1) An integrated delivery system involving agriculture, nutrition education, and marketing is needed to effectively deliver biofortified orange-fleshed sweetpotato and improve vitamin A intake.
2) Pilot projects in several African countries found that community nutrition education combined with increased sweetpotato production led to significantly higher vitamin A intake among young children.
3) Sustained adoption requires developing reliable sweetpotato vine supply systems, building demand through promotion, and investing in marketing, though effects are longer term.
The presentation was shared at the recent annual meeting of the American Society for Plant Biologists, and outlines the barriers to agricultural technology adoption in developing countries and discusses the potential role of biofortification in helping people get access to more nutritious food worldwide.
This presentation was given by Alan de Brauw, Senior Researchers in the Markets Trade and Institutions Division at the International Food Policy Research Institute (IFPRI). Alan also serves as Flagship Leader of Value Chains for Enhanced Nutrition for the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH). More information can be found at a4nh.cgiar.org.
The Role of Mycotoxin Contamination on Nutrition: The Aflatoxin Story
Amare Ayalew, Program Manager, Partnership for Aflatoxin Control in Africa (PACA), Ethiopia
The presentation was shared at the recent annual meeting of the American Society for Plant Biologists, and outlines the barriers to agricultural technology adoption in developing countries and discusses the potential role of biofortification in helping people get access to more nutritious food worldwide.
This presentation was given by Alan de Brauw, Senior Researchers in the Markets Trade and Institutions Division at the International Food Policy Research Institute (IFPRI). Alan also serves as Flagship Leader of Value Chains for Enhanced Nutrition for the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH). More information can be found at a4nh.cgiar.org.
The Role of Mycotoxin Contamination on Nutrition: The Aflatoxin Story
Amare Ayalew, Program Manager, Partnership for Aflatoxin Control in Africa (PACA), Ethiopia
Forward Look on Agriculture and Nutrition in Ghana by Jeff Waage, LIDC DirectorGlo_PAN
Forward Look on Agriculture and Nutrition in Ghana - by Jeff Waage, Technical Adviser of the Global Panel and
Leverhulme Centre for Integrative Researchon Agriculture and Health.
2016 ReSAKSS Annual Conference, Accra, Ghana, October 18 - 20, 2016
by
Alex Bambona
Assistant Commissioner, Food & Nutrition Security, Ministry of Agriculture, Animal Industry and Fisheries, (MAAIF), Uganda
Overview of the 2015 Annual Trends and Outlook Report (ATOR)
Namukolo Covic, Research Coordinator, Poverty, Health, and Nutrition Division (PHND), IFPRI, Ethiopia
In April 2016, Singapore hosted the first ever Food Vision Asia event. Food Vision Asia focused exclusively on this high growth market and the challenges it faces as increased consumer buying power drives its consumer’s appetite for a diet predicated on ‘world food’ choice and variety.
Shining a brighter light: Data-driven evidence on adoption and diffusion of a...Francois Stepman
Karen Macours, Chaired Paris School of Economics Professor, Research Director INRAE; Chair, SPIA (Standing Panel on Impact Assessment). WEBINAR: 21 January 2021. Shining a Brighter Light: Comprehensive Evidence on Adoption and Diffusion of CGIAR-Related Innovations in Ethiopia
Scaling Up Nutrition Action for Africa: Where Are We and What Challenges Need To Be
Addressed To Accelerate Momentum
Lawrence Haddad, Executive Director, Global Alliance for Nutrition (GAIN), United Kingdom
Joseph Bbemba
Side Event: How Japan’s know-how can help address food and nutrition challenges in the developing world
Tokyo Nutrition for Growth (N4G) Summit 2021
NOV 30, 2021
De groote etal 2010 extension of qpm_aaae v4_slideshareHugo De Groote
Abstract
Biofortified crops can be promoted with extension strategies based on their agronomic qualities, nutritional qualities, or both, but the effectiveness of these different strategies has so far not been studied. Since 2003, quality protein maize (QPM) has been disseminated using both approaches in East Africa. This study therefore analyzes the effectiveness of promoting biofortified crops based on their agronomic and their nutritional qualities on the adoption of QPM cultivars in East Africa. A random sample survey was conducted in Ethiopia, Kenya, Tanzania, and Uganda, with 423 households from QPM extension areas and 539 households from similar areas outside the extension zone. Propensity score matching and regression analysis were used to assess determinants of QPM adoption, including farmers’ awareness of QPM, understanding of its nutritional benefits, and evaluation of agronomic performance to evaluate the agronomic and nutritional extension strategies. Results showed high familiarity with QPM, but low understanding of nutritional benefits. Farmers evaluated QPM varieties as equal or superior to conventional maize for post-harvest traits, but not always for agronomic traits (in particular yield in Ethiopia and Tanzania). Adoption in extension areas varied from 73% in Uganda and 25% in Tanzania to none in Kenya. Key factors that increased adoption were farmers’ participation in extension, having heard of QPM, higher overall evaluation ratings of QPM vs. conventional maize varieties, and understanding of QPM’s nutritional benefits. Agronomic performance was found to be more important than an understanding of nutritional benefits. For biofortified crops to be adopted and have a nutritional impact on target populations, they should, first and foremost, be agronomically equal or superior to conventional varieties. If farmers are convinced of the agronomic performance of biofortified crops, additional gains in adoption can be achieved by focusing extension efforts on imparting farmers with knowledge of the benefits of biofortified crops for human nutrition.
Expositor: Anthony Hehir – Director Programa Mejoramiento de la Nutrición de DSM
Seminario Internacional sobre Experiencia exitosas en Nutrición, organizado por el Programa Mundial de Alimentos de las Naciones Unidas (PMA) en Colombia y DSM.
14 y el 15 de mayo de 2015.
Bogotá, Colombia.
Harold Roy-Macauley's presentation on "Global research partnership efforts: tackling food and environmental challenges in sub-Saharan Africa" at the Sixth Tokyo International Conference on African Development (TICAD VI) Side Event organized by the World Bank on the “Future of Food in sub-Saharan Africa: Reviewing progress, charting next steps” held in Nairobi, Kenya, 26 August 2016.
Forward Look on Agriculture and Nutrition in Ghana by Jeff Waage, LIDC DirectorGlo_PAN
Forward Look on Agriculture and Nutrition in Ghana - by Jeff Waage, Technical Adviser of the Global Panel and
Leverhulme Centre for Integrative Researchon Agriculture and Health.
2016 ReSAKSS Annual Conference, Accra, Ghana, October 18 - 20, 2016
by
Alex Bambona
Assistant Commissioner, Food & Nutrition Security, Ministry of Agriculture, Animal Industry and Fisheries, (MAAIF), Uganda
Overview of the 2015 Annual Trends and Outlook Report (ATOR)
Namukolo Covic, Research Coordinator, Poverty, Health, and Nutrition Division (PHND), IFPRI, Ethiopia
In April 2016, Singapore hosted the first ever Food Vision Asia event. Food Vision Asia focused exclusively on this high growth market and the challenges it faces as increased consumer buying power drives its consumer’s appetite for a diet predicated on ‘world food’ choice and variety.
Shining a brighter light: Data-driven evidence on adoption and diffusion of a...Francois Stepman
Karen Macours, Chaired Paris School of Economics Professor, Research Director INRAE; Chair, SPIA (Standing Panel on Impact Assessment). WEBINAR: 21 January 2021. Shining a Brighter Light: Comprehensive Evidence on Adoption and Diffusion of CGIAR-Related Innovations in Ethiopia
Scaling Up Nutrition Action for Africa: Where Are We and What Challenges Need To Be
Addressed To Accelerate Momentum
Lawrence Haddad, Executive Director, Global Alliance for Nutrition (GAIN), United Kingdom
Joseph Bbemba
Side Event: How Japan’s know-how can help address food and nutrition challenges in the developing world
Tokyo Nutrition for Growth (N4G) Summit 2021
NOV 30, 2021
De groote etal 2010 extension of qpm_aaae v4_slideshareHugo De Groote
Abstract
Biofortified crops can be promoted with extension strategies based on their agronomic qualities, nutritional qualities, or both, but the effectiveness of these different strategies has so far not been studied. Since 2003, quality protein maize (QPM) has been disseminated using both approaches in East Africa. This study therefore analyzes the effectiveness of promoting biofortified crops based on their agronomic and their nutritional qualities on the adoption of QPM cultivars in East Africa. A random sample survey was conducted in Ethiopia, Kenya, Tanzania, and Uganda, with 423 households from QPM extension areas and 539 households from similar areas outside the extension zone. Propensity score matching and regression analysis were used to assess determinants of QPM adoption, including farmers’ awareness of QPM, understanding of its nutritional benefits, and evaluation of agronomic performance to evaluate the agronomic and nutritional extension strategies. Results showed high familiarity with QPM, but low understanding of nutritional benefits. Farmers evaluated QPM varieties as equal or superior to conventional maize for post-harvest traits, but not always for agronomic traits (in particular yield in Ethiopia and Tanzania). Adoption in extension areas varied from 73% in Uganda and 25% in Tanzania to none in Kenya. Key factors that increased adoption were farmers’ participation in extension, having heard of QPM, higher overall evaluation ratings of QPM vs. conventional maize varieties, and understanding of QPM’s nutritional benefits. Agronomic performance was found to be more important than an understanding of nutritional benefits. For biofortified crops to be adopted and have a nutritional impact on target populations, they should, first and foremost, be agronomically equal or superior to conventional varieties. If farmers are convinced of the agronomic performance of biofortified crops, additional gains in adoption can be achieved by focusing extension efforts on imparting farmers with knowledge of the benefits of biofortified crops for human nutrition.
Expositor: Anthony Hehir – Director Programa Mejoramiento de la Nutrición de DSM
Seminario Internacional sobre Experiencia exitosas en Nutrición, organizado por el Programa Mundial de Alimentos de las Naciones Unidas (PMA) en Colombia y DSM.
14 y el 15 de mayo de 2015.
Bogotá, Colombia.
Harold Roy-Macauley's presentation on "Global research partnership efforts: tackling food and environmental challenges in sub-Saharan Africa" at the Sixth Tokyo International Conference on African Development (TICAD VI) Side Event organized by the World Bank on the “Future of Food in sub-Saharan Africa: Reviewing progress, charting next steps” held in Nairobi, Kenya, 26 August 2016.
This is a talk I gave as part of the "Nourishing 9 Billion" symposium at the 2014 American Society for Plant Biologists Annual Meeting in Portland, Oregon. I talked first about how major grains are actually quite available in an aggregate sense-- moreover there is plenty of unexploited capacity. A larger problem is a relative lack of availability of nutritious crops -- legumes and pulses, fruits, and vegetables, and among specific populations animal source foods. Two ideas to reduce micronutrient deficiencies, being promoted by the CGIAR program Agriculture for Nutrition and Health, are to promote nutritious crops and foods through value chains, as well as to promote micronutrient intakes through biofortification.
Postharvest Loss Reduction & Mycotoxins programs in USAID’s Feed the Future I...Francois Stepman
Ahmed Kablan, Ph.D.
International Nutrition & Public Health Adviser
USAID /Bureau For Food Security/Office of Agriculture Research and Policy
USDA/ARS/Office of International Research Program
Its provides information about nutrition situation in India and its solution. Bio-fortification in the context of horticultural crops and its methods . Global initiatives and Future Challenges associated with bio-fortification.
Gordon Prain - Agriculture - Health Linkages Research at CIPWorldFish
Biofortification and food systems research for improved nutrition. A roadmap towards investing in agriculture, food security and nutrition. Presented at the Agriculture Nutrition Linkages Seminar in Dhaka, Bangladesh on the 18th of April, 2012.
The economic case for investing in nutritionGlo_PAN
Presented by Shawn Baker, Director of the Nutrition team at the Bill and Melinda Gates Foundation, during the launch of "African Leaders for Nutrition" at the African Development Bank Annual meeting (23 May 2016, Lusaka, Zambia).
More info: Glopan.org/african-leaders-nutrition
M.S. Swaminathan presents: Achieving the Zero Hunger Challenge & the Role of ...Harvest Plus
Professor M.S. Swaminathan presents "Achieving the Zero Hunger Challenge & the Role of Biofortification" at The 2nd Global Conference on Biofortification: Getting Nutritious Foods to People in Kigali, Rwanda. April 1, 2014
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Low delivery vit a
1. Developing Effective Delivery Systems for Biofortified Crops:
Some Thoughts on the Integrated Delivery of
Orange-fleshed Sweetpotato in Sub-Saharan Africa
Jan Low
International Potato Center
9 November 2010
2. The Situation:
Decline in Vitamin A Deficiency among
Children 6-60 months of age not
on track in SSA except for North Africa
Number Rate
(Millions) 1990-2007
1990 2007 2007 ppts/yr
East Africa 43.7 37.5 17,825 -0.36 -0.87
Central Africa 40.8 42.5 9,259 0.10 -0.82
North Africa 32.6 22.4 4,942 -0.60 -0.65
Southern Africa 37.2 25.0 1,530 -0.20 -0.74
West Africa 45.0 40.4 19,163 -0.27 -0.90
Total for Africa 41.4 36.4 52,718 -0.29 -0.83
Rate
required
to meet
MDG
Prevalence
(serum retinol <20 ug/dl)
30 African countries >30% prevalence low serum retinol
UNSCN, 6th Report on World Nutrition Situation (2010), p. 16
3. The Situation, cont.:
1 in 3 persons in SSA (265 million people)
not getting enough to eat daily
19 SSA countries moving in the right direction
14 SSA countries worse hunger than in 1990
Trends in underweight (children under 5 yrs) not improving
UNSCN, 6th Report on World Nutrition Situation (2010), pp. 90
Projects and programmes that aim to
improve food and nutrition security through increased
yields will be most successful if they are implemented in
tandem with efforts to improve crop and dietary diversity.
Those agriculture interventions that invested broadly in
different types of capital (physical, natural, financial, human
and social) were more likely to improve nutrition outcomes.
Berti, et al. Public Health Nutrition (2004) 7(5), 599-609.
4. The Potential Contribution of Orange-fleshed
Sweetpotato
1. Marginal
change
... VAD
2. Increased
area,
yields,
marketing
... Food
security
5. A Few Sweetpotato Facts
Grows from sea level to 2300 meters
Produces on marginal soils (3-12 t/ha)
Yet responds dramatically to favorable
conditions (40-60 t/ha)
Women dominant producers in SSA
Flexible harvesting and planting times
Dual purpose use: roots & vines
Vegetatively propagated
Easy farmer-to-farmer sharing
Limited "seed" commercialization
6. Overcoming the Conventional Wisdom :
African and Asians will not eat orange-
fleshed sweetpotatoes
Attempts by AVRDC to introduce them in Asia had failed
Failure to understand that rejection was due to texture, not
color
Pilot work in Kenya (1995-97) among 20 women's groups
Sweet potato cultivars with deep
yellow or orange-fleshed roots are
unfortunately rejected in many
developing countries in favor of white
or cream-fleshed types
having little or no provitamin A activity.
The Sweet Potato: an Untapped Food
Resource. Jennifer Wolfe 1992.
7. Key Lessons
From Pilot Work in
Western Kenya:
Nutrition education
component essential for
increased frequency of
consumption of vitamin A rich
foods by young children
Orange color accepted, but
preferences differed
--Adults: high dry matter
--Children: low dry matter
Yellow-fleshed variety had
inadequate beta-carotene
Eat OrangeKARI/CIP/CARE collaboration funded
by ICRW/OMNI/USAID
8. Bosbok
Resisto
Efficacy
studies
Almost all carotenoids trans-beta-carotene with high
retention when boiled (70-92%)
120 grams (small root) fed to school children for 5 days a
week for 3 months significantly improved amounts of
Vitamin A stored in the liver
Retention & efficacy studies
established that OFSP is a rich and
bioavailable source of vitamin A
Source: van Jaarsveld et al. 2005 and 2006, MRC-South Africa
9. #1 Access to Beta-Carotene-
Rich Sweetpotato Vines
Buy more Vitamin-A-Rich
Foods & Health Services
INTEGRATED DELIVERY SYSTEM
Increase Young Child
Feeding Frequency &
Diet Diversity
#2 Demand
Creation &
Empowerment
Through
Knowledge
Substitute white-fleshed with
orange fleshed, beta-carotene
rich varieties
Earn
income from
sales
of roots &
processed
products
Produce more Energy &
Beta-Carotene per hectare
Improved agronomic & storage
practices to assure availabilityBEHAVIORAL
CHANGE
Work with
caregivers to
improve feeding
practices AWARENESS
Media
campaign
to increase
demand
#3 Ensure
Sustained
Adoption &
Use through
Market
Development
Sustainably Improve Young
Child Intake of Vitamin A
& Energy
Improved
Vitamin A Status
Increase area
to meet demand
10. Delivery at the Community Level (TSNI)
in Rural MozambiqueCentral Mozambique
Zambézia Province
Design:
2 yr quasi-experimental design
Agriculture & nutrition extensionists
based in target areas
2 Intervention groups: 498 hhs
More intensive: group + home visits
Less intensive: group sessions only
1 Control group: 243 hhs
data collection: Jan 2003-Mar 2005
90% completed study
Funded by the Micronutrient Initiative, Rockefeller Foundation, USAID, & HarvestPlus
11. Did the Intervention Impact the Young Child?
Median intake vitamin A almost 8 times higher (24 h recall)
Group sessions sufficient to achieve improved intake
15% decline in low serum retinol (VAD) due to intervention
Median nutrient intakes yesterday:
non-breastfed children (mean 32 months old)
426
1414
56
1226
0
200
400
600
800
1000
1200
1400
1600
Vitamin A (μg RAE)
P-value=0.00
Energy (kcal)
P-value=0.00
AmountofNutrient
Intervention (n=465)
Control (n=234)
Low et al., Journal of Nutrition 137: 1320-1327, 2007
12. How can we reach larger number of
households cost effectively?
Reaching End Users Project (2006-2009)
in Uganda & Mozambique (HarvestPlus)
TSNI used direct extensionist to farmer contact:
relatively expensive
Can the cost be reduced through use of village
level promoters for agriculture & nutrition without
compromising adoption and vitamin A intake
rates?
How long do we need the community level
nutrition intervention?
More intensive Model: 2 years
Less intensive Model: 1 year
Short Answer: Yes, can reduce significantly & have
good adoption and intakes with less intensive model
13. What have we learned
about the Integrated
Approach?
Pathway #1: Agriculture
Agronomically competitive, tasty varieties essential
Consumer preferences can vary within/between countries
In areas with short dry seasons (2-3 months), single
massive distributions sufficient for widespread adoption
In areas with longer dry seasons (4-6 months), need to
establish reliable supply of vines, preferably at
decentralized level
Trained farmer multipliers with access to water
Willingness-to-pay exists, but extent depends on market demand
for roots & purchasing power in the community
15. Pathway #2: Demand
Creation at the Community
Level
Group sessions on nutrition effective for many messages
Utilization of OFSP, and knowledge of its benefits
Increase in young child feeding frequency
Use of other locally available plant sources of vitamin A
Difficult behaviors to change
Health-related practices: boiling water
Addition of small amounts of fat, purchasing practices
Using promoters results in adoption and use of OFSP, but
fewer additional practices than direct extension contact
How minimal can we go on the community level intervention?
How effective is integrating OFSP into broader interventions?
16. Marketing component is longer-term investment
Need 3-5 years to develop, but most projects are 2-3 yrs
Invest in educating traders and building consumer demand
Where significant sweetpotato markets already exist
Must "break-into" the market against strong existing preference
Where sweetpotato markets are not well-developed
Links between farmers and traders need to be facilitated/subsidized
Processed products liked, but requires sustained supply
Need to invest in training on fresh storage
Boiled and mashed superior to dried chips/flour
Pathway #3:
Marketing
17. Next Step:
Building the Evidence for
Linking Agriculture & Nutrition
with Health to Maximize Impact
Need to minimize loss of vitamin A after intake
Need for greater investment in women's well-being
Launched 5 year study in Western Kenya (2009)
[CIP, PATH, CREADIS, ARDAP, Ministries of Health/Ag]
Can linking OFSP access and nutritional training to existing health
services for pregnant women provide:
1) an incentive to pregnant women to increase health service
utilization?
2) lead to increases in consumption of OFSP and other vitamin A
rich foods by the women and their young infants in a cost-
effective manner?