RESUMO
Background: This study was undertaken to evaluate if there are differences between visual estimation of blood loss (EBL) and quantitative blood loss (QBL) for maternal outcomes related to obstetrical hemorrhage. Methods: This retrospective study compared EBL (n = 500) to QBL (n = 501) for outcomes of length of stay, readmission within 30 days of discharge, percent receiving blood transfusions, time between delivery to receiving blood transfusion, and postpartum hemoglobin level. Results: The QBL group had a significantly lower mean length of stay than the EBL group (2.6 vs 3.2 days, P < 0.001). Multivariate linear regression analysis adjusting for relevant covariates had a similar finding of lower length of stay for QBL vs EBL (B = -0.13, SE = 0.01, P < 0.001). Readmission within 30 days, blood transfusion, time to transfusion since delivery, and postpartum hemoglobin did not significantly differ between the QBL and EBL groups. Conclusion: We recommend that clinicians adopt QBL over EBL as standard practice since QBL is associated with lower length of stay and does not negatively impact other clinical outcomes.
RESUMO
BACKGROUND: As concerns about agrodiversity loss and its impact on food security increase, interest in seed-saving practices and motivations has risen, especially in regions characterized by ancestral farming. Agroecology practitioners in the northern Andes of Ecuador (n = 65) participated in this study to describe (1) the dynamics of intergenerational agrodiversity, (2) perceptions of relevance of the crops they grow, (3) criteria for characterizing the differences between conventional and non-conventional seeds, and (4) their seed-saving practices. METHODS: This exploratory study incorporated a community-based participatory research approach using mixed methods. We conducted (1) a timeline mapping for exploring the dynamics of intergenerational agrodiversity and (2) structured interviews to explore the perception of relevance of crops grown to identify criteria for characterizing conventional and non-conventional seeds and for identifying seed-saving practices. We computed ranks and frequencies from free listing data derived from the interviews to detect the most salient patterns for crop diversity and seed-saving practices. A principal component analysis was performed to illustrate crops distribution within the study area. RESULTS AND DISCUSSION: Based on the timeline-mapping tool, we found that participants perceive an intergenerational loss of agrodiversity. Data derived from free listing determined that salient crops differ in each location of the study area, mostly due to geographic (altitude, climate), market factors, and crop management limitations. Responses from open-ended interview questions revealed that farmers discriminate conventional from non-conventional seeds using yield, adaptation to local conditions, pest tolerance, taste, and crop management as criteria. Analysis of free listing data determined that the most salient reported practices related to seed saving were soil fertility management, seed selection, safe seed storage, tilling and rowing, and weeding. CONCLUSIONS: This study contributes to raising awareness of intergenerational agrodiversity loss and replacement with modern crops. We found the relevance of crops and practices is subject to cultural and environmental context, and few agricultural practices are exclusively used for seed saving. Further, farmers clearly discriminate conventional from non-conventional seeds based on advantages and disadvantages, cultural motivation, and produce destination. The community-based participatory approach resulted in positive engagement from participants and promoted commitment from farmers to preserve agrodiversity and support practices at the community level.