Clinical utility of folate-containing oral contraceptives

Folate is a generic term for a water-soluble B-complex vitamin which plays an important role in protein synthesis and metabolism and other processes related to cell multiplication and tissue growth. Pregnant and lactating women are at increased risk of folic acid deficiency because generally their dietary folate is insufficient to meet their physiological requirements and the metabolic demands of the growing fetus. The evidence pertaining to the reduction of the risk of neural tube defects (NTDs) due to folate is so compelling that supplementation with 400 μg of folic acid to all women trying to conceive until 12 weeks of pregnancy has been recommended by every relevant authority. A recent Cochrane review has also found protective effects of folate supplementation in occurrence and reoccurrence of NTDs. Despite food fortification and targeted public health campaigns promoting folic acid supplementation, 4,300,000 new cases occur each year worldwide resulting in an estimated 41,000 deaths and 2.3 million disability-adjusted life years (DALYS). This article will review the burden and risk factors of NTDS, and the role of folate in preventing NTDs. It will also describe different modes of supplementing folate and the newer evidence of the effectiveness of adding folate in oral contraceptives for raising serum and red blood cell folate levels

EU Dairy Sector: Impact of Luxemburg Reform, EU Enlargement and Trade Negotiations

The EU dairy sector is facing a period of significant changes that are due to three major decisions: the EU enlargement, the Luxembourg reform and on-going WTO negotiations. To evaluate the impact of such changes we developed a model of the EU and world dairy industry. The model is composed of two modules that interact: a milk and beef supply module and a dairy industry module. In this paper we present the model and focus on elements that are crucial for a better understanding of the impact of reforms: quota rents in the EU, evolution of production in the new member states and trade policy.agricultural policy, dairy industry, partial equilibrium model, International Relations/Trade, C21, Q13, Q18,

Impact of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria

In this paper, we aim to evaluate the effectiveness of community-based interventions (CBIs) for the prevention and management of malaria. We conducted a systematic review and identified 42 studies for inclusion. Twenty-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets (ITNs), indoor residual spraying (IRS), or impregnated bed sheets; 14 studies evaluated intermittent preventive therapy (IPT) delivered in community settings; two studies focused on community-based education for malaria prevention; and one study evaluated environmental management through drain cleaning. Our analysis suggests that, overall, the community-based delivery of interventions to prevent and control malaria resulted in a significant increase in ITNs ownership (RR: 2.16, 95% CI: 1.86, 2.52) and usage (RR: 1.77, 95% CI: 1.48, 2.11). However, usage of ITNs was limited to two-thirds of the population who owned them. Community-based strategies also led to a significant decrease in parasitemia (RR: 0.56, 95% CI: 0.42, 0.74), malaria prevalence (RR: 0.46, 95% CI: 0.29, 0.73), malaria incidence (RR: 0.70, 95% CI: 0.54, 0.90), and anemia prevalence (RR: 0.79, 95% CI: 0.64, 0.97). We found a non-significant impact on splenomegaly, birth outcomes (low birth weight, prematurity, stillbirth/miscarriage), anthropometric measures (stunting, wasting, and underweight), and mortality (all-cause and malaria-specific). The subgroup analysis suggested that community-based distribution of ITNs, impregnated bed sheets and IRS, and IPT are effective strategies. Qualitative synthesis suggests that high coverage could be achieved at a lower cost with the integration of CBIs with existing antenatal care and immunization campaigns. Community-based delivery of interventions to prevent and control malaria are effective strategies to improve coverage and access and reduce malaria burden, however, efforts should also be concerted to prevent over diagnosis and drug resistance

The conceptual framework and assessment methodology for the systematic reviews of community-based interventions for the prevention and control of infectious diseases of poverty

This paper describes the conceptual framework and the methodology used to guide the systematic reviews of community-based interventions (CBIs) for the prevention and control of infectious diseases of poverty (IDoP). We adapted the conceptual framework from the 3ie work on the \u27Community-Based Intervention Packages for Preventing Maternal Morbidity and Mortality and Improving Neonatal Outcomes\u27 to aid in the analyzing of the existing CBIs for IDoP. The conceptual framework revolves around objectives, inputs, processes, outputs, outcomes, and impacts showing the theoretical linkages between the delivery of the interventions targeting these diseases through various community delivery platforms and the consequent health impacts. We also describe the methodology undertaken to conduct the systematic reviews and the meta-analyses

PEMBERDAYAAN KWT PUCAK DESA PUCAK KECAMATAN TOMPOBULU KABUPATEN MAROS DALAM MEMANFAATKAN DAUN GAMAL Gliricidia sepium (Jacq.) Steud. SEBAGAI UPAYA MENINGKATKAN PEREKONOMIAN KELUARGA

Gamal merupakan kelompok tanaman Leguminosae yang mempunyai potensi besar dan bernilai gizi tinggi khususnya kandungan protein serta ketersediaannya kontinyu sepanjang tahun. Desa pucak merupakan salah satu Desa di Kecamatan Tompobulu Kabupaten Maros yang memiliki potensi untuk memanfaatkan daun gamal sebagai basis hijauan untuk pakan ternak. Hal ini didukung dengan banyaknya gamal yang tumbuh di sekitar Desa Pucak baik yang tumbuh liar maupun yang sengaja ditanam oleh masyarakat setempat sebagai pagar pembatas. Hal ini dapat dimanfaatkan oleh masyarakat Desa Pucak menjadi salah satu kesibukan yang menghasilkan tambahan pemasukan bagi keluarga melalui pembuatan awetan hijauan kering maupun yang difermentasikan. Pengabdian ini melibatkan 32 anggota KWT Mawar Pucak, tokoh masyarakat desa dan juga mahasiswa. Kegiatan pengabdian diawali dengan pemaparan materi kemudian dilanjutkan dengan diskusi bersama. Adanya kegiatan ini memberikan  pengetahuan dan wawasan bagi warga Desa Pucak khususnya KWT Mawar Pucak dalam memanfaatkan bahan pakan alternatif yaitu daun gamal sebagai pakan ternak yang dapat diolah, dikemas dan dipasarkan dalam bentuk hijauan kering dan pakan fermentasi. Kata kunci: Gamal, hijauan kering, fermentasi. ABSTRACT Gamal is a group of Leguminosae plants that have great potential and high nutritional value, especially protein content and continuous availability throughout the year. Pucak village is one of the villages in Tompobulu District, Maros Regency which has the potential to utilize gamal leaves as a forage base for animal feed. This is supported by the large number of gamals that grows around Pucak Village, both wild and intentionally planted by the local community as a guardrail. This can be used by the people of Pucak Village to become one of the activities that generate additional income for their family through the manufacture of dried and fermented forage preserves. This service involved 32 members of the KWT Mawar Pucak, village community leaders and students. The service activity begins with the presentation of the material then continues with a joint discussion. The existence of this activity provides knowledge and insight for the residents of Pucak Village, especially KWT Mawar Pucak in utilizing alternative feed ingredients, namely gamal leaves as animal feed that can be processed, packaged and marketed in the form of dry forage and fermented feed. Keywords: Gamal, dry forage, fermentation

Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age

Background:Diarrhoeal disorders and acute respiratory infections (ARIs), especially pneumonia, are the most common causes of death in low-income countries. Studies evaluating the impact of zinc supplementation as an adjunct in the management of pneumonia are limited and have shown variable results.Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), which contains the Cochrane Acute Respiratory Infections (ARI) Group\u27s and the Cochrane Infectious Diseases Group\u27s Specialised Registers, MEDLINE (1950 to March week 2, 2011), EMBASE (1974 to March 2011), CINAHL (1981 to March 2011), LILACS (1985 to March 2011), AMED (1985 to March 2011), CAB Abstracts (1910 to March 2011) and Web of Science (2000 to March 2011).Selection criteria: Randomised control trials (RCTs) evaluating supplementation of zinc as an adjunct to antibiotics for pneumonia in children aged two to 59 months.Data collection and analysis: Two review authors independently assessed trial eligibility and screened all available titles and abstracts for inclusion. If the relevance could not be ascertained by screening the title and abstract, we retrieved and reviewed the full text of the article.Main results: We included four trials in which 3267 children aged two to 35 months participated. Analysis showed that zinc supplementation in addition to standard antibiotic therapy in children with severe and non-severe pneumonia failed to show a statistically significant effect on clinical recovery (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.93 to 1.11). Similary, zinc supplementation in children with severe pneumonia, as an adjunct to standard antibiotic therapy, did not show a statistically significant effect on clinical recovery measured as resolution of tachypnoea (respiratory rate \u3e 50 breaths per minute) (RR 1.13, 95% CI 0.82 to 1.57) and cessation of chest indrawing (RR 1.08, 95% CI 0.88 to 1.31) as compared to the control group. Zinc supplementation in children with severe pneumonia also showed a non-significant effect on the duration of hospitalization stay as compared to the control (RR 1.04, 95% CI 0.89 to 1.22).Authors\u27 Conclusion: Evidence provided in this review is insufficient to recommend the use of zinc as an adjunct to standard antibiotic therapy for pneumonia in children aged two to 35 months

Tackling the existing burden of infectious diseases in the developing world: existing gaps and the way forward

This series evaluates the effectiveness of community-based interventions (CBIs) to prevent and control infectious diseases of poverty (IDoP). Evidence from our reviews suggests that CBIs and school-based delivery platforms are effective in averting risk behaviors and reducing the disease burden. Co-implementation of interventions through existing community-based programs including immunization campaigns, antenatal care and maternal and child health programs have the potential to scale-up interventions for IDoP. Future research should focus on the process of developing and implementing efficient community-based programs through a comprehensive approach, and to gauge the effectiveness of various existing delivery models in order to improve morbidity and mortality outcomes