was measured using the WHOQOL-Bref HIV. The association between food insecurity and socio-demographic, economic and health characteristics was evaluated by the Chi-square test. To assess quality of life scores in relation to the characteristics mentioned, we used nonparametric tests: Kruskal Wallis and Mann Whitney. In order to evaluate the associations between quality of life and food insecurity, the variables that showed significant differences to the quality of life were included in the multiple regression model of Poisson. A decision tree model was generated for the purpose of classifying the self-evaluation of the quality of life. The results show that in addition to the fragility that resulted from infection with HIV, people living with HIV/Aids demonstrate other types of vulnerability: average age above 30 years, significant number of women, low economic condition, low education level, high number of people employed or receiving pensions and aid. The prevalence of food insecurity found was considered high, 62.8%. The average scores of all domains of quality of life, were considered good. The lowest average scores were found in the environmental domain, followed by the domain level of independence and the largest in the field, in the physical domain of spirituality and psychology. Lower average scores in the areas were observed among women, individuals with lower per capita income, low education, without occupation and inactive. Food insecurity increases the prevalence of a worse quality of life in the areas: physical (19%), level of independence (20%), environment (23%) and on assessment of QOL (20%). PLWHA in food insecurity, regardless of the seriousness of the same average scores that are lower than those on food safety in all areas of quality of life, there was a significant difference (p < 0.01). Correlation exists between all domains of quality of life and food insecurity. The decision tree model generated contributes to the association between food insecurity and the quality of life. On the subjectivity and multidimensionality of quality of life, the findings of this study are relevant, contribute to filling existing gaps in the literature on the subject and need to be considered in order to promote a positive cycle of combat against HIV/Aids. / Um número expressivo de pessoas vive com o vírus da imunodeficiência humana (HIV) e com a síndrome da imunodeficiência adquirida (Aids) no mundo, atualmente. Com o aumento da sobrevida proporcionado pela terapia antirretroviral, as pessoas infectadas pelo HIV passaram a ter preocupações com a sua qualidade de vida (QV). A insegurança alimentar corrobora com os impactos socioeconômicos advindos da doença enquanto que a infecção pelo HIV tende a agravar a situação de insegurança alimentar pelo fato de reduzir a capacidade de trabalho e a produtividade dos indivíduos afetados. Estudos de intervenção nutricional têm demonstrado que a assistência nutricional promove boas respostas ao tratamento e melhora a qualidade de vida dos portadores HIV. Nesse contexto, a presente tese tem como objetivo principal conhecer as condições de vida e saúde de pessoas vivendo com HIV e Aids (PVHA) em função da situação de insegurança alimentar, qualidade de vida e estado nutricional. Trata-se de um estudo analítico de corte transversal, envolvendo 481 PVHA atendidas em serviço de referência do Estado da Paraíba - Brasil, realizado entre os meses de setembro e dezembro de 2015. A insegurança alimentar foi avaliada utilizando a escala brasileira de insegurança alimentar e a qualide de vida foi medida utilizando o WHOQOL-HIV Bref. A associação entre a insegurança alimentar e as características sócio demográficas, econômicas e de saúde foi avaliada através do teste qui-quadrado. Para avaliar os escores de qualidade de vida em relação às características citadas, foram utilizados os testes não paramétricos de Kruskal Wallis e Mann Whitney. Com o objetivo de avaliar as associações entre a qualidade de vida e a insegurança alimentar, as variáveis que apresentaram diferenças significativas com a qualidade de vida foram incluídas no modelo de regressão múltipla de Poisson. Um modelo de árvore de decisão foi gerado com o propósito de classificar a auto avaliação da qualidade de vida. Os resultados demonstram que além da fragilidade advinda pela infecção com o HIV, pessoas vivendo com HIV/Aids demonstram outros tipos de vulnerabilidade: faixa etária média acima dos 30 anos, número expressivo de mulheres, baixa condição econômica, baixo nível de escolaridade, número elevado de pessoas sem ocupação ou recebendo aposentadorias e auxílios. A prevalênciade insegurança alimentar encontrada foi considerada alta, 62,8%. Os escores médios de todos os domínios de qualidade de vida, foram considerados bons. Os menores escores médios foram encontrados no domínio ambiental, seguido do domínio nível de independência e os maiores, no domínio espiritualidade, no domínio fisico e psicológico. Menores escores médios nos domínios foram observados entre as mulheres, nos indivíduos com menor renda per capita, baixa escolaridade, sem ocupação e inativos. A insegurança alimentar aumenta a prevalência de uma pior qualidade de vida nos domínios: físico (19%), nível de independência (20%), meio ambiente (23%) e na auto avaliação da QV (20%). PVHA em insegurança alimentar, independentemente da gravidade da mesma, apresentam escores médios menores do que aqueles em segurança alimentar em todos os domínios da qualidade de vida, houve diferença significativa (p < 0,01). Existe correlação entre todos os domínios da qualidade de vida e a insegurança alimentar. O modelo de árvore de decisão gerado contribui para a associação entre a insegurança alimentar e a qualidade de vida. Diante da subjetividade e multidimensionalidade da qualidade de vida, os achados do presente estudo são relevantes, contribuem para o preenchimento de lacunas existentes na literatura acerca do tema e precisam ser considerados no sentido de promover um ciclo positivo de enfrentamento do HIV/Aids.

abstract: BACKGROUND: The purpose of this study was to gain a better understanding of what food insecurity among college students. Qualitative research regarding food insecurity on college campuses has been growing as we gain a better understanding of how prevalent this issue is and its broad impact on students. However, to our knowledge there are only a handful of studies that examined the student and university staff experience using mixed methods. Qualitative data is needed to gain a deeper understanding of the student experience. OBJECTIVE: To gain deeper insights about students’ food insecurity experiences from students themselves and the university staff members who work with them. This insight is necessary to shift university’s current policies and approach to helping students experiencing food insecurity and removing the stigma of the “starving student” experience. METHODS: Surveys and interviews were used to collect data from students to gain an understanding of their current living situations and understand their personal experiences accessing food. University staff completed surveys focused on understanding staff’s experiences with student food insecurity as well as their attitudes and beliefs about students who experience hunger. RESULTS: The current study found that the financial burden of attending college along with student’s food literacy level can contribute to student’s food insecurity. Students identified barriers to food access, discussed their perceptions of their food experience, and also discussed who they lean on for support when struggling with food. Student’s previous life experiences, food literacy, and social support systems all impact the student food experience. University staff identified similar barriers that they perceive students experience when struggling with hunger and also indicated that they have received little to no training or instruction on how to support students experiencing food insecurity. CONCLUSION: These findings can be used as a building block for developing interventions and the implementation of new resources to help minimize food insecurity on college campuses. / Dissertation/Thesis / Masters Thesis Nutrition 2018

Para a mensuração da insegurança alimentar freqüentemente são feitas estimativas a partir da definição de linhas de pobreza ou indigência, associando o grau de carência alimentar ao nível de rendimentos do domicílio, intuindo que famílias pobres (baixa renda) vivam em condição de insegurança alimentar. Entretanto, é possível encontrar unidades domiciliares com rendimentos situados abaixo da linha de pobreza e que vivem em segurança alimentar, do mesmo modo que existem aquelas com rendimentos acima do corte da pobreza que passa por restrição alimentar quantitativa. O exercício teórico desenvolvido por Amartya Sen, abrange uma série de conceitos que permitem a análise de realidades sociais, como a insegurança alimentar no Rio Grande do Sul, de maneira multidimensional, incorporando variáveis quantitativas e indo além delas. Um desses conceitos que pode auxiliar na compreensão das dificuldades de acesso digno a alimentos adequados, quantitativamente e qualitativamente, é a noção de intitulamento (entitlement), termo que foi originalmente desenvolvido por Sen para tratar do problema da fome na Ásia e na África. Através da abordagem das capacitações, o objetivo deste trabalho é analisar os intitulamentos que se relacionam com a insegurança alimentar no Rio Grande do Sul, e avaliar os impactos dessa situação para a expansão das capacitações das famílias rurais gaúchas. Os resultados da análise realizada, através do Coeficiente de Contingência, Teste Qui-Quadrado e do modelo de regressão Probit, que permitiram diferenciar e tecer comentários entre os espaços rural e urbano do Rio Grande do Sul, evidenciam a necessidade de um tratamento multidimensional para a caracterização das situações de insegurança alimentar no estado gaúcho, sugerindo a inclusão de novas percepções que permitam melhor caracterizar as dificuldades de acesso à alimentação adequada, propondo uma alternativa à perspectiva tradicional. / Frequently, estimates to measure food insecurity are made based on the definition of poverty lines or indigence, associating the degree of lack of food considering the household productivity, and having in mind that poor families (low income) live in a condition of nutrition insecurity. However, it is possible to find household units with income considered below the poverty line and that live in a nutritional stability, as well as those ones with income above poverty line that have quantitative food restriction. The theoretical exercise developed by Amartya Sen encloses a series of concepts which allows the analysis of social reality, like food insecurity in Rio Grande do Sul, in a multidimensional way, including quantitative analysis and venturing beyond them. One of these concepts which can help the understanding of those difficulties of reaching dignified access to adequate nutritional levels, quantitatively and qualitatively, is the notion of entitlements, terminology which was originally developed by Sen to deal with the problem of hunger in Asia and Africa. By means of the capability approach, the objective of this work is to analyze the entitlements which are intertwined with food insecurity in Rio Grande do Sul, and evaluate the impacts of this situation to expand the condition of rural families in the state of Rio Grande do Sul. The results of this analysis which was performed through contingency coefficient, chi-square tests and a probit regression model, which allow to differentiate between rural and urban spaces in Rio Grande do Sul, show clearly the necessity of a multidimensional treatment in the Gaucho State, suggesting an inclusion of new concepts which allow better characterize the difficulties of access to adequate alimentation, proposing an alternative to traditional perspective.

Magister Artium (Development Studies) - MA(DVS) / With changes in climatic conditions being increasingly noticed around the world in the past 2 decades, drought has been identified as one of the main causes of food insecurity. Given the inseparable nature of food security and poverty, it has been impossible for Africa to attain the poverty reduction Millennium Development Goal as most of the continent still suffers food insecurity. Impacts of the drought described as one of the worst droughts which occurred in West an East Africa between 2009-2011, are still felt in some parts of Kenya, Ethiopia, Somalia, Djibouti and parts of Northern Tanzania close to Kenya. With almost 70% of sub- Saharan Africa’s population involved in agriculture, the occurrence of drought not only causes failure in food production but also negatively impacts food security and increases poverty. Understanding the impacts of drought on household food security is important for reducing household’s risk of poverty. Following this the study proposes policies for reducing the impact of drought on food security and other policies that can ensure complete eradication of food insecurity.

Gestational weight gain outside the recommended ranges puts women at risk for pregnancy complications and adverse birth outcomes. Food insecurity and environmental factors including neighborhood deprivation may influence gestational weight gain. This research 1) examines the impact of neighborhood deprivation on gestational weight gain, 2) identifies if the association varies by selected maternal characteristics, 3) examines the relationship between food insecurity and gestational weight gain, 4) determines if stress mediates the relationship between food insecurity and gestational weight gain, and 5) examines whether selected maternal characteristics mediate this relationship. The research was conducted through the analysis of the Pregnancy Risk Assessment Monitoring System, the American Community Survey and Florida Vital Statistics. Bivariate analyses, logistic regression and multilevel logistic regression were conducted to examine the associations. Results indicate that neighborhood deprivation and food insecurity are important risk factors for gestational weight gain that vary by stress and maternal characteristics.

This study aims to test the performance of agricultural markets in the Democratic Republic of Congo (DRC). Although the DRC is classified as the fifth biggest producer of cassava, nearly 70 percent of its population living mainly in urban areas is suffering from food shortages. Since the markets are poorly integrated, food prices are very volatile. Small agricultural producers obtain low prices for their products, while vulnerable household’s consumers experience high prices. Over the last few years, the price of cassava has increased considerably, from US$ 72 per ton in 2007 to US$ 123 per ton in 2009. This dramatic increase in the price of a basic foodstuff has significantly affected poor people in both urban and rural areas. The increase in cassava market prices and the food insecurity level in DRC are an indication that markets have not efficiently performed their fundamental role of connecting producers and consumers. Therefore, understanding the status of value chain development and the degree of market integration is important to improve food security, as well as people’s livelihood in rural areas. Several techniques were identified in the literature for testing agricultural market performance, including: market integration, parity bound analysis, causality, symmetry, error correction mechanisms and value chain analysis. Some studies used mathematical models including deterministic analytical models and stochastic analytical models. For the purpose of this study and because of data limitations, value chain analysis and market integration techniques were applied. The value chain analysis was performed to identify critical issues and constraints that undermine value chain development, as well as to identify business and technological opportunities that can enhance the performance and competitiveness of the sub-sector. The prices of cassava products in the DRC were found to be high, due to the high costs of production, processing and marketing of cassava at different levels of the market chain. Poor market linkages lead to low utilisation of value addition technologies, and this contributes directly to poor market opportunities. This results in a wide range of negative aspects for the sector, such as decreasing incentives for the production and consumption of cassava products and lack of sufficient competitiveness to make cassava a significant commercial commodity. Investment in the sector is considered risky by different chain actors, and is limited as a result of the overall non-competitiveness of the sector. The cassava market in the DRC is organised around Kinshasa in Western Congo, and around Lubumbashi in the South-eastern part of the country. In view of the strategic importance of the two marketplaces, a market integration analysis was conducted to consider whether food policy focusing on those two reference marketplaces would be sufficient to stabilise the cassava supply nationwide, since most of the marketplaces seem to have a strong relationships with these two reference markets. Using co-integration techniques, an error correction mechanism and an index of market connection, the findings established that among the 11 pairs of trading markets, 6 of them were segmented, meaning that price changes in the reference markets were not fully transmitted to the regional markets. Four key factors, including macroeconomic environment, transportation infrastructure, market information flow and distance, played a significant role in price differentials, and caused potential and existing markets to cease to function as efficient generators of wealth and distributors of food. This is apparently one of the most important reasons for increased food insecurity and poverty among food producers and consumers alike. The results confirm the poor value chain status of cassava, which leads to the stagnation of this crop as a semi-commercial crop, and restrains its absorption into the mainstream market chain in local, national and regional markets. The market integration results showed segmented and moderated integrated markets arising from the 11 pairs of trading markets, of which 6 were identified as segmented. The results from the error correction mechanism (ECM) suggest that on average about 30% of past deviations from the long run are corrected each month. Among the 11 paired markets, the highest coefficient of price adjustment in the long run was indicated by the paired markets Bukavu–Goma (43%), Mbujimayi–Kananga (38%) and Matadi-Kinshasa (36%); and the lowest was given by the paired market Kisangani–Kinshasa (15%). In the short run, the IMC of 0.85 suggests a strong market connection between Matadi and Kinshasa, which then suggests that price shocks that occur in the market of Kinshasa affect immediately, and partially, the Matadi markets supplying it. This high IMC coefficient was also found between Bukavu and Goma (0.86), and Kananga and Mbujimay (0.81). None of the other markets trading with Kinshasa and Lubumbashi respond in the short run to price changes in these reference markets. This implies that only 3 market pairs out of 11 hav strong intgration which therefore presents clear evidence of weak market integration between production and deficient areas in the DRC as awhole. This weak linear relationship between markets can be postulated as one of major causes of food insercurity in the country. This understanding of cause of food insecurity and various issues surrounding market integration would futher help policy makers to improve efficiency of cassava marketing system, lower farm to retail price spread and consolidate food security accross the country. Copyright / Dissertation (MSc(Agric))--University of Pretoria, 2012. / Agricultural Economics, Extension and Rural Development / unrestricted

Thesis (M. Sc. (Agriculture)) -- University of Limpopo, 2015 / Food insecurity is a huge challenge for any government. Since food is a human need, it is often at the priority of any endeavour, policy or strategy undertaken by a household or government. The issue of food insecurity and the use of agricultural intervention to address it were at the centre of this study. Agricultural reform programs such as the Masibuyele Emasimini programme investigated here are argued to be the best mechanism to address food insecurity in rural areas of developing countries. This understanding, however, does not go unchallenged with some scholars believing that these programmes only mask the problem and once withdrawn an even bigger problem would arise. This study investigated why there is little indication of farmer growth despite the introduction of the Masibuyele Emasimini programme in the new forest irrigation scheme. A number of aspects such as increases in production, skills set, challenges, etc., were investigated to get a comprehensive picture of what is happening on the ground. A descriptive approach was followed in presenting the data. The major challenges faced by the programme are: poor communication, limited mechanization, insufficient production inputs late arrival of seeds and fertilizers, inexperienced drivers, and lack of consultation. From this analysis of the challenges presented by both farmers and extension officers, it becomes apparent that there is a failure of government to deliver on time. Secondly that there is a mismatch between the demand and supply of inputs, two aspects play a role firstly budgetary constraints that might limit the availability of inputs and secondly insufficient budgeting due to miscalculated demands. The study revealed that any programme meant to uplift the poor should not be a top down approach that is drafted and imposed on people. Proper consultation during the planning phase should be sought, but more crucial is the on-going communication and consultation with the people on the ground. The study then argues that poor monitoring also had a role in the weakening of the sustainability of the programme. Administrative issues on the part of government and service providers discouraged farmers and weakened the relationship of farmers with government; it also decreased the momentum of the programme. Key words: Sustainability, Food insecurity, Food security, Smallholder farmer, Masibuyele Emasimini programme.

In the United States, 30.3 million people live with diabetes. The cost of the disease is immense and the need for successful management strategies is pertinent. Food insecurity is associated with both the development and the poor management of diabetes. Several behavioral risk factors associated with food insecurity that influence the poor management of the disease include financial concerns, smoking, and disrupted eating patterns. Food insecurity screening in the clinical setting is endorsed by several professional organizations. To address the intersection between clinical care and this social determinant of health, an educational and training program was developed and implemented. The Theory of Planned Behavior is utilized for provider-level interventions and was applied to the program design for What About Food? Food insecurity screening in the clinical setting, which focuses on the topics of food insecurity and screening patients for food insecurity. Program content was evidence-based and employed a variety of learning strategies. The program was evaluated with a non-experimental pre- and post-test design. The program was successful in increasing knowledge about food insecurity, self-efficacy in screening for food insecurity, and in improving attitude toward food insecurity screening. The potential to tailor the program for specific groups is promising.

This thesis addresses the deep-rooted systemic issue of food justice, through the development of a Food Security & Sustainability Hub in Northampton, Massachusetts. As part of the thesis process, I initiated engagement with local stakeholders and organizations using established practices of public interest design. This included a series of meetings and site visits with the leaders of a nonprofit social justice farm in Northampton, MA. These conversations shaped the project scope and design. In doing so, the thesis project tested ideas about social process and the overarching role of discourse in design. My hope is that through thoughtful analysis and engagement through the lens of a real project, I can contribute to this ongoing conversation and inform future pursuits.

This is a qualitative study that seeks to understand the intersections of food insecurity and chronic diseases in the lives of women living in Mattapan. This research takes place in Mattapan, a neighborhood in Boston. Mattapan is a very diverse and unique community which is home to a majority of people of color. Mattapan is often criticized and viewed as an undesirable place to live for those who live outside of its borders. These negative stereotypes and the presence of structural violence has generated a built site scarcity within the Mattapan community. This makes it incredibly difficult for Black women in Mattapan to be healthy because their environment actively prevents them from doing so. It is important to give women special consideration when looking at food insecurity because more increasingly they are becoming the sole and primary caregivers in their homes. They are responsible for the production and preparation of food within their families. Therefore, it is necessary and important to focus on this particular population and obstacles they endure navigating those obstacles. This research focuses on how past and present lived experiences of women of color in Mattapan inform how these women identify, understand, define, and interpret structural factors that contribute to food insecurity, and chronic diseases. Having access to fresh and affordable food is one of the most basic necessities of life. Yet, many communities of color across the country lack this basic access. Twenty percent of all African American household’s experience food insecurity compared 12.5 percent of the nation as a whole. In addition, African-American women are almost twice as likely to be overweight and obese compared to non-Hispanic White women. With such grave proportions of African-Americans suffering from chronic diseases, it is important to consider the ways in which obesity systematically occurs. Structural violence and the presence of structural barriers inhibit Black women from eating healthy. In predominately Black and immigrant communities like Mattapan, the environment is a major barrier that women must navigate every day in order to achieve healthiness.