Moving forward with complimentary feeding

"For a number of reasons, progress in improving child feeding practices in the developing world has been remarkably slow. First, complementary feeding practices encompass a number of interrelated behaviors that need to be addressed simultaneously. Child feeding practices are also age-specific within narrow age ranges, which add to the complexity of developing recommendations and measuring responses. Finally, the lack of clear international recommendations for some aspects of complementary feeding has prevented the development of universal indicators to define optimal feeding. Without appropriate measurement tools, the design and evaluation of programs to improve complementary feeding practices cannot move forward. The present paper is the first systematic attempt at filling this gap. It puts forth a framework for the development of indicators of complementary feeding practices and proposes a series of possible indicators to measure some of the most critical aspects of infant and young child feeding. The emphasis is on simple indicators for use in large surveys or in program contexts. Indicators for the following aspects of complementary feeding of 6-23-month-old children are discussed: (1) breastfeeding; (2) energy from complementary foods; (3) nutrient density of complementary foods; and (4) safe preparation and storage of complementary foods. Finally, possible approaches to validate the proposed indicators are discussed and research priorities are highlighted." Authors' Abstract"Child Feeding ,Child care ,evaluation ,

Moving forward with complimentary feeding

"For a number of reasons, progress in improving child feeding practices in the developing world has been remarkably slow. First, complementary feeding practices encompass a number of interrelated behaviors that need to be addressed simultaneously. Child feeding practices are also age-specific within narrow age ranges, which add to the complexity of developing recommendations and measuring responses. Finally, the lack of clear international recommendations for some aspects of complementary feeding has prevented the development of universal indicators to define optimal feeding. Without appropriate measurement tools, the design and evaluation of programs to improve complementary feeding practices cannot move forward. The present paper is the first systematic attempt at filling this gap. It puts forth a framework for the development of indicators of complementary feeding practices and proposes a series of possible indicators to measure some of the most critical aspects of infant and young child feeding. The emphasis is on simple indicators for use in large surveys or in program contexts. Indicators for the following aspects of complementary feeding of 6-23-month-old children are discussed: (1) breastfeeding; (2) energy from complementary foods; (3) nutrient density of complementary foods; and (4) safe preparation and storage of complementary foods. Finally, possible approaches to validate the proposed indicators are discussed and research priorities are highlighted." Authors' Abstract"Child Feeding ,Child care ,evaluation ,

Mid-Upper Arm Circumference based Nutrition Programming: evidence for a new approach in regions with high burden of Acute Malnutrition

In therapeutic feeding programs (TFP), mid-upper arm circumference (MUAC) shows advantages over weight-for-height Z score (WHZ) and is recommended by the World Health Organization (WHO) as an independent criterion for screening children 6-59 months old. Here we report outcomes and treatment response from a TFP using MUAC ≤118 mm or oedema as sole admission criteria for severe acute malnutrition (SAM)

The Life and Times of Joseph Beuys

Program for the seventh annual RISD Cabaret held in the Waterman Building. Graphic design: Mark Snyder; program editor: Margaret Lewis; program photography: Marcin Gizycki.https://digitalcommons.risd.edu/liberalarts_cabaret_programs/1006/thumbnail.jp

PTH Signaling During Exercise Contributes to Bone Adaptation

Improving the structural integrity of bone reduces fracture risk and development of osteoporosis later in life. Exercise can increase the mechanical properties of bone, and this increase is often attributed to the dynamic loading created during exercise. However, the increase in systemic parathyroid hormone (PTH) levels during exercise gives reason to hypothesize that PTH signaling also regulates bone adaptation in response to exercise. Therefore, the first aim of this study was to establish the impact PTH signaling has on bone adaptation during exercise by inhibiting PTH signaling with PTH(7‐34); the second aim was to determine whether increasing PTH levels during exercise with PTH(1‐34) can augment bone adaptation. Thirty minutes after a single bout of running on a treadmill, mice exhibited a twofold increase in systemic PTH levels. Under the same exercise regimen, the influence of PTH signaling on bone adaptation during exercise was then evaluated in mice after 21 consecutive days of exercise and treatment with PTH(7‐34), PTH(1‐34), or vehicle. Exercise alone caused a significant increase in trabecular bone volume with adaptation to a more platelike structure, which was inhibited with PTH(7‐34) during exercise. Changes in structural‐level and tissue‐level mechanical properties during exercise occurred in the absence of significant changes to cortical bone geometry. Inhibition of PTH signaling during exercise attenuated the changes in structural‐level mechanical properties, but not tissue‐level properties. Enhanced PTH signaling during exercise with PTH(1‐34) increased trabecular and cortical bone volume, but had little effect on the structural‐level and tissue‐level mechanical properties compared to exercise alone. Our study is the first to demonstrate that bone adaptation during exercise is not only a function of dynamic loading, but also PTH release, and that PTH signaling contributes differently at the structural and tissue levels. © 2015 American Society for Bone and Mineral Research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111785/1/jbmr2432.pd

The Big Yes and the Little No

Program for the sixth annual RISD Cabaret held in the cellar at the top of the Waterman Building. Design and layout by Nonie Close.https://digitalcommons.risd.edu/liberalarts_cabaret_programs/1005/thumbnail.jp

Protein-coding variants implicate novel genes related to lipid homeostasis contributing to body-fat distribution.

Body-fat distribution is a risk factor for adverse cardiovascular health consequences. We analyzed the association of body-fat distribution, assessed by waist-to-hip ratio adjusted for body mass index, with 228,985 predicted coding and splice site variants available on exome arrays in up to 344,369 individuals from five major ancestries (discovery) and 132,177 European-ancestry individuals (validation). We identified 15 common (minor allele frequency, MAF ≥5%) and nine low-frequency or rare (MAF <5%) coding novel variants. Pathway/gene set enrichment analyses identified lipid particle, adiponectin, abnormal white adipose tissue physiology and bone development and morphology as important contributors to fat distribution, while cross-trait associations highlight cardiometabolic traits. In functional follow-up analyses, specifically in Drosophila RNAi-knockdowns, we observed a significant increase in the total body triglyceride levels for two genes (DNAH10 and PLXND1). We implicate novel genes in fat distribution, stressing the importance of interrogating low-frequency and protein-coding variants

Patient/family views on data sharing in rare diseases: study in the European LeukoTreat project.: Survey assessing data sharing in leukodystrophies

International audienceThe purpose of this study was to explore patient and family views on the sharing of their medical data in the context of compiling a European leukodystrophies database. A survey questionnaire was delivered with help from referral centers and the European Leukodystrophies Association, and the questionnaires returned were both quantitatively and qualitatively analyzed. This study found that patients/families were strongly in favor of participating. Patients/families hold great hope and trust in the development of this type of research. They have a strong need for information and transparency on database governance, the conditions framing access to data, all research conducted, partnerships with the pharmaceutical industry, and they also need access to results. Our findings bring ethics-driven arguments for a process combining initial broad consent with ongoing information. On both, we propose key item-deliverables to database participants

National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010.

BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 g), in 138 countries of low and middle income in 2010. METHODS: Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal and Perinatal Health (23 countries) were used to model the prevalence of term-SGA births. Prevalence of preterm-SGA infants was calculated from meta-analyses. FINDINGS: In 2010, an estimated 32·4 million infants were born small for gestational age in low-income and middle-income countries (27% of livebirths), of whom 10·6 million infants were born at term and low birthweight. The prevalence of term-SGA babies ranged from 5·3% of livebirths in east Asia to 41·5% in south Asia, and the prevalence of preterm-SGA infants ranged from 1·2% in north Africa to 3·0% in southeast Asia. Of 18 million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were born in India, Pakistan, Nigeria, and Bangladesh. INTERPRETATION: The burden of small-for-gestational-age births is very high in countries of low and middle income and is concentrated in south Asia. Implementation of effective interventions for babies born too small or too soon is an urgent priority to increase survival and reduce disability, stunting, and non-communicable diseases. FUNDING: Bill & Melinda Gates Foundation by a grant to the US Fund for UNICEF to support the activities of the Child Health Epidemiology Reference Group (CHERG)

Using system dynamics for collaborative design: a case study

<p>Abstract</p> <p>Background</p> <p>In order to facilitate the collaborative design, system dynamics (SD) with a group modelling approach was used in the early stages of planning a new stroke unit. During six workshops a SD model was created in a multiprofessional group.</p> <p>Aim</p> <p>To explore to which extent and how the use of system dynamics contributed to the collaborative design process.</p> <p>Method</p> <p>A case study was conducted using several data sources.</p> <p>Results</p> <p>SD supported a collaborative design, by facilitating an explicit description of stroke care process, a dialogue and a joint understanding. The construction of the model obliged the group to conceptualise the stroke care and experimentation with the model gave the opportunity to reflect on care.</p> <p>Conclusion</p> <p>SD facilitated the collaborative design process and should be integrated in the early stages of the design process as a quality improvement tool.</p