Pilot Study of Heat-Stabilized Rice Bran Acceptability in Households of Rural Southwest Guatemala and Estimates of Fiber, Protein, and Micro-Nutrient Intakes among Mothers and Children.

Nutrient-dense, acceptable foods are needed in low-resource settings. Rice bran, a global staple byproduct of white rice processing, is rich in amino acids, fibers, and vitamins, when compared to other cereal brans. This pilot study examines the nutritional contribution of rice bran to the daily diets of mother-child pairs in rural southwest Guatemala. Thirty households were screened. Mothers (≥18 years) and children (6 to 24 months) completed 24 h dietary recalls at baseline and after 12 weeks (endline) for diet intake and diversity analyses. During biweekly visits for 12 weeks, households with <5 members received 14 packets containing 60 g of heat-stabilized rice bran, and those with ≥5 members received 28 packets. The macro- and micro-nutrient contributions of rice bran and whole, cooked black beans were included in dietary simulation models with average intakes established between the recalls and for comparison with dietary reference intakes (DRIs). A baseline child food frequency questionnaire was administered. The 27 mothers and 23 children with complete recalls were included in analyses. Daily maternal consumption of 10 g/d of rice bran plus 100 g/d of black beans resulted in all achieving at least 50% of the fiber, protein, magnesium, niacin, potassium, and thiamin DRIs. Daily child consumption of 3 g/d of rice bran plus 10 g/d of black beans resulted in all achieving at least 50% of the magnesium, niacin, phosphorous, and thiamine DRIs. For 15/17 food categories, male children had a higher intake frequency, notably for animal-source foods and coffee. Dietary rice bran coupled with black beans could improve nutritional adequacy, especially for fiber and key micro-nutrients, with broader implications for addressing maternal and child malnutrition in low-resource settings.

Decolonizing Global Child Health Education for More Equitable and Culturally Safe Collaborations.

Global health (GH) as an academic field is fraught with both historical and present systemic injustice, including unilateral partnerships, power asymmetry in grant funding and research agenda setting, lack of acknowledgment of low- and middle-income countries' contributions, and bias toward high-income countries' institutions. Reflecting on colonialism and White supremacy's legacy is vital for training pediatricians to actively work to create more bidirectional partnerships to improve the health of all children worldwide. In this review, we discuss the present challenges within academic GH and offer four key action steps to decolonize GH education: (1) reflecting on the history of global child health; (2) creating a new language framework; (3) reviewing cultural humility, antiracism, and decolonization curricula; and (4) discussing institutional action steps to decolonize and sustain culturally safe global child health education. [Pediatr Ann. 2023;52(12):e467-e473.].

Decolonizing Global Child Health Education for More Equitable and Culturally Safe Collaborations.

Global health (GH) as an academic field is fraught with both historical and present systemic injustice, including unilateral partnerships; power asymmetry in grant funding and research agenda setting; lack of acknowledgment of contributions from low- and middle-income country collaborators; and disadvantageous bias toward low- and middle-income country institutions. Reflecting on the legacies of colonialism and White supremacy is vital for training pediatricians to actively work to improve the health of all children worldwide, within bidirectional and culturally safe partnerships in which power dynamics and ethnocentrism are dismantled. In this article, we discuss the present challenges within academic GH education (GHE) and offer four key action steps to decolonize GHE: (1) reflecting on the history of global child health; (2) creating a new language framework on pertinent concepts in GHE; (3) developing cultural humility, antiracism, and decolonization curricula; and (4) intentional institutional action steps to decolonize and sustain culturally safe global child health education. [Pediatr Ann. 2023;52(9):e344-e350.].

[Evaluation of an intervention for the use of thromboprophylaxis based on electronic alert transmission to first-year medical residents from two hospitals of Lima, Peru]. / Evaluación de una intervención para el uso de tromboprofilaxis basada en el envío de alertas electrónicas a médicos residentes de primer año de dos hospitales de Lima, Perú.

OBJECTIVES.: To assess the implementation of an intervention based on the sending of text messages and e-mails to internal medicine residents in order to achieve an increase in the prescription of thromboprophylaxis according to Clinical Practice Guidelines (CPG). MATERIALS AND METHODS.: A quasi-experimental study was conducted in the inpatient units of internal medicine at two general hospitals in Lima, Peru: one selected to implement the intervention and the other as control. The unit of analysis was the therapeutic order sheet. It was considered that the intervention should increase the order of thromboprophylaxis according to CPG with respect to the initial assessment and also in relation to the control hospital. RESULTS.: Atotal of 394 therapeutic order sheets, 227 (57.4%) from the intervention hospital and 167 (42.4%) from the control, were evaluated. In the intervention hospital, 64.5% initially had an order of thromboprophylaxis according to CPG, which decreased to 54.4% after the intervention; overuse increased from 13.6 to 26.8%. CONCLUSIONS.: Intervention based on sending text messages and e-mails had no impact, showing a tendency to overuse of thromboprophylaxis post-intervention.

Evaluación de una intervención para el uso de tromboprofilaxis basada en el envío de alertas electrónicas a médicos residentes de primer año de dos hospitales de Lima, Perú / Evaluation of an intervention for the use of thromboprophylaxis based on electronic alert transmission to first-year medical residents from two hospitals of Lima, Peru

RESUMEN Objetivos. Evaluar la aplicación de una intervención basada en el envío de mensajes de texto y correos electrónicos dirigido a médicos residentes de medicina interna para lograr el incremento de la prescripción de tromboprofilaxis acorde a Guías de Práctica Clínica (GPC). Materiales y métodos. Se realizó un estudio tipo cuasiexperimental en los servicios de hospitalización de medicina interna de dos hospitales generales de Lima, Perú, uno seleccionado para aplicar la intervención y el otro como control. La unidad de análisis fue la hoja de prescripción médica. Se consideró que la intervención debería incrementar la prescripción acorde a GPC con respecto a la evaluación inicial y también respecto al hospital control. Resultados. Se evaluaron 394 hojas de prescripción médica, 227 (57,4%) procedentes del servicio intervenido y 167 (42,4%) correspondieron del control. En el servicio intervenido, inicialmente el 64,5% tuvo una prescripción acorde a GPC, para disminuir a 54,4% luego de la intervención; el sobreuso aumentó de 13,6 a 26,8%. Conclusiones. La intervención basada en el envío de mensajes de texto y correos electrónicos no tuvo impacto, observándose una tendencia al sobreuso de tromboprofilaxis posintervención.

ABSTRACT Objectives. To assess the implementation of an intervention based on the sending of text messages and e-mails to internal medicine residents in order to achieve an increase in the prescription of thromboprophylaxis according to Clinical Practice Guidelines (CPG). Materials and methods. A quasi-experimental study was conducted in the inpatient units of internal medicine at two general hospitals in Lima, Peru: one selected to implement the intervention and the other as control. The unit of analysis was the therapeutic order sheet. It was considered that the intervention should increase the order of thromboprophylaxis according to CPG with respect to the initial assessment and also in relation to the control hospital. Results. Atotal of 394 therapeutic order sheets, 227 (57.4%) from the intervention hospital and 167 (42.4%) from the control, were evaluated. In the intervention hospital, 64.5% initially had an order of thromboprophylaxis according to CPG, which decreased to 54.4% after the intervention; overuse increased from 13.6 to 26.8%. Conclusions. Intervention based on sending text messages and e-mails had no impact, showing a tendency to overuse of thromboprophylaxis post-intervention.