David Osrin and colleagues discuss the critical importance of reducing global neonatal mortality in developing countries and how community-based approaches can help.
Cognitive readiness can be defined as “possessing the psychological (mental) and sociological (social) knowledge, skills, and attitudes (KSAs) that individuals and team members need to sustain competent professional performance and mental wellbeing in the dynamic, complex, and unpredictable environments of military operations.” Determining if medical personnel are cognitively ready to perform their job poses a considerable challenge to the research community both in terms of understanding what is meant by being cognitively ready and in terms of developing methods to actually assess it. Accordingly, as part of a government-sponsored research program, we set out to gain a better understanding of what is meant by being “cognitively ready” for military medical teams as well as develop a tool for predicting cognitive readiness. In this paper, we describe the design, development, and initial user testing of our Medical Cognitive REadiness Survey Tool (M-CREST).
SUMMARY In a community based study, height and weight increments of 441 Nepali children aged 0-6 years were measured before harvest and six months later and compared with centile standards derived from American children. Low mean growth velocities for height were found only in children under 2 years of age, and for weight during the first 18 months. The mean height for age standard deviation score for the 12-23 months age group was already -2-8 at first measurement. The effect of the initial thinness of the child on subsequent height and weight velocity was reciprocal: thin children seemed to catch up weight at the expense of height.These results suggest that stunting is caused largely by a reduced growth velocity during the nutrition dependent infantile phase of growth, with some additional impairment and delay in onset of the early childhood phase of growth hormone dependent growth, especially in thin children. Nutritional interventions after the second year of life are unlikely to alter the prevalence of linear growth retardation in poor communities. Growth velocity may be more useful than static anthropometry to assess the impact of such interventions.
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