Procedimientos metodológicos para evaluar el estado de los sistemas alimentarios locales

Introducción: El desarrollo del sector agroalimentario local, prioridad estratégica para alcanzar la autosuficiencia alimentaria municipal del país, se alcanza mediante la transformación de los sistemas actuales en sistemas alimentarios sensibles a la nutrición. Objetivo: Diseñar una propuesta metodológica para evaluar los sistemas alimentarios locales como parte del Plan de Soberanía Alimentaria y Educación Nutricional, y disminuir la dependencia de importaciones mediante el incremento de las producciones propias. Métodos: Se hicieron una revisión y recopilación de la información relativa a cada componente de la cadena alimentaria a través del trabajo de grupo con actores clave en la gestión a nivel municipal. Se utilizó la información aportada por la Oficina Nacional de Estadística, el Ministerio de la Agricultura y el Ministerio de Salud Pública provincial y municipal. Resultados: La propuesta incluyó la estimación de las recomendaciones nutricionales ponderadas, la identificación de los principales indicadores de salud, la estimación de energía y nutrientes, el nivel de autonomía o dependencia del territorio, la estimación de las brechas entre disponibilidad y oferta, la repercusión en la salud del déficit o exceso de nutrientes, y la selección de las cadenas productivas prioritarias. Conclusiones: La metodología diseñada permitió dotar a los Gobiernos, productores, comercializadores y decisores de métodos sencillos para el seguimiento, el monitoreo y la evaluación del programa, con mayor aprovechamiento de sus potencialidades, mediante la producción sostenible, resiliente y con equidad de alimentos sanos e inocuos para alcanzar la autosuficiencia alimentaria local.

Introduction: The development of the local agro-food sector, a strategic priority to achieve municipal food self-sufficiency in the country, is achieved through the transformation of current systems into nutrition-sensitive food systems. Objective: To design a methodological proposal to evaluate local food systems as part of the Food Sovereignty and Nutritional Education Plan, and to reduce dependence on imports by increasing local production. Methods: A review and compilation of information related to each component of the food chain were conducted through group work with key actors in management at the municipal level. Information provided by the National Statistics Office, the Ministry of Agriculture, and the provincial and municipal Ministry of Public Health was used. Results: The proposal included the estimation of pondered nutritional recommendations, the identification of the main health indicators, the estimation of energy and nutrients, the level of autonomy or dependence of the territory, the estimation of gaps between availability and provision, the impact on health of nutritional deficiency or excess, and the selection of priority productive chains. Conclusions: The methodology designed allowed providing governments, producers, traders and decision-makers with simple methods for follow-up, monitoring, and evaluation of the program, with greater use of its potential, through sustainable, resilient and equitable production of healthy and safe food to achieve local food self-sufficiency.

Breastfeeding success in the first 6 months of online breastfeeding counseling after cesarean delivery and its effect on anthropometric measurements of the baby: a randomized controlled study

SUMMARY OBJECTIVE: The aim of this study was to determine the effect of online breastfeeding counseling after cesarean section on breastfeeding success and anthropometric measurements of the baby in the first 6 months. METHODS: The study was conducted with single-blind randomized controlled experimental research design and performed with 151 primiparous women as intervention (n=76) and control (n=75) groups. The mothers were given training in the first 24 h postpartum by applying the "Data Collection Form," "Breastfeeding and Infant Follow-up Form," and "Breastfeeding Self-Efficacy Scale - Short Form," who followed up at the first and sixth months, and further again for 6 months. RESULTS: Although there was no difference and homogeneity at the beginning of study among the participants in the intervention group compared with the control group, it was observed that the breastfeeding rates at the first and sixth months were higher and significant. When the anthropometric measurements of the participants in both the groups were compared, it was found that there was a significant difference between the measurements of height and weight at discharge, first, and sixth months. Breastfeeding self-efficacy scores in the intervention group were significantly higher at discharge, 4 weeks postpartum, and 6 months postpartum than those in the control group (p<0.05). CONCLUSIONS: Breastfeeding training and online counseling given to mothers who give birth by cesarean section during the early postpartum period increased breastfeeding rates and self-sufficiency, and the anthropometric measurements of babies were found to be higher at healthy limits.

From Dietary Guidelines to Dietary Guidance.

One challenge is to make food consumption healthful and sustainable. Tools to achieve this include science-based documented dietary advice (here: 'dietary guidelines'), and policy-based initiatives and legislation (here: 'dietary guidance'). These two scientific and political tools operate independently, which may be counterproductive, especially if the future gives rise to high-impact scenarios of food crisis. This paper analyses, based on empirical trend data, the potential of dietary guidelines and guidance, and provides suggestions for these to align. Trend-analyses and empirical data point out that dietary guidelines, although relevant, achieve limited uptake by the consumer. Scientists apparently lack the management tools and communication channels to effectively reach the consumer, and thus major changes are not expected. By contrast, emerging issues such as the obesogenic environment and climate change are likely to call for greater involvement of policy-makers. This paper therefore advocates alignment of science and food policy. First, dietary guidelines, used for individual health promoting purposes, should be calibrated on global considerations. Guidelines on red meat consumption are recommended, as red meat consumption is a burden on both health and sustainability. Second, dietary guidance, used for global health and sustainability promoting purposes, should be calibrated on empowering the individual. Guidance in creating self-sufficient local food networks is recommended, as self-sufficient local food networks address both health and sustainability.

Autonomia, gênero e gravidez na adolescência: uma análise comparativa da experiência de adolescentes e mulheres jovens provenientes de camadas médias e populares em Belo Horizonte / Autonomía, género y embarazo en la adolescencia: un análisis comparativo de la experiencia de adolescentes y mujeres jóvenes provenientes de capas medias y populares en Belo Horizonte / /Self-sufficiency, gender and pregnancy during adolescence: a comparative analysis of the experience of adolescents and young women from middle class and popular strata of the city of Belo Horizonte

Neste trabalho, investiga-se como desigualdades de classe e de gênero atuam no sentido de reduzir o grau de autonomia de adolescentes (15 a 19 anos) e mulheres jovens (20 a 24 anos), influenciando seu comportamento sexual e reprodutivo, especificamente na experiência da gravidez na adolescência. Na análise foram utilizados dados provenientes de dois inquéritos, cuja amostra total foi de 648 jovens do sexo feminino entre 15 e 24 anos de idade, 292 residentes em bairros de classe média e 356 em favelas situados na região centro-sul da cidade de Belo Horizonte, Brasil. Nos resultados, encontrou-se uma prevalência bruta de 27,3% de gravidez até os 19 anos entre as jovens residentes em favelas e de 1,7% entre as moradoras em bairros da região centro-sul de Belo Horizonte. Os dados apontam para uma relação direta entre a gravidez na adolescência com o controle e a violência por parte do parceiro. Entre aquelas residentes em favelas, 48% das que declararam ter sofrido violência física por parte de um parceiro e 58% das que declararam ter sofrido violência sexual haviam engravidado ao menos uma vez antes dos 19 anos. A associação da violência de gênero com a gravidez na adolescência se manteve presente mesmo quando controlada por classe social, ainda que seu peso fosse muito mais pronunciado entre as jovens de baixa renda. Esses resultados reforçam a importância de se aprofundar a compreensão acerca do impacto das desigualdades de classe e gênero no comportamento sexual e reprodutivo de adolescentes e mulheres jovens.

En este trabajo se investiga cómo desigualdades de clase y género actúan en el sentido de reducir el grado de autonomía de adolescentes (15 a 19 años) y mujeres jóvenes (20 a 24 años), influyendo sobre su comportamiento sexual y reproductivo, específicamente en la experiencia del embarazo en la adolescencia. En el análisis se utilizaron datos provenientes de dos investigaciones, con una muestra total de 648 jóvenes del sexo femenino entre los 15 y los 24 años de edad, 292 de ellas residentes en barrios de clase media y 356 en favelas situados en la región centro-sur de la ciudad de Belo Horizonte, Brasil. En los resultados se encontró una prevalencia bruta de 27,3% de embarazo hasta los 19 años entre las jóvenes residentes en favelas y de 1,7% entre las que residían en barrios de la región centro-sur de Belo Horizonte. Los datos señalan una relación directa entre el embarazo en la adolescencia y el control y la violencia de parte del compañero. Entre las jóvenes residentes en favelas, un 48% de las que declararon haber sufrido violencia física de parte de un compañero y un 58% de las que declararon haber sufrido violencia sexual habían quedado embarazadas por lo menos una vez antes de los 19 años. La asociación de la violencia de género con el embarazo en la adolescencia se mantuvo presente incluso cuando controlada por clase social, aunque su peso sea mucho más pronunciado entre las jóvenes de las clases más desposeídas. Estos resultados refuerzan la importancia de profundizar la comprensión acerca del impacto de las desigualdades de clase y género en el comportamiento sexual y reproductivo de adolescentes y mujeres jóvenes.

The present study investigates how class and gender inequalities work toward reducing the level of self-sufficiency of adolescents (15 to 19 years) and young women (20 to 24 years), influencing their sexual and reproductive behavior, specifically with the experience of a teenage pregnancy. In the analysis, the authors used data from two surveys, with a total sample of 648 young females between 15 and 24 years of age: 292 residents in middle class neighborhoods, and 356 from favelas (slums) in the center-south region of the city of Belo Horizonte, Brazil. Results showed an overall prevalence of 27.3% of pregnancy up to 19 years among teenagers living in favelas, and of 1.7% among dwellers of the center-south region neighborhoods of Belo Horizonte. Data point toward a direct relationship between teenage pregnancy and control and violence by partners. Among favela dwellers, 48% of those who declared having been physically abused by their partner, and 58% of those who declared having been sexually abused had been pregnant at least once before the age of 19. The association between gender violence and pregnancy during adolescence remained, even if controlled for social class, although its weight was more pronounced among low income youth. These results strengthen the importance of in-depth understanding of the impact of class and gender inequalities in sexual and reproductive behavior of adolescents and young women.

Regional Variation in Accessing Regional Hospitals for Cancer Patients / 한국역학회지

OBJECTIVES: To investigate the differences in accessing regional hospitals and the utilization rate of hospitals located in other regions for cancer patients by regions. METHODS: Data for the utilization of regional hospitals for cancer patients were obtained from the Korean National Cancer Incidence Databases in 1999 and 2002. We divided the regions into 16 provinces by administrative districts. We using the SAS 9.1.3 to analyze difference of regional self-sufficiency and the Arcview 3.2 to show in a schematize for regional variation of the regional self-sufficiency. RESULTS: There were regional variations in the regional self-sufficiency of cancer patients. Especially, Jeollanam-do(1999 13.6%, 2002 12.8%), Gyeongsangbuk-do(1999 22.0%, 2002 20.7%), and Chungcheongnam-do(1999 27.8%, 2002 27.1%) had low regional self-sufficiency. The regional self-sufficiency in Gyeonggi-do and utilization rate of cancer patients who lived in other regions were increased between 1999 and 2002(regional self-sufficiency: 1999 37.2%, 2002 48.2%). CONCLUSION: The results of this study showed that there were regional variation in utilization of regional hospitals for cancer patients. Accessibility of cancer patients in metropolitan areas was higher than in small size cities, medium size cities, and rural county areas. These results suggested that it should be considered support medical facilities for cancer patients in rural areas where have lower relevance rate.