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32 Food and Agriculture-based Approaches to Safeguarding Nutrition Before, During and After Emergencies: The Experience of FAO

Thompson, B., Amoroso, L. CABI PDF

32

Food and Agriculture-based Approaches to Safeguarding Nutrition Before, During and

After Emergencies: The Experience of FAO

Emergency and Rehabilitation Division (TCE),*†

Technical Cooperation Department (TC)

Food and Agriculture Organization of the United Nations, Rome, Italy

Summary

Standard food-based approaches to nutrition in emergencies are dominated by food aid and emergency feeding programmes. However, agriculture has an important role to play as part of a more integrated package to tackle nutrition in emergencies. In order to maximize the impact of agriculture-based responses, two ‘lenses’ are important. First, a ‘nutrition lens’ to ensure that projects and programmes are designed, implemented and monitored with nutritional outcomes in mind. Secondly, a ‘disaster risk management’ lens, which highlights the importance of reducing the impact of disasters through risk reduction and recovery actions in addition to standard response actions. FAO is involved in a range of emergency projects with assumed or measured nutritional impacts, and is striving to apply both ‘lenses’ to its interventions in emergencies; however, there are a number of challenges. Meeting these challenges requires a combination of activities that include: nutrition awareness raising between FAO and the food security ‘community’; incorporating nutrition-related objectives as well as required indicators for targeting and monitoring (e.g. dietary diversity for adults, diversity of complementary foods for children); building the evidence base on agriculture–nutrition linkages through improved monitoring and evaluation (M&E) and lesson sharing; advocating joint planning by agencies at country level using a shared conceptual and analytical framework for food and nutrition interventions; better articulation of Food Security and Nutrition clusters; and better enforcement of nutrition goals and mainstreaming in appeal programmes and project documents and monitoring. Support to sustainable food-based interventions in emergencies from a ‘right to food’ perspective is another area that requires a stronger focus.

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5: Individual assessment

Peter Blake Karnac Books ePub

There are two broad ways of individually assessing a child. It can be done in a structured way, with formal testing and/or a particular set of questions. Alternatively, it can be unstructured, with no preconceived agenda. The unstructured approach entails careful and detailed observation of whatever is happening in the room, allowing the child to take the lead.

My first training was in clinical psychology, and I began assessing children by administering formal tests (such as projective cards and questionnaires). In my early days I was anxious when seeing children. I wasn't sure how to talk to them or what to do in the interview. I found these tests gave me some structure. This enabled me to be less anxious and more able to observe and think about their responses.

As my experience grew I felt more comfortable in doing away with this structure. I was becoming more interested in a psychoanalytic way of working. This meant allowing greater space or freedom to explore what the child was spontaneously giving me. In the interview this meant I had a rough idea of the areas I wanted to cover, but I was more relaxed to let the child wander off the topic and follow their lead. As my psychotherapy training developed, I found my anxiety lessened and my observational skills increased. This enabled me to let go of any kind of structure and to enter a session and to see what happens. This latter approach I am calling unstructured.

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7 Colonization and Its Importance for the Emergence of Clinical Resistance

LaPlante. K. CABI PDF

7

Colonization and Its Importance for the Emergence of Clinical

Resistance

Curtis J. Donskey*

Case Western Reserve University and Louis Stokes Cleveland Veterans Affairs

Medical Center, Cleveland, Ohio, US

Introduction

Selective pressure exerted by antimicrobials plays a central role in the emergence and dissemination of antimicrobial-resistant pathogens. Systemic antimicrobials exert selective pressure not only on infecting microorganisms, but also on the normal microbiota of the host (e.g., the gastrointestinal tract, genitourinary tract, upper respiratory tract, and skin). Although a minority of those acquiring colonization with resistant pathogens develop infection, colonized individuals serve as a major reservoir for transmission. The intestinal tract is a particularly important source for the dissemination of resistant pathogens, including Enterococcus spp., Gram-negative bacilli,

Clostridium difficile, Candida spp., and Staphylococcus aureus (Vollaard and Clasener, 1994; Cole et  al.,

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10. Concerning the perception of one’s own attributes and its relation to language development

Donald Meltzer Karnac Books ePub

Donald Meltzer with Mme Eve Cohen (Paris)

The differentiation in the clinical setting of psychoanalysis be tween the manifestations of delusions and the reporting of primitive perceptions would seem to be an area of observation and description opened up by Bion’s Theory of Thinking. By offering us a model that enables us to conceive of such a differentiation he has made possible our monitoring the phenomena of our consulting room for their realizations. The theory of alpha-function and beta-elements has already proved itself fruitful for clinical observation in the area of communication of meaningful messages versus communication-like missiles of meaningless stuff. In work with psychotic children it has helped us to recognize their response to bombardment with emotional experiences for which they have no capacity either of containment or thought. It also gives us a basis for distinguishing between immaturity and psychosis.

A report presented by Mme Eve Cohen at a seminar held in Paris in April 1982 throws some valuable light on the problem. Mme Cohen’s material concerned her patient, Henri, aged twenty-six, who had had a breakdown while abroad after six years of aimless wanderings following upon his mother’s departure from the family home to live with a lover with whom she had had a secret liaison for over ten years. Among his complaints at the time of hospitalization there was none of the usual delusional ideas nor was his demeanour and mode of communication bizarre or unfriendly or secretive. On the contrary, he was very open in describing the many phenomena of perception of himself and the world which troubled him and prevented him from maintaining any settled mode of life.

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CHAPTER EIGHT. Extended family explorations using dreams, drawings, and play when the referred child does not speak

Jeanne Magagna Karnac Books ePub

Jeanne Magagna

Henri Rey in Universals of Psychoanalysis states that “what patients think they are coming to treatment for and that which emerges in the course of treatment could be very different” (Rey, 1994, p. 229). He goes on to say that people may be asking for “an improvement”, while the real request is how to bring about reparation of some threatened and dying internalised family members. Without such reparation of some damaged mentalizing functions of the internalised parents, the individual referred child cannot function normally and happily. Psychic reparation of mentalizing functions may be required, not only in the individual child, but also within family relationships.

Most frequently, when parents perceive that their non-speaking child is having a difficulty or they are having a difficulty with their non-speaking child, they refer the child for individual psychotherapy and sometimes for speech therapy. They are bringing something which needs repairing in the child.

In this particular chapter, I am referring specifically to families where the severely regressed and withdrawn child is not talking, walking, or eating; however, the chapter is equally pertinent to families with children who are simply not talking for various reasons. Out of concern for the child, it is important to offer 2 or 3 individual psychotherapy assessments for a non-speaking child, who obviously may still be able to think, regardless of whether or not he is speaking and thus still deserves to have a thoughtful person thinking about the emotional situation in which the child finds himself. Out of respect for the nature of the difficulties which require repair, I believe it is also essential to create an adequate mental space for looking at family relationships within the entire family, including all siblings and anyone living with the family. Family explorations are useful to ascertain which aspect of the emotional relationships within the external and internal mental life of the family require repair. Family explorations are also useful to discover the family strengths which can be used to facilitate development of the family’s capacity to think together about emotional experiences.

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