bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rethinking integrated nutrition‐health strategies to address micronutrient deficiencies in children under five in Mozambique
Authors: Picolo Melanie , Barros Iracema , Joyeux Mathieu , Gottwalt Allison , Possolo Edna , Sigauque Betuel , Kavle Justine A. 
Published: February 2019

AbstractIn Mozambique, about two thirds of children 6–59 months of age are affected by vitamin A deficiency and anaemia. The objective of this case study is to provide programme considerations for planning, implementing, monitoring, and evaluating vitamin A and iron deficiency interventions within the context of lessons learned to date for vitamin A supplementation, micronutrient powders (MNPs), and food‐based strategies. For 15 years, the Mozambique Ministry of Health implemented twice‐yearly vitamin A supplementation through both campaigns and routine health services. Yet coverage in 2017 (55%) was not much higher than in 2003 (44%). Reaching every district/reaching every child, a strategy adapted from the field of immunization, was used to achieve equitable coverage of vitamin A and for microplanning of outreach services in health facilities, with support from the Maternal and Child Survival Program. In Mozambique, a free or subsidized distribution model for MNPs has been rolled out, yet integration of MNPs into infant and young child feeding programming (i.e., cooking demonstrations) is needed to reinforce “the who, what, and why” of MNPs through culturally sensitive behaviour change communication. Food‐based strategies to promote dietary diversity, such as through complementary feeding recipes, are also critical. To harmonize efforts, the Mozambique government should consider the development of a national strategy for the prevention and control of micronutrient malnutrition, with clear monitoring and evaluation targets. Ongoing monitoring of the prevalence of micronutrient deficiencies and coverage of implemented micronutrient interventions is needed to make evidence‐based decisions to drive nutrition–health programming.
Accelerating progress for complementary feeding in Kenya: Key government actions and the way forward
Authors: Ahoya Brenda , Kavle Justine A. , Straubinger Sarah , Gathi Constance M. 
Published: February 2019

AbstractOptimal complementary feeding practices, a critical component of infant and young child feeding, has been demonstrated to prevent micronutrient deficiencies, stunting, overweight, and obesity. In Kenya, while impressive gains have been made in exclusive breastfeeding, progress in complementary feeding has been slow, and the country has failed to meet targets. Recent 2014 Kenya Demographic and Health Survey reveal that only 22% of Kenyan children, 6–23 months, met criteria for a minimum acceptable diet. This case study describes key actions for complementary feeding put in place by the Kenya Ministry of Health as well as approaches for improving and monitoring complementary feeding within existing health platforms. Experience from USAID's Maternal and Child Survival Program and Ministry of Health on development of 23 complementary feeding recipes through application of a national guide for recipe development and Trials of Improved Practices is described. Challenges in how to prepare, modify, and cook foods, including meat, for young children 6–23 months of age was relayed by mothers. Addressing cultural beliefs around complementary feeding meant providing reassurance to mothers that young children are developmentally able to digest fruit and vegetables and ready to consume animal‐source protein. Through the Baby Friendly Community Initiative platform, cooking demonstrations and key hygiene actions were integrated with complementary feeding messages. Future programming for complementary feeding should consider development of context specific counselling messages on consumption of animal source foods, strengthen production and use of local foods through agriculture‐nutrition linkages, and include complementary indicators through routine health monitoring systems to track progress.
Strengthening nutrition services within integrated community case management (iCCM) of childhood illnesses in the Democratic Republic of Congo: Evidence to guide implementation
Authors: Kavle Justine A. , Pacqué Michel , Dalglish Sarah , Mbombeshayi Evariste , Anzolo Jimmy , Mirindi Janvier , Tosha Maphie , Safari Octave , Gibson Lacey , Straubinger Sarah , Bachunguye Richard 
Published: February 2019

AbstractIn the Democratic Republic of Congo, 43% of children under 5 years of age suffer from stunting, and the majority (60%) of children, 6–59 months of age, are anaemic. Malaria, acute respiratory infections, and diarrheal diseases are common among children less than 5 years of age, with 31% of children 6–59 months affected by malaria. This qualitative implementation science study aimed to identify gaps and opportunities available to strengthen service delivery of nutrition within integrated community case management (iCCM) at the health facility and community level in Tshopo Province, Democratic Republic of Congo, through the following objectives: (a) examine cultural beliefs and perceptions of infant and young child feeding (IYCF) and child illness, (b) explore the perspectives and knowledge of facility‐based and community‐based health providers on nutrition and iCCM, and (c) gain an understanding of the influence of key family and community members on IYCF and care‐seeking practices. This study involved in‐depth interviews with mothers of children under 5 years of age (n = 48), grandmothers (n = 20), fathers (n = 21), facility‐based providers (n = 18), and traditional healers (n = 20) and eight focus group discussions with community health workers. Study findings reveal most mothers reported diminished quantity and quality of breastmilk linked to child/maternal illness, inadequate maternal diet, and feedings spaced too far apart. Mothers' return to work in the field led to early introduction of foods prior to 6 months of age, impeding exclusive breastfeeding. Moreover, children's diets are largely limited in frequency and diversity with small quantities of foods fed. Most families seek modern and traditional medicine to remedy child illness, dependent on type of disease, its severity, and cost. Traditional healers are the preferred source of information for families on certain child illnesses and breastmilk insufficiency. Community health workers often refer and accompany families to the health centre, yet are underutilized for nutrition counselling, which is infrequently given. Programme recommendations are to strengthen health provider capacity to counsel on IYCF and iCCM while equipping health workers with updated social and behavior change communication (SBCC) materials and continued supportive supervision. In addition, targeting key influencers to encourage optimal IYCF practices is needed through community and mother support groups. Finally, exploring innovative ways to work with traditional healers, to facilitate referrals for sick/malnourished children and provide simple nutrition advice for certain practices (i.e., breastfeeding), would aid in strengthening nutrition within iCCM.
Integrating micronutrient status assessment into the 2015–2016 Malawi Demographic and Health Survey: A qualitative evaluation
Authors: Rhodes Elizabeth C. , Hennink Monique , Jefferds Maria Elena D. , Williams Anne M. , Suchdev Parminder S. , Mapango Carine , Nyirenda Eunice , Mshali Glory , Tripp Katie 
Published: February 2019

AbstractDemand for national‐level micronutrient status data continues to grow, yet little is known about the implementation of different approaches for collecting these data. We conducted an evaluation of the process of linking the 2015–2016 Malawi Demographic and Health Survey (MDHS) and 2015–2016 Malawi Micronutrient Survey (MNS). We conducted 24 in‐depth interviews with stakeholders from the Malawi government and international agencies and field staff. Interview questions explored perceptions of what worked and what was challenging during three phases of implementation: preparation; data collection; and data analysis, reporting, and dissemination. Data were analysed using thematic analysis. Results showed that there was strong government interest to integrate the MDHS and MNS. Perceived benefits included potential cost savings and lower respondent burden. However, government and international agency stakeholders did not view the linkage of the surveys to be a fully integrated approach. The lack of full integration produced challenges throughout implementation, such as complex field logistics and duplication in nutrition indicators assessed and reported. Some stakeholders believed integration was not attainable primarily due to timing. The MDHS and MNS were originally designed as stand‐alone surveys, and planning for each survey was at an advanced stage once the government sought to integrate the surveys. Additionally, the MNS could not be incorporated as a module within the MDHS given the complexity of the MNS data collection and short timeframe for planning. These findings can inform decisions about implementing the next MNS and may be transferable to other countries that are conducting micronutrient surveys to address data gaps.
Baby‐Friendly Community Initiative—From national guidelines to implementation: A multisectoral platform for improving infant and young child feeding practices and integrated health services
Authors: Kavle Justine A. , Ahoya Brenda , Kiige Laura , Mwando Rael , Olwenyi Florence , Straubinger Sarah , Gathi Constance M. 
Published: February 2019

AbstractThe Baby‐Friendly Community Initiative (BFCI) is an extension of the 10th step of the Ten Steps of Successful Breastfeeding and the Baby‐Friendly Hospital Initiative (BFHI) and provides continued breastfeeding support to communities upon facility discharge after birth. BFCI creates a comprehensive support system at the community level through the establishment of mother‐to‐mother and community support groups to improve breastfeeding. The Government of Kenya has prioritized community‐based programming in the country, including the development of the first national BFCI guidelines, which inform national and subnational level implementation. This paper describes the process of BFCI implementation within the Kenyan health system, as well as successes, challenges, and opportunities for integration of BFCI into health and other sectors. In Maternal and Child Survival Program (MCSP) and UNICEF areas, 685 community leaders were oriented to BFCI, 475 health providers trained, 249 support groups established, and 3,065 children 0–12 months of age reached (MCSP only). Though difficult to attribute to our programme, improvements in infant and young child feeding practices were observed from routine health data following the programme, with dramatic declines in prelacteal feeding (19% to 11%) in Kisumu County and (37.6% to 5.1%) in Migori County from 2016 to 2017. Improvements in initiation and exclusive breastfeeding in Migori were also noted—from 85.9% to 89.3% and 75.2% to 92.3%, respectively. Large gains in consumption of iron‐rich complementary foods were also seen (69.6% to 90.0% in Migori, 78% to 90.9% in Kisumu) as well as introduction of complementary foods (42.0–83.3% in Migori). Coverage for BFCI activities varied across counties, from 20% to 60% throughout programme implementation and were largely sustained 3 months postimplementation in Migori, whereas coverage declined in Kisumu. BFCI is a promising platform to integrate into other sectors, such as early child development, agriculture, and water, sanitation, and hygiene.
Root phenotypes for improved nutrient capture: an underexploited opportunity for global agriculture
Authors: Lynch Jonathan P. 
Published: February 2019

SummaryNutrient‐efficient crops are a solution to the two grand challenges of modern agriculture: improving food security while reducing environmental impacts. The primary challenges are (1) nitrogen (N) and phosphorus (P) efficiency; (2) potassium (K), calcium (Ca), and magnesium (Mg) efficiency for acid soils; and (3) iron (Fe) and zinc (Zn) efficiency for alkaline soils. Root phenotypes are promising breeding targets for each of these. The Topsoil Foraging ideotype is beneficial for P capture and should also be useful for capture of K, Ca, and Mg in acid soils. The Steep, Cheap, and Deep ideotype for subsoil foraging is beneficial for N and water capture. Fe and Zn capture can be improved by targeting mechanisms of metal mobilization in the rhizosphere. Root hairs and phenes that reduce the metabolic cost of soil exploration should be prioritized in breeding programs. Nutrient‐efficient crops should provide benefits at all input levels. Although our current understanding is sufficient to deploy root phenotypes for improved nutrient capture in crop breeding, this complex topic does not receive the resources it merits in either applied or basic plant biology. Renewed emphasis on these topics is needed in order to develop the nutrient‐efficient crops urgently needed in global agriculture.
Comparing Urban Citizenship, Sanctuary Cities, Local Bureaucratic Membership, and Regularizations
Authors: Kaufmann David 
Published: February 2019

AbstractIrregular migrants tend to live in dense urban settings. Cities respond to this phenomenon with a variety of urban immigration and citizenship policies in support of irregular migrants. These urban policies produce a disparity between local inclusion and national exclusion. This article describes and compares such urban policies, namely, urban citizenship, sanctuary cities, local bureaucratic membership, and regularizations. Urban citizenship serves as the normative foundation of these policies because it claims membership for all people who inhabit a city. Regularization programs confer national residency status on irregular migrants. Pro‐immigration actors favor this policy; however, when regularizations are not possible, cities can turn to sanctuary city and local bureaucratic membership policies. It is important for practitioners to comprehend and engage with these types of urban policies since they are likely to travel to cities worldwide.
Active emotion regulation mediates links between shyness and social adjustment in preschool
Authors: Hipson Will E. , Coplan Robert J. , Séguin Daniel G. 
Published: February 2019

AbstractShyness is characterized by the experience of heightened fear, anxiety, and social‐evaluative concerns in social situations and is associated with increased risk for social adjustment difficulties. Previous research suggests that shy children have difficulty regulating negative emotions, such as anger and disappointment, which contributes to problems interacting with others. However, it remains unclear precisely which strategies are involved among these associations. Accordingly, the goal of this study was to explore the mediating role of emotion regulation strategies in the links between young children’s shyness and social adjustment at preschool. Participants were 248 preschool children aged 2.5–5 years. Parents rated children’s shyness and emotion regulation strategies in the context of anger and fear. Early childhood educators assessed indices of social adjustment 4 months later. Among the results, active regulation mediated associations between shyness and subsequent prosocial and socially withdrawn behaviors. Child gender further moderated these linkages, such that the model predicting socially withdrawn behavior was stronger among boys. These results expand on our understanding of emotion regulation strategies in shy children’s early socio‐emotional development.
The Politics of Digital Agricultural Technologies: A Preliminary Review
Authors: Rotz Sarah , Duncan Emily , Small Matthew , Botschner Janos , Dara Rozita , Mosby Ian , Reed Mark , Fraser Evan D.G. 
Published: February 2019

AbstractDigital technologies are being developed and adopted across the agro‐food system, from farm to fork. Within decision‐making spaces, however, little attention is being paid to political factors arising from such technological developments. This review draws from critical social sciences to examine emerging technologies and big data systems in agriculture and assesses some key issues arising in the field. We begin with an introduction and review of the so‐called ‘digital revolution’ and then briefly outline how political economy is effective for understanding major challenges for governing technologies and data systems in agriculture. These challenges include: (1) data ownership and control, (2) the production of technologies and data development, and (3) data security. We then use literature and examples to consider the extent to which the political and economic landscape can be shifted to support greater equity in agriculture, while reflecting on structural challenges and limits. In doing so, we emphasise that while there are significant systemic tensions between digital ag‐tech development and agroecological approaches, we do not see them as mutually exclusive per se. This article intends to provide decision‐makers, practitioners and scholars from a wide range of disciplines with a timely assessment of agro‐food digitalisation that attends to political economic factors. In doing so, this article contributes to policy and decision‐making discussions, which, from our perspective, continue to be rather technocentric in nature while paying little attention to how digital technologies can support agroecological systems specifically.
How can training in care of the dying be improved?
Authors: Gajebasia Sareena , Pearce Jessica , Redman Melody , Johnson Miriam , Finn Gabrielle 
Published: February 2019

SummaryBackgroundCare of the dying patient is an intrinsic part of the role of Foundation Year doctors (FYs). This study aimed to explore FYs’ experiences of training and their perceived training needs for their role in care of the dying.Care of the dying patient is an intrinsic part of the role of Foundation Year doctorsMethodsAll FYs in one Foundation school were invited to take part in semi‐structured group or individual interviews. A total of 8 group interviews and 21 individual interviews were conducted with 47 participants. Interview recordings were transcribed verbatim and framework analysis was undertaken.FindingsKey themes derived from the interviews included FYs’ teaching opportunities regarding care of the dying and their learning methods for this subject matter which included learning from experience, observation, simulation, written guidance and supervision. Areas for further training was another key theme and training needs identified included prescribing, communication, recognising dying, documentation, societal perspective and emotional resilience.DiscussionFYs’ training experiences in this area vary. This study identifies training needs that can be used to inform both undergraduate and postgraduate curricula.
Effects of long‐term exposure to elevated temperature on Zea mays endosperm development during grain fill
Authors: Boehlein Susan K. , Liu Peng , Webster Ashley , Ribeiro Camila , Suzuki Masaharu , Wu Shan , Guan Jiahn‐Chou , Stewart Jon D. , Tracy William F. , Settles A. Mark , McCarty Donald R. , Koch Karen E. , Hannah Larkin C. , Hennen‐Bierwagen Tracie A. , Myers Alan M. 
Published: February 2019

SummaryCereal yields decrease when grain fill proceeds under conditions of prolonged, moderately elevated temperatures. Endosperm‐endogenous processes alter both rate and duration of dry weight gain, but underlying mechanisms remain unclear. Heat effects could be mediated by either abnormal, premature cessation of storage compound deposition or accelerated implementation of normal development. This study used controlled environments to isolate temperature as the sole environmental variable during Zea mays kernel‐fill, from 12 days after pollination to maturity. Plants subjected to elevated day, elevated night temperatures (38°C day, 28°C night (38/28°C])) or elevated day, normal night (38/17°C), were compared with those from controls grown under normal day and night conditions (28/17°C). Progression of change over time in endosperm tissue was followed to dissect contributions at multiple levels, including transcriptome, metabolome, enzyme activities, product accumulation, and tissue ultrastructure. Integrated analyses indicated that the normal developmental program of endosperm is fully executed under prolonged high‐temperature conditions, but at a faster rate. Accelerated development was observed when both day and night temperatures were elevated, but not when daytime temperature alone was increased. Although transcripts for most components of glycolysis and respiration were either upregulated or minimally affected, elevated temperatures decreased abundance of mRNAs related to biosynthesis of starch and storage proteins. Further analysis of 20 central‐metabolic enzymes revealed six activities that were reduced under high‐temperature conditions, indicating candidate roles in the observed reduction of grain dry weight. Nonetheless, a striking overall resilience of grain filling in the face of elevated temperatures can be attributed to acceleration of normal endosperm development.
Hyperexcitability and plasticity induced by sustained hypoxia on rectus abdominis motoneurons
Authors: da Silva Melina P. , Moraes Davi José A. , Bonagamba Leni G.H. , Mecawi André de Souza , Varanda Wamberto A. , Machado Benedito H. 
Published: February 2019

Key points
Acute hypoxia induces active expiration in rectus abdominis (RA) muscles in conscious freely moving rats, although its overall contribution is smaller than in internal oblique (IO) muscles.
Tonically active and silent RA motoneurons were identified in in vitro preparations of rat spinal cords.
Sustained hypoxia (SH) increased the synaptic strength and induced morphological changes in tonically active RA motoneurons.
Expiratory RA motoneurons were recorded in the in situ preparation and SH enhanced both the excitability and the synaptic transmission in those firing during the stage 2 expiration.
The present study contributes to a better understanding of the mechanisms involved in SH recruitment of RA motoneurons to induce active expiration in rats.
AbstractRectus abdominis (RA) motoneurons translate the complex respiratory brainstem inputs into effective muscle contractions. Despite their fundamental role in respiration, their functional and morphological properties are not fully understood. In the present study, we investigated for the first time the contribution of RA muscle to active expiration and characterized RA motoneurons regarding their electrical, molecular and morphological profiles in control rats and in rats submitted to sustained hypoxia (SH), which induces chronic recruitment of abdominal muscles. Electromyographic experiments in conscious freely moving control rats and SH rats showed that RA contributes to active expiration induced by acute hypoxia, although its contribution is smaller than in internal oblique muscles. in vitro whole‐cell patch clamp recordings from RA motoneurons revealed two populations of cells: tonically active and silent. SH induced hyperexcitability in the tonically active cells by changing their action potential properties, and EPSCs. Three‐dimensional morphological reconstructions of these cells showed that SH increased the dendritic complexity, stimulated the appearance of dendrite spines, and increased the somatic area and volume. Physiologically identified RA motoneurons, firing in two distinct phases of expiration, were recorded in the brainstem–spinal cord in situ preparation of rats. SH increased the firing frequency and EPSCs of neurons firing during stage 2 expiration. Taken together, our results show that RA motoneurons reconfigure their biophysical properties, morphology and synaptic strength to produce an appropriate expiratory drive in response to SH in rats.