Levels and Correlates of Non-Adherence to WHO Recommended Inter-Birth Intervals in Rufiji, Tanzania.

Poorly spaced pregnancies have been documented worldwide to result in adverse maternal and child health outcomes. The World Health Organization (WHO) recommends a minimum inter-birth interval of 33 months between two consecutive live births in order to reduce the risk of adverse maternal and child health outcomes. However, birth spacing practices in many developing countries, including Tanzania, remain scantly addressed. METHODS: Longitudinal data collected in the Rufiji Health and Demographic Surveillance System (HDSS) from January 1999 to December 2010 were analyzed to investigate birth spacing practices among women of childbearing age. The outcome variable, non-adherence to the minimum inter-birth interval, constituted all inter-birth intervals <33 months long. Inter-birth intervals >=33 months long were considered to be adherent to the recommendation. Chi-Square was used as a test of association between non-adherence and each of the explanatory variables. Factors affecting non-adherence were identified using a multilevel logistic model. Data analysis was conducted using STATA (11) statistical software. RESULTS: A total of 15,373 inter-birth intervals were recorded from 8,980 women aged 15--49 years in Rufiji district over the follow-up period of 11 years. The median inter-birth interval was 33.4 months. Of the 15,373 inter-birth intervals, 48.4% were below the WHO recommended minimum length of 33 months between two live births. Non-adherence was associated with younger maternal age, low maternal education, multiple births of the preceding pregnancy, non-health facility delivery of the preceding birth, being an in-migrant resident, multi-parity and being married. CONCLUSION: Generally, one in every two inter-birth intervals among 15--49 year-old women in Rufiji district is poorly spaced, with significant variations by socio-demographic and behavioral characteristics of mothers and newborns. Maternal, newborn and child health services should be improved with a special emphasis on community- and health facility-based optimum birth spacing education in order to enhance health outcomes of mothers and their babies, especially in rural settings

Quality and Safety Aspects of Infant Nutrition

Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health. Copyright (C) 2012 S. Karger AG, Base

Determinación de la precisión de DEMs generados con puntos digitalizados a partir de cartografía existente : relación con el algoritmo utilizado

1-17Basic information about watershed relief, drawn from analytical-descriptive methodologies, allows for the physical parameters necessary to the study of natural resources, such as watershed integrated management, environmental impact, soil degradation, deforestation, water resource conservation, among others. All these processes linked to a strong spatial component allow the use of geographic information systems. Digital elevation models (DEMs) and their derivatives are an important component of these data sources. In this work we evaluated DEMs generated from indirect source data (digitized points from existing contour maps) to determine whether elevation accuracy varies with DEM spatial resolution (grid size). We also assessed the possible existence of some interaction between grid size and the software used that could influence the altimetric quality of the DEM. It was concluded that spatial resolution affects DEM quality. We also found that it is possible to find an ideal grid size in terms of the altimetric accuracy and computer weight size of the generated DEM. Regarding the existence of an interaction between grid size and the software used, which could affect the quality of models obtained based on the methodology of source data acquisition, we found that this possibility does exist when the database is generated from digitized points

Elementos conceptuales y metodológicos para la evaluación de impactos ambientales acumulativos (eiaac) en bosques subtropicales : el caso del este de salta, argentina

163-178Northern Argentina experienced an unprecedented deforestation rate of xerophitic forests as a consequence of agricultural expansion. In the Province of Salta, 26 percent of the forest were removed between 1977 and 2008. At the end of 2007, just before the No. 26331 Law of Native Forest Protection was voted by the Congress, the highest annual rate of deforestation was registered, reaching a value of 2.1 percent. Regarding this situation, indigenous people of Eastern Salta along with the "criollos" (local small ranchers) appealed to the National Supreme Court of Justice for legal protection. The Court requested the province to elaborate a Cumulative Environmental Effects Assessment (CEEA) regarding the process of logging and deforestation in four departments of Salta Province (San Martín, Rivadavia, Santa Victoria, and Orán). The aim of this work is to present a conceptual framework to conduct a CEEA in eastern Salta and to present the evidences and existing methodologies to characterize the impacts of deforestation. The conceptual framework suggested depends on the quantitative characterization of the changes in the provision level of key ecosystem services as a function of the stress and/or disturbance level (in this case deforestation). Based on the literature and our own data, the effects of deforestation on four key ecosystem services have been assessed: C dynamics, energy balance and greenhouse gases emissions, water dynamics and landscape structure. Deforestation produced emissions of 2000 t of CH 4, 200 t of N 2O, above 20 Gg of C/year, a 1.1 watt/m2 reduction in reflected radiation and 4400 TJ radiative energy emissions caused by deforestation fires, increases in the risk of soil salinization and landscape fragmentation. Considering these aspects of the structure and functioning of the ecosystems provides objective elements to evaluate management alternatives and to elaborate monitoring programmes. To consider such management and monitoring alternatives arises technical challenges but also institutional and political ones

Accuracy determination for DEMs generated from digitized points from existing mapping: relationship with the algorithm used

La información básica sobre el relieve de cuencas hidrográficas, mediante metodologías analítico-descriptivas permite contar con los parámetros físicos necesarios para el estudio de los recursos naturales tales como manejo integrado de cuencas, impacto ambiental, degradación de suelos, deforestación, conservación de los recursos hídricos, entre otros. Todos estos procesos ligados a una fuerte componente espacial permiten el uso de sistemas de información geográfica. Los Modelos Digitales de Elevación (DEM) y sus derivados son un componente relevante de estas fuentes de datos. En este trabajo se planteó evaluar los DEMs, generados por captura indirecta de datos fuente, (puntos digitalizados sobre un plano, en formato papel, con curvas de nivel) para determinar si su calidad altimétrica varía con la resolución espacial del mismo (tamaño de grilla). Asimismo se evaluó la posible existencia de alguna interacción entre el software utilizado y los tamaños de grilla, que podría influir sobre la calidad altimétrica del DEM. Se concluyó que la resolución espacial afecta la calidad altimétrica del DEM. Se constató, asimismo, que es posible encontrar un tamaño de grilla ideal en cuanto a calidad altimétrica y peso informático del modelo digital de elevaciones generado. Respecto de la existencia de una interacción entre el tamaño de grilla y el software, que pudieran afectar la calidad de los modelos obtenidos en función de la metodología de adquisición de datos fuente, se demostró que existe esta posibilidad cuando la base de datos se genera a partir de puntos digitalizados.Basic information about watershed relief, drawn from analytical-descriptive methodologies, allows for the physical parameters necessary to the study of natural resources, such as watershed integrated management, environmental impact, soil degradation, deforestation, water resource conservation, among others. All these processes linked to a strong spatial component allow the use of geographic information systems. Digital elevation models (DEMs) and their derivatives are an important component of these data sources. In this work we evaluated DEMs generated from indirect source data (digitized points from existing contour maps) to determine whether elevation accuracy varies with DEM spatial resolution (grid size). We also assessed the possible existence of some interaction between grid size and the software used that could influence the altimetric quality of the DEM. It was concluded that spatial resolution affects DEM quality. We also found that it is possible to find an ideal grid size in terms of the altimetric accuracy and computer weight size of the generated DEM. Regarding the existence of an interaction between grid size and the software used, which could affect the quality of models obtained based on the methodology of source data acquisition, we found that this possibility does exist when the database is generated from digitized points.Facultad de Ciencias Agrarias y Forestale

Sibling death clustering in India : genuine scarring vs unobserved heterogeneity

Data from a range of environments indicate that the incidence of death is not randomly distributed across families but, rather, that there is a clustering of death among siblings. A natural explanation of this would be that there are (observed or unobserved) differences across families, e.g. in genetic frailty, education or living standards. Another hypothesis that is of considerable interest for both theory and policy is that there is a causal process whereby the death of a child influences the risk of death of the succeeding child in the family. Drawing language from the literature on the economics of unemployment, the causal effect is referred to here as state dependence (or scarring). The paper investigates the extent of state dependence in India, distinguishing this from family level risk factors that are common to siblings. It offers some methodological innovations on previous research. Estimates are obtained for each of three Indian states, which exhibit dramatic differences in socio-economic and demographic variables. The results suggest a significant degree of state dependence in each of the three regions. Eliminating scarring, it is estimated, would reduce the incidence of infant mortality (among children who are born after the first child) by 9.8% in the state of Uttar Pradesh, 6.0% in West Bengal and 5.9% in Kerala