A Gender-responsive Approach to Climate-Smart Agriculture: Evidence and guidance for practitioners

Taking a gender-responsive approach to Climate-Smart Agriculture (CSA) means that the particular needs, priorities, and realities of men and women are recognized and adequately addressed in the design and application of CSA so that both men and women can equally benefit. The gender gap in agriculture affects how men and women access and benefit from CSA. A gender-responsive approach to CSA addresses this gap by recognizing the specific needs and capabilities of women and men. Site-specific CSA practices that are also gender-responsive can lead to improvements in the lives of smallholder farmers, fishers and foresters, as well as more sustainable results

Association Between Breastfeeding, Oxytocin, and Risk of Postpartum Hemorrhage

Rates of maternal morbidity and mortality are far too high in the United States compared to other developed countries. Additionally, breastfeeding is often poorly prioritized, leading to a negative community connotation and low rates of exclusive breastfeeding. The purpose of this study was to compile the available research on breastfeeding initiation and its association with risk for postpartum hemorrhage. Fifteen peer-reviewed articles were collected from databases and other scholarly articles and screened for correlation between breastfeeding and maternal health risk. Overall, many articles suggest that skin-to-skin contact and early initiation of breastfeeding may be the most effective way to reduce risk for postpartum hemorrhage and increase likelihood of long term exclusive breastfeeding. While further research needs to be conducted to acquire more data and hopefully affect best-practice standards, the findings in this literature review suggest that natural, or endogenous, oxytocin is the most optimal and least invasive way to prevent complications such as postpartum hemorrhage

Neptune: Marine ROV Retrofit and Shape Memory Alloy Water Sampler

The Robotics Systems Lab at Santa Clara University worked closely with Monterey Bay Aquarium Research Institute to design and modernize a safe, low-voltage remotely operated vehicle (ROV) and fabricate a shape memory alloy (SMA) triggered water sampler. The scope of this project was split into two parts. The first was to modernize an existing ROV frame and flotation device with low-cost, low-voltage components for depths up to 300ft. The second scope was to design and manufacture a 100ml water sampling system that was mostly mechanical. Due to the onset of COVID-19, the functionality and performance of the ROV was verified and confirmed through extensive Simulink simulations and calculations. The ROV is expected to perform at a translational speed of 2.8 ft/s and a vertical speed of 1.6 ft/s when deployed. The sampler was self-manufactured during the pandemic and successfully took a 135ml sample. After the modernization was complete, the controls were verified through a mass properties analysis and thruster mapping simulation

Ovarian antibodies as detected by indirect immunofluorescence are unreliable in the diagnosis of autoimmune premature ovarian failure: a controlled evaluation

BACKGROUND: Ovarian antibodies as detected by indirect immunofluorescence have been used to detect ovarian autoimmunity, but to our knowledge the rate of false positive findings using this method has never been reported. METHODS: Here we examine whether a commercially available ovarian antibody test system, using cynomologous monkey ovary, might be useful in the diagnosis of autoimmune premature ovarian failure. The test was performed in a blinded manner in 26 young women with 46,XX spontaneous premature ovarian failure, in 26 control women with regular menstrual cycles (matched for age, race, and parity) and 26 control men (matched for age and race). We also compared the frequency of other autoantibodies associated with ovarian autoimmunity. RESULTS: As a group young women with premature ovarian failure had an increased incidence of thyroid and gastric parietal cell autoimmunity (p < 0.05). Unexpectedly, however, nearly one third (31%) of normal control women had ovarian antibodies using the commercially available test. One half of young women with premature ovarian failure were found to have ovarian antibodies (P = 0.26). In our own laboratory we found similar results and we were unable to improve the specificity of the test. None of 26 men were found to have ovarian antibodies (P < 0.001). CONCLUSION: Since approximately one third of normal women were found to have ovarian antibodies using the system under study, we conclude that ovarian antibodies as detected by this indirect immunofluorescence method have poor specificity. The specificity of any ovarian antibody test should be established before it is used clinically

Anti-Müllerian hormone for the diagnosis and prediction of menopause:a systematic review

Background: The early onset of menopause is associated with increased risks of cardiovascular disease and osteoporosis. As a woman’s circulating anti-Müllerian hormone (AMH) concentration reflects the number of follicles remaining in the ovary and declines towards the menopause, serum AMH may be of value in the early diagnosis and prediction of age at menopause. Objective and Rationale: This systematic review was undertaken to determine whether there is evidence to support the use of AMH alone, or in conjunction with other markers, to diagnose menopause, to predict menopause, or to predict and/or diagnose premature ovarian insufficiency (POI). Search Methods: A systematic literature search for publications reporting on AMH in relation to menopause or POI was conducted in PubMed®, Embase®, and the Cochrane Central Register of Controlled Trials up to 31 May 2022. Data were extracted and synthesized using the Synthesis Without Meta-analysis for diagnosis of menopause, prediction of menopause, prediction of menopause with a single/repeat measurement of AMH, validation of prediction models, short-term prediction in perimenopausal women, and diagnosis and prediction of POI. Risk-of-bias was evaluated using the Tool to Assess Risk of Bias in Cohort Studies protocol and studies at high risk of bias were excluded. Outcomes: A total of 3207 studies were identified, and 41, including 28 858 women, were deemed relevant and included. Of the three studies that assessed AMH for the diagnosis of menopause, one showed that undetectable AMH had equivalent diagnostic accuracy to elevated FSH (&gt;22.3 mIU/ml). No study assessed whether AMH could be used to shorten the 12 months of amenorrhoea required for a formal diagnosis of menopause. Studies assessing AMH with the onset of menopause (27 publications [n = 23 835 women]) generally indicated that lower age-specific AMH concentrations are associated with an earlier age at menopause. However, AMH alone could not be used to predict age at menopause with precision (with estimates and CIs ranging from 2 to 12 years for women aged &lt;40 years). The predictive value of AMH increased with age, as the interval of prediction (time to menopause) shortened. There was evidence that undetectable, or extremely low AMH, may aid early diagnosis of POI in young women with a family history of POI, and women presenting with primary or secondary amenorrhoea (11 studies [n = 4537]). Wider Implications: The findings of this systematic review support the use of serum AMH to study the age of menopause in population studies. The increased sensitivity of current AMH assays provides improved accuracy for the prediction of imminent menopause, but diagnostic use for individual patients has not been rigorously examined. Prediction of age at menopause remains imprecise when it is not imminent, although the finding of very low AMH values in young women is both of clinical value in indicating an increased risk of developing POI and may facilitate timely diagnosis

Prevalência de anemia em escolares de escolas públicas de Maringá-PR, 2008

A anemia é um problema de saúde pública que afeta tanto países desenvolvidos quanto os em desenvolvimento. O objetivo deste estudo foi de estimar a prevalência de anemia em crianças que ingressaram no primeiro ano do Ensino Fundamental das escolas públicas do município de Maringá-PR, no ano de 2008 e os fatores associados à sua ocorrência. Estudo transversal realizado nas 57 escolas públicas de Maringá-PR, com população amostral probabilística constituída de 371 escolares. A dosagem de hemoglobina (Hb) foi feita pelo HemoCue, e a anemia classificada pelo critério estabelecido pela Organização Mundial da Saúde, Hb <11,5g/dL. Foram realizadas análises univariada e multivariada com regressão logística para as variáveis relacionadas ao evento. A prevalência da anemia foi de 39,3%. Foi verificada associação significativa entre anemia e número de filhos, verificando-se que em famílias com mais de 3 filhos a criança tem 8,6 vezes mais chance de ter a doença quando comparada à outras famílias. A prevalência da anemia nos escolares ingressantes foi elevada no município,evidenciando a necessidade de implementação e adoção de ações efetivas para sua prevenção e controle

Expanding Scope of Practice for Ontario Regulated Health Professionals during COVID-19

On 21 April 2021, the Ontario government issued a new order under the Emergency Management and Civil Protection Act, 1990 that authorized regulated health professionals to practice beyond their regular scope of practice when working in hospital settings and providing pandemic-related care. This order required that professionals use their best judgement in practice and work within hospital-assigned duties and privileges. It also allowed health professionals licensed in other provinces or territories to practise without an Ontario license. The goal of this temporary scope of practice expansion and suspension of licensure requirements was to expand health workforce capacity to care for COVID-19 patients. In place for just over a year, this pandemic workforce policy reform was instituted without warning to the health profession regulators in the province and raised questions about how concerns around competence to practise in these expanded roles would be resolved. While there is no clear evaluation plan for this temporary pandemic policy, restrictions and expansions to health professional scope of practice will continue to have broader implications given the worsening workforce crisis. Le 21 avril 2021, le gouvernement de l'Ontario a émis une nouvelle ordonnance en vertu de la Loi de 1990 sur la protection civile et la gestion des situations d'urgence, qui autorise les professionnels de la santé réglementés à exercer au-delà de leur champ d'exercice habituel lorsqu'ils travaillent en milieu hospitalier et fournissent des soins liés à une pandémie. Cette ordonnance exigeait que les professionnels fassent preuve de leur meilleur jugement dans leur pratique et qu'ils travaillent dans le cadre des fonctions et des privilèges assignés par l'hôpital. Elle permettait également aux professionnels de la santé titulaires d'un permis dans d'autres provinces ou territoires d'exercer sans permis en Ontario. L'objectif de cette ordonnance temporaire était d'accroître la capacité du personnel de santé à prendre en charge les patients atteints du syndrome COVID-19. En place depuis un peu plus d'un an, cette réforme de la politique a été instituée sans avertissement et a soulevé des questions quant à la façon dont les préoccupations concernant la compétence à exercer dans ces rôles élargis seraient résolues. Bien qu'il n'y ait pas de plan d'évaluation clair pour cette politique temporaire, les restrictions et l'élargissement du champ d'exercice des professionnels de la santé continueront à avoir des implications plus larges étant donné l'aggravation de la crise des effectifs

Índice de proporcionalidade do baixo peso ao nascer e a sua relação com a mortalidade neonatal

O estudo da relação do baixo peso ao nascer (BPN) com a mortalidade neonatal é de importância vital para o estabelecimento de estratégias de prevenção e redução dos altos percentuais encontrados em populações de países em desenvolvimento. Neste sentido, realizou-se este estudo com o objetivo de verificar o índice de proporcionalidade em crianças BPN e a sua relação com o risco de óbito, estimado através do Índice de Rohrer. A população amostral foi constituída por todas as mães biológicas e suas crianças menores de um ano de idade atendidas em cinco dias úteis nas 22 unidades de saúde do Município de Maringá, em 1998, perfazendo um total de 575. Consideraram-se BPN (baixo peso ao nascer) todas as crianças com peso = 2,51, proporcionadas. Do total das crianças, 168 (29,2%) foram consideradas desproporcionadas. Para as crianças BPN, o percentual foi de 76,5%. Para os outros grupos de crianças com peso insuficiente e adequado, os percentuais foram de 53,7% e 18,3%. Para o total da amostra, quando se associa o I