Public health nutrition capacity: assuring the quality of workforce preparation for scaling up nutrition programmes.

Objective: To describe why and how capacity-building systems for scaling up nutrition programmes should be constructed in low- and middle-income countries (LMIC).

Design: Position paper with task force recommendations based on literature review and joint experience of global nutrition programmes, public health nutrition (PHN) workforce size, organization, and pre-service and in-service training.

Setting: The review is global but the recommendations are made for LMIC scaling up multisectoral nutrition programmes.

Vitamin A policies need rethinking.

The prevalence of vitamin A (VA) deficiency, which affects about one-third of children in developing countries, is falling only slowly. This is despite extensive distribution and administration of periodic (4- to 6-monthly) high-dose VA capsules over the past 20 years, now covering a reported 80% of children in developing countries. This massive programme was motivated largely by an expectation of reducing child mortality, stemming from findings in the 1980s and early 90s.

The first 500 days of life: policies to support maternal nutrition.

Background: From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months--about 500 days--is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here.

Nutrition capacity development: a practice framework.

Objective: To outline a framework and a process for assessing the needs for capacity development to achieve nutrition objectives, particularly those targeting maternal and child undernutrition.

Design: Commentary and conceptual framework.

Setting: Low- and middle-income countries.

Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?

Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved.

Trends in low birthweight among the Bhutanese refugee population in Nepal.

Background: Although much is known about risk factors for low birthweight, an important cause of neonatal death, little is known about how to reduce or prevent low birthweight.

Objective: This study aimed to verify a low rate in the incidence of low birthweight reported in the Bhutanese refugee camps in Nepal and, if true, to try to understand how this came about.

Methods: Medical records from 1994 to 2001 were recovered for half of the refugee population, and birthweight and other maternal factors were analyzed.

Worldwide timing of growth faltering: revisiting implications for interventions.

Objective: Our goal was to describe worldwide growth-faltering patterns by using the new World Health Organization (WHO) standards.

Methods: We analyzed information available from the WHO Global Database on Child Growth and Malnutrition, comprising data from national anthropometric surveys from 54 countries. Anthropometric data comprise weight-for-age, length/height-for-age, and weight-for-length/height z scores.

Multiple micronutrient supplementation during pregnancy in developing-country settings: policy and program implications of the results of a meta-analysis.

Background: An independent Systematic Review Team performed a meta-analysis of 12 randomized, controlled trials comparing multiple micronutrients with daily iron-folic acid supplementation during pregnancy.

Objective: To provide an independent interpretation of the policy and program implications of the results of the meta-analysis.

Methods: A group of policy and program experts performed an independent review of the meta-analysis results, analyzing internal and external validity and drawing conclusions on the program implications.

An effectiveness trial of multiple micronutrient supplementation during pregnancy in Vietnam: impact on birthweight and on stunting in children at around 2 years of age.

Background: Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development offuture generations.

Objective: We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years of age.

Methods: We conducted a nonrandomized, non-blinded, side-by-side effectiveness trial in a normal program setting in three districts in the Red River Delta in the north of Vietnam.

CD205 (DEC-205): a recognition receptor for apoptotic and necrotic self.

CD205 is an endocytic receptor that is expressed at high levels by cortical thymic epithelial cells and by dendritic cell (DC) subsets, including the splenic CD8+ DC population that is responsible for cross-presentation of apoptotic cell-derived antigens. Antigen endocytosed via CD205 enters the MHC class I and MHC class II antigen presentation pathways and is subsequently presented to both CD4+ and CD8+ T cells. Despite the known role of CD205 in antigen uptake, the nature of the ligands bound by CD205 has not been determined, and most studies have relied on the use of monoclonal antibodies as surrogate ligands.

Setting priorities for zinc-related health research to reduce children's disease burden worldwide: an application of the Child Health and Nutrition Research Initiative's research priority-setting method.

Objective: To make the best use of limited resources for supporting health-related research to reduce child mortality, it is necessary to apply a suitable method to rank competing research options. The Child Health and Nutrition Research Initiative (CHNRI) developed a new methodology for setting health research priorities. To broaden experience with this priority-setting technique, we applied the method to rank possible research priorities concerning the control of Zn deficiency.

Growth monitoring and promotion: review of evidence of impact.

Unlabelled: [Table: see text]

Summary: The rationale for growth monitoring and promotion is persuasive but even in the 1980s the appropriateness of growth monitoring programmes was being questioned. The concerns centred largely around low participation rates, poor health worker performance and inadequacies in health system infrastructure that constrained effective growth‐promoting action. More recently there has been a call for a general review of the impact of large‐scale growth monitoring and promotion programmes to determine if the investments are justified.

Nutrition education in the context of the United Nations Standing Committee on Nutrition activities and publications, 1985-2006.

The United Nations System Standing Committee on Nutrition (SCN) is a forum where United Nations (UN) agencies, bilateral partners, and nongovernmental agencies meet to harmonize and coordinate nutrition policy and programs. This report reviews the positions taken regarding nutrition education throughout SCN publications, annual sessions, and thematic working groups. The first Nutrition Policy Paper, published in 1985, was a State-of-the-Art Review that investigated 6 aspects of a nutrition education system.

Altered expression and endocytic function of CD205 in human dendritic cells, and detection of a CD205-DCL-1 fusion protein upon dendritic cell maturation.

CD205 (DEC-205) is a member of the macrophage mannose receptor family of C-type lectins. These molecules are known to mediate a wide variety of biological functions including the capture and internalization of ligands for subsequent processing and presentation by dendritic cells. Although its ligands await identification, the endocytic properties of CD205 make it an ideal target for those wishing to design vaccines and targeted immunotherapies.