Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions.

BACKGROUND: An estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding. Timely provision of resuscitation if needed is also critical to newborn survival. This paper describes health system barriers to BNC and neonatal resuscitation and proposes solutions to scale up evidence-based strategies. METHODS: The maternal and newborn bottleneck analysis tool was applied by 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops engaged technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" that hinder the scale up of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for BNC and neonatal resuscitation. RESULTS: Eleven of the 12 countries provided grading data. Overall, bottlenecks were graded more severely for resuscitation. The most severely graded bottlenecks for BNC were health workforce (8 of 11 countries), health financing (9 out of 11) and service delivery (7 out of 9); and for neonatal resuscitation, workforce (9 out of 10), essential commodities (9 out of 10) and service delivery (8 out of 10). Country teams from Africa graded bottlenecks overall more severely. Improving workforce performance, availability of essential commodities, and well-integrated health service delivery were the key solutions proposed. CONCLUSIONS: BNC was perceived to have the least health system challenges among the seven maternal and newborn intervention packages assessed. Although neonatal resuscitation bottlenecks were graded more severe than for BNC, similarities particularly in the workforce and service delivery building blocks highlight the inextricable link between the two interventions and the need to equip birth attendants with requisite skills and commodities to assess and care for every newborn. Solutions highlighted by country teams include ensuring more investment to improve workforce performance and distribution, especially numbers of skilled birth attendants, incentives for placement in challenging settings, and skills-based training particularly for neonatal resuscitation

Social support, but not perceived food environment, is associated with diet quality in French-speaking Canadians from the PREDISE study

The objectives were to assess whether social support for healthy eating and perceived food environment are associated with diet quality, and to investigate if sociodemographic characteristics moderate these associations. A probability sample of French-speaking adults from the Province of Québec, Canada, was recruited in the context of the PREDISE study. Participants reported their perceptions of supportive and non-supportive actions related to healthy eating from close others at home and outside of home (n = 952), and of the accessibility to healthy foods (n = 1035). The Canadian Healthy Eating Index (C-HEI) was calculated based on three Web-based 24 h food recalls. Multiple linear regression models showed that supportive (B = 1.50 (95% CI 0.46, 2.54)) and non-supportive (B = −3.06 (95% CI −4.94, −1.18)) actions related to healthy eating from close others at home were positively and negatively associated with C-HEI, respectively, whereas actions from close others outside of home were not. The negative association between non-supportive actions occurring at home and C-HEI was stronger among participants with lower (vs. higher) levels of education (p interaction = 0.03). Perceived accessibility to healthy foods was not associated with C-HEI (p > 0.05). These results suggest that the social environment may have a stronger influence on healthy eating than the perceived physical environment. This adds support for healthy eating promotion programs involving entire families, especially for more socioeconomically disadvantaged individuals, whose efforts to eat healthily may be more easily thwarted by non-supportive household

Regards d’enseignants québécois sur les élèves doués : points de vue diversifiés

This study examines teachers’ perceptions of gifted students in their class, in a Quebec school service centre, and the influence of personal and contextual variables. The sample consists of 21 primary school teachers (18 women and 3 men). After the lexical analysis carried out with the Alceste software, four specific classes of statements emerge from the teachers’ discourse. In addition, age, teaching cycle, type of class, number of years of experience, involvement in an intervention plan and experience with giftedness predict the heterogeneity of the perceptions of teachers towards giftedness. The results suggest more traditional and stereotypical perceptions of giftedness by teachers. Keywords: perceptions, representations, teachers, giftedness, characteristics, high potential, lexical analysisCette étude s’intéresse aux perceptions des enseignants concernant les élèves doués de leur classe, dans un centre de services scolaire québécois, et à l’influence de certaines variables personnelles et contextuelles sur ces perceptions. L’échantillon se compose de 21 enseignants du primaire (18 femmes et 3 hommes). À l’issue de l’analyse lexicale réalisée avec le logiciel Alceste, quatre classes d’énoncés spécifiques se dégagent du discours des enseignants. L’âge, le cycle d’enseignement, le type de classe, le nombre d’années d’expérience, l’implication dans un plan d’intervention et l’expérience envers la douance constituent des facteurs explicatifs de l’hétérogénéité des perceptions des enseignants envers la douance. Les résultats portent également à croire que des perceptions plus traditionnelles et stéréotypées de la douance persistent chez certains enseignants. Mots-clés : perceptions, représentations, enseignants, douance, caractéristiques, haut potentiel, analyse lexical

7. Stratégies d’intervention pour la nutrition

Malgré une amélioration significative de la nutrition des populations au niveau mondial, des efforts supplémentaires doivent être consentis car les coûts humains et économiques de la sur- et de la sous-nutrition ne sont plus tenables. Des investissements efficaces et durables, répondant aux besoins des populations concernées, sont nécessaires de la part de tous les secteurs, pas seulement celui de la santé. Pour atteindre cet objectif, nous proposons et réitérons l’importance d’une approche d..

IMPACT DE LA FORMATION ET DE L’ACCOMPAGNEMENT PÉDAGOGIQUE DESTINÉS AUX NOUVEAUX PROFESSEURS D’UNIVERSITÉ SUR LEUR TÂCHE RÉELLE : COMPARAISON INTERNATIONALE (CANADA–FRANCE)

International audienceThis article presents some of the results of an international qualitative study conducted in Canada and in France entitled “Impacts of training and pedagogical coaching on the practices of new university professors and their students”. Considering that the actual work of a university professor has been subjected to numerous changes over the past few years, many universities have decided to develop training measures and offer pedagogical coaching in order to prepare new university professors to perform their duties. Though these measures have been in effect for several years, few studies have looked at their impacts. The objective of this article is to present the findings that seem to have had an impact on the lived experiences of teaching that occurred over the course of the study.Cet article présente une partie des résultats issus d’une recherche qualitative internationale qui a été menée au Canada et en France qui s’intitule « Effets de la formation et de l’accompagnement pédagogiques sur les pratiques des nouveaux professeurs d’université et leurs étudiants ». Considérant que la tâche réelle d’un professeur d’université a été soumise à de nombreux changements depuis ces dernières années, plusieurs universités ont décidé de développer des dispositifs de formation et d’accompagnement pédagogique, afin de préparer les nouveaux professeurs à exercer leurs fonctions. Après quelques années d’existence, peu de recherches portent sur leurs effets. Cet article a pour but de présenter les résultats qui semblent avoir eu un impact sur l’expérience d’enseignement vécue pendant le déroulement de la recherche

IMPACT DE LA FORMATION ET DE L’ACCOMPAGNEMENT PÉDAGOGIQUE DESTINÉS AUX NOUVEAUX PROFESSEURS D’UNIVERSITÉ SUR LEUR TÂCHE RÉELLE : COMPARAISON INTERNATIONALE (CANADA–FRANCE)

International audienceThis article presents some of the results of an international qualitative study conducted in Canada and in France entitled “Impacts of training and pedagogical coaching on the practices of new university professors and their students”. Considering that the actual work of a university professor has been subjected to numerous changes over the past few years, many universities have decided to develop training measures and offer pedagogical coaching in order to prepare new university professors to perform their duties. Though these measures have been in effect for several years, few studies have looked at their impacts. The objective of this article is to present the findings that seem to have had an impact on the lived experiences of teaching that occurred over the course of the study.Cet article présente une partie des résultats issus d’une recherche qualitative internationale qui a été menée au Canada et en France qui s’intitule « Effets de la formation et de l’accompagnement pédagogiques sur les pratiques des nouveaux professeurs d’université et leurs étudiants ». Considérant que la tâche réelle d’un professeur d’université a été soumise à de nombreux changements depuis ces dernières années, plusieurs universités ont décidé de développer des dispositifs de formation et d’accompagnement pédagogique, afin de préparer les nouveaux professeurs à exercer leurs fonctions. Après quelques années d’existence, peu de recherches portent sur leurs effets. Cet article a pour but de présenter les résultats qui semblent avoir eu un impact sur l’expérience d’enseignement vécue pendant le déroulement de la recherche

Postmenopausal women with abdominal obesity choosing a nutritional approach for weight loss: A decisional needs assessment

Objectives: To identify the decisional needs of postmenopausal women with abdominal obesity choosing between two nutritional approaches for weight loss: a low-fat diet or a diet rich in fruit and vegetables. Study design: Our descriptive qualitative study was based on the Ottawa Decision Support Framework. Main outcome measures: Four focus groups were conducted with postmenopausal women. A thematic content analysis was performed to determine the decisional needs influencing the choice of a low-fat diet or a diet rich in fruit and vegetables. Results: Seventeen postmenopausal women participated in the study (median age 59 years). Most frequently reported decisional needs for each nutritional approach were sufficient levels of nutritional skills and knowledge, consideration of the physiological impacts and the sensory aspect of approaches, food availability, social support, finances and motivation. Partners, friends and daughters were considered as the most important individuals involved in the decision. Conclusions: We identified several decisional needs influencing postmenopausal women when choosing between a low-fat diet and a diet rich in fruit and vegetables. These findings could inform the design of decision support interventions that address the decisional needs of women for making and implementing informed decisions about a nutritional approach for weight loss