The Integrated Strategy for Attention in Nutrition (EsIAN) Reduces the Prevalence of Anemia in Children 6 to 59 Months in the Context of a Conditional Cash-transfer Program in Mexico.

Objectives: EsIAN is designed to improve nutritional outcomes through a strong behavior change campaign and free distribution of nutritional products (micronutrient powders, MNP and/or a fortified complementary food, FCF) for children 6 m to 5 y of age living in poverty. Both products were distributed in rural areas and MNP only in urban. We assessed changes in the prevalence of anemia in children, in a pre-post effectiveness trial. Methods: EsIAN was implemented in 2008 in 91 health care centers in central Mexico. Effectiveness was assessed in 2012 using a mixed methods approach. Data from two crosssectional samples of children aged 6 to 59 months (Rural: 2008 n=802, 2012 n=356; 2008 n=569, Urban: 2012 n=546) were analyzed adjusting standard errors by health care center clusters. Results: In rural areas, the concentration of hemoglobin increased from 12.0±0.1 (mean±SE) in 2008 to 12.7±0.1 g/dL in 2012 (P˂0.001). The prevalence of anemia dropped significantly both in urban (23.1±2.5% in 2008; 16.1±2.0% in 2012; P<0.05) and rural areas (23.5±2.0% in 2008; 7.0±1.3% in 2012; P˂0.001). The drop was largest among children aged 6 to 23 months in rural areas (28.3±4.5% percentage points reduction). Conclusions: We document here a dramatic reduction in the prevalence of anemia in communities where EsIAN was implemented. Although this pre-post design does not allow for direct causal attribution, impact pathway review suggests that these changes are likely to be due to the EsIAN.

An Integrated Strategy for Attention in Nutrition (EsIAN) Increases Physicians' and Nurses' Nutrition Knowledge and Perceptions in Mexico.

Objectives: To assess changes in physicians' and nurses nutrition knowledge and perceptions from EsIAN. EsIAN was developed to attend to the nutritional needs of Oportunidades beneficiary families. Oportunidades is the Mexican conditional cash transfer program. In Mexico, appropriate attention to undernutrition and anemia is needed simultaneous with attention to overweight and obesity. EsIAN includes nutritional supplements and a behavior change communication strategy with nutrition counseling tools. The strategy was implemented on pilot scale; we report here the effects on health-care providers' nutrition knowledge and perceptions. Methods: EsIAN was implemented in 2008 in 91 clinics in central Mexico. Effectiveness was assessed in 2012 using a mixed methods approach. Data from two cross-sectional samples were analyzed adjusting standard errors by health care center clusters. Results: Physicians' and nurses' (PN) perceived they have more than 90% capacity to implement the EsIAN in their everyday's practice. Compared to baseline, in 2012 a significantly higher proportion of PN reported recommending exclusive breastfeeding for 6 months (85.7% vs. 23.4%) and breastfeeding techniques (79.8% vs. 12.8%) (p<0.001). More than 88% monitored children growth using weight-for-height and height-for-age indicators as recommended by EsIAN. Nutritional supplements seemed appropriate to 97.8% and 92.3% urban and rural PN, respectively. Conclusions: EsIAN is a highly accepted strategy that can be nationally implemented and is effective to improve providers knowledge and perceptions of essential nutrition actions.

Estabilidad de híbridos de Bagre pseudoplatystoma fasciatum x pimelodus blochii y Pseudoplatystoma fasciatum x perrunichthys perruno almacenados en hielo / Stability of pseudoplatystoma fasciatum x pimelodus blonchii and pseudoplatystoma fasciatum x perrunichthys perruno catfish hybrids stored on ice

Híbridos de bagre provenientes de los cruces P. fasciatum x P. blochii y P. fasciatum x P. perruno, designados como "chorrosco" y "perruno" respectivamente, cultivados, caracterizados mediante análisis proximal y rendimiento porcentual, fueron almacenados en hielo por 19 días evaluándoles la frescura mediante análisis químico (ph, nitrógeno básico volátil), microbiológico (contaje de aeróbios mesófilos y psicrófilos) y sensorial. El contenido graso del bagre "chorrosco" fue aproximadamente el doble al del bagre "perruno", el rendimiento porcentual de ambos híbridos fue similar. Los resultados obtenidos durante el almacenamiento sugieren que la evaluación sensorial es el indicador más útil para predecir el tiempo de vida útil de ambos híbridos y que el tiempo límite de aceptabilidad corresponde con el 10mo. día de almacenamiento en hielo para el bagre "perruno" y entre el 10mo y 12vo día para el bagre "chorrosco" , después comienza un rápido deterioro. Las determinaciones de ph y nitrógeno básico volátil dan información sobre el estado de frescura de ambos híbridos. Para el 7mo día de almacenamiento en hielo el ph alcanzó valores de 7.3 y 7.5 para "chorrosco" y "perruno" respectivamente; los valores de nitrógeno básico volátil se incrementaron de 15.49 mg/100g a 33.5 mg/100g para el bagre "chorrosco" y de 9.62 mg/100g a 30.38 mg/100g en el bagre "perruno", estos incrementos en los valores de ph y de NBVT coincidieron con el inicio de pérdida de la frescura de ambos híbridos según la escala de criterios utilizada en la evaluación sensorial. En el límite de aceptabilidad los contajes de microorganismos psicrófilos y mesófilos fueron del orden de 10 elevado a la cinco UFC/g en el caso del bagre "perruno" y de 10 elevado a la cinco UFC/g y 10 elevado a la tres UFC/g respectivamente, en el caso del bagre "chorrosco"