Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023

Abstract Complementary feeding (CF) is defined as infant feeding that complements breastfeeding or, alternatively, breastfeeding with a breast milk substitute, and is a process that goes beyond simply providing guidance on what and how to introduce foods. The information provided by health professionals should be up-to-date and evidence-based. There are different guidelines or position papers at the international level, which, although most of the recommendations may be applicable, there are some others that require regionalization or adaptation to the conditions and reality of each area. The Nutrition working group of the Latin American Society of Pediatric Gastroenterology, Hepatology and Nutrition convened a group of experts, representatives from each of the countries that make up the society, with the objective of developing a consensus on CA, incorporating, when possible, local information that adapts to the reality of the region. The purpose of this document is to show the results of this work. Through Delphi methodology, a total of 34 statements or statements regarding relevant aspects of CA were evaluated, discussed and voted upon.Resumen La alimentación complementaria (AC) se define como la alimentación de los lactantes que complementa a la lactancia materna o en su defecto, a la lactancia con un sucedáneo de la leche materna, y es un proceso que va más allá de simplemente una guía sobre qué y cómo introducir los alimentos. La información brindada por parte de los profesionales de la salud debe ser actualizada y basada en evidencia. Existen diferentes guías o documentos de posición a nivel internacional, que, aunque la mayoría de las recomendaciones pueden ser aplicables, hay algunas otras que requieren una regionalización o adecuación a las condiciones y realidad de cada zona. El grupo de trabajo de Nutrición de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica convocó a un grupo de expertos, representantes de cada uno de los países que conforman la sociedad, con el objetivo de desarrollar un consenso sobre la AC, que incorporó cuando así fue posible, información local que se adapte a la realidad de la región. El objetivo de este documento es mostrar los resultados de dicho trabajo. A través de metodología Delphi, se evaluaron, discutieron y votaron un total de 34 declaraciones o enunciados con respecto a aspectos relevantes de la AC

Current threats faced by Neotropical parrot populations

Berkunsky I, Quillfeldt P, Brightsmith DJ, et al. Current threats faced by Neotropical parrot populations. Biological Conservation. 2017;214:278-287.Psittaciformes (parrots, cockatoos) are among the most endangered birds, with 31% of Neotropical species under threat. The drivers of this situation appear to be manifold and mainly of anthropogenic origin. However, this assessment is based on the last extensive consultation about the conservation situation of parrots carried out in the 1990s. Given the rapid development of anthropogenic threats, updated data are needed to strategize conservation actions. Using a population approach, we addressed this need through a wide-ranging consultation involving biologists, wildlife managers, government agencies and non-governmental conservation organizations. We gathered up-to-date information on threats affecting 192 populations of 96 Neotropical parrot species across 21 countries. Moreover, we investigated associations among current threats and population trends. Many populations were affected by multiple threats. Agriculture, Capture for the Pet Trade, Logging, each of them affected > 55% of the populations, suggesting a higher degree of risk than previously thought. In contrast to previous studies at the species level, our study showed that the threat most closely associated with decreasing population trends is now Capture for the local Pet Trade. Other threats associated with decreasing populations include Small-holder Farming, Rural Population Pressure, Nest Destruction by Poachers, Agro-industry Grazing, Small-holder Grazing, and Capture for the international Pet Trade. Conservation actions have been implemented on < 20% of populations. Our results highlight the importance of a population-level approach in revealing the extent of threats to wild populations. It is critical to increase the scope of conservation actions to reduce the capture of wild parrots for pets

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients