Report on an international workshop on kangaroo mother care: lessons learned and a vision for the future.

Globally, complications of prematurity are the leading cause of death in children under five. Preterm infants who survive their first month of life are at greater risk for various diseases and impairments in infancy, childhood and later life, representing a heavy social and economic burden for families, communities and health and social systems. Kangaroo mother care (KMC) is recommended as a beneficial and effective intervention for improving short- and long-term preterm birth outcomes in low- and high-income settings. Nevertheless, KMC is not as widely used as it should be. The International Network on KMC runs biennial workshops and congresses to help improve the coverage and quality of KMC worldwide. This paper reports the results of the two-day workshop held in November 2016, where 92 participants from 33 countries shared experiences in a series of round tables, group work sessions and plenaries. Barriers to and enablers of KMC are discussed with regard to parents, health workers and the health system. Key factors for effective implementation and uptake relate to appropriate training for health staff, adherence to protocols and the creation of a welcoming environment for families. Recommendations for planning for national programmes are made according to a six-stage change model. Resources and the cost of making progress are discussed in terms of investment, maintenance, and acceleration and scaling-up costs. KMC training requirements are presented according to three levels of care. To ensure quality KMC, key requisites are proposed for the different KMC components and for sensitive communication with caregivers. The group attending to the monitoring and evaluation of KMC at a national and subnational level highlight the lack of standard indicator definitions. Key priorities for investment include health services research, harmonisation of indicators, development of a costing tool, programming and scaling up, and the follow-up of preterm infants. It is hoped that this report will help to further scale-up and sustain KMC through a systematic approach that includes raising commitment, identifying key strategies to address the main barriers and using existing facilitators, ensuring training and quality, agreeing on indicators for monitoring and evaluation, and advancing implementation research

Positive effects of intercrop yields in farms from across Europe depend on rainfall, crop composition, and management

\ua9 The Author(s) 2024.Modern “intensive” agriculture drives the biodiversity-climate crisis but is also central to global food security. Future farming needs management approaches that maintain (or even enhance) food production while reducing negative climate and biodiversity impacts. Intercrops could provide part of the solution, increasing biodiversity and boosting production with fewer inputs. However, barriers remain to their wide-scale uptake, in particular tailoring intercrops to local equipment, management practice, and environment. We analyze data from multiple trials of cereal-legume intercrops conducted on farms across Europe between 2018 and 2021. Our study is the first attempt, to our knowledge, to quantify the yield benefits of cereal-legume intercropping undertaken at commercially relevant scales for farms across Europe. We used crop performance ratio (CPR)—the ratio of the observed intercrop yield compared to the expected yield based on monoculture yields—as our metric of intercrop performance. Using CPR, we found a roughly 30% yield gain across all sites. However, CPR was modulated by a number of factors. CPR was not strongly affected by management except for the negative effects of direct drilling and the positive effects of organic fertilizer addition. CPR also depended on intercrop composition (number and identity of components), background yields (being highest where yields were lower), and rainfall (being higher with higher rainfall). Our findings allow us to reduce uncertainty about how intercrops will perform in realistic local farm conditions, give guidance for tailoring intercrops to local farming conditions, and provide key goals for further work to integrate intercrops into sustainable farming systems

Comparative study of paediatric prescription drug utilization between the spanish and immigrant population

<p>Abstract</p> <p>Background</p> <p>The immigrant population has increased greatly in Spain in recent years to the point where immigrants made up 12% of the infant population in 2008. There is little information available on the profile of this group with regard to prescription drug utilization in universal public health care systems such as that operating in Spain. This work studies the overall and specific differences in prescription drug utilization between the immigrant and Spanish population.</p> <p>Methods</p> <p>Use was made of the Aragonese Health Service databases for 2006. The studied population comprises 159,908 children aged 0-14 years, 13.6% of whom are foreign nationals. Different utilization variables were calculated for each group. Prescription-drug consumption is measured in Defined Daily Doses (DDD) and DDD/1000 persons/day/(DID).</p> <p>Results</p> <p>A total of 833,223 prescriptions were studied. Utilization is lower for immigrant children than in Spanish children for both DID (66.27 v. 113.67) and average annual expense (€21.55 v. €41.14). Immigrant children consume fewer prescription drugs than Spanish children in all of the therapy groups, with the most prescribed (in DID) being: respiratory system, anti-infectives for systemic use, nervous system, sensory organs. Significant differences were observed in relation to the type of drugs and the geographical background of immigrants.</p> <p>Conclusion</p> <p>Prescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities.</p

Lateral variability of ichnological content in muddy contourites: Weak bottom currents affecting organisms’ behavior

Although bioturbation is commonly recognized in contourites, only a few studies have analyzed the ichnological content of these deposits in detail. These studies have mainly focused on meso-scale bigradational sequence (a coarsening upward followed by a fining-upward sequence resulting from variations in current velocity). Here we present data from gravitational cores collected along the NW Iberian Margin showing systematic variation in ichnological content across proximal to distal depocenters within a large-scale elongated contourite drift. Data demonstrate that tracemakers’ behavior varies depending on the distance relative to the bottom current core. Trace fossils are already known to be a useful tool for studying of contouritic deposits and are even used as criterion for differentiating associated facies (e.g., turbidites, debrites), though not without controversy. We propose a mechanism by which the distance to the bottom current core exerts tangible influence on specific macro-benthic tracemaker communities in contourite deposits. This parameter itself reflects other bottom current features, such as hydrodynamic energy, grain size, nutrient transport, etc. Ichnological analysis can thus resolve cryptic features of contourite drift depositional settings.The contribution and research by JD was funded through the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 792314 (ICON-SE). The research of FJR-T was funded by project CGL2015-66835-P (Secretaría de Estado de Investigacion, Desarrollo e Innovacion, Spain), Research Group RNM-178 (Junta de Andalucía), and Scientific Excellence Unit UCE-2016- 05 (Universidad de Granada). AM’s research is funded by the I2C program of the Xunta de Galicia Postdoctoral programme (ED481B 2016/029-0). The research was conducted as part of “The Drifters Research Group” (RHUL) and “Ichnology and Palaeoenvironment Research Group” (UGR) programs