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Iodine is an essential trace element that is present on the thyroid hormones, thyroxine and triiodotyronine. American Journal of Clinical Nutrition: Economic growth is necessary but not sufficient to accelerate reduction of hunger and malnutrition. Infants aged 6—8 months who receive solid, semisolid or soft foods. They offer no nutritional value and may increase activity in the muscles around the bladder and worsen urinary urgency symptoms. Photo Credits elder berries in a glass image by Maria Brzostowska from Fotolia. The kidneys, unlike the other organs of the abdominal cavity, are located posterior to the peritoneum and touch the muscles of the back.
Why are kidney stones important?
Exclusive breastfeeding reduces infant mortality due to common childhood illnesses, such as diarrhoea and pneumonia, and leads to quicker recovery from illness. Breastfeeding contributes to the health and well-being of mothers, by helping to space children, reducing their risks for ovarian and breast cancers and saving family and national resources.
It is a secure way of feeding and is safe for the environment. Infants aged 6—8 months who receive solid, semisolid or soft foods. WHO recommends starting complementary feeding at 6 months of age. It is defined as the proportion of infants aged 6—8 months who receive solid, semisolid or soft foods.
When breast milk alone no longer meets the nutritional needs of the infant, complementary foods should be added. This is a very vulnerable period, and it is the time when malnutrition often starts, contributing significantly to the high prevalence of malnutrition among children under 5 worldwide. Children aged 6—23 months who receive a minimum dietary diversity.
This indicator is the percentage of children aged 6—23 months who receive a minimum dietary diversity. As per revised recommendation by TEAM in June , dietary diversity is present when the diet contained five or more of the following food groups: Children aged 6—23 months who receive a minimum acceptable diet.
This indicator is the percentage of children aged 6—23 months who receive a minimum acceptable diet. Proportion of children aged months who receive a minimum acceptable diet is included as a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework. The composite indicator of a minimum acceptable diet is calculated from: Dietary diversity is present when the diet contained four or more of the following food groups: The minimum daily meal frequency is defined as: A minimum acceptable diet is essential to ensure appropriate growth and development for feeding infants and children aged 6—23 months.
Without adequate diversity and meal frequency, infants and young children are vulnerable to malnutrition, especially stunting and micronutrient deficiencies, and to increased morbidity and mortality.
Source of all infant and young child feeding indicators. Infant and Young Child Feeding database. Infant and young child feeding list of publications. Global Nutrition Monitoring Framework. Children with diarrhoea receiving oral rehydration therapy and continued feeding. This indicator is the prevalence of children with diarrhoea who received oral rehydration therapy and continued feeding. It is the proportion of children aged months who had diarrhoea and were treated with oral rehydration salts or an appropriate household solution and continued feeding.
As oral rehydration therapy is a critical component of effective management of diarrhoea, monitoring coverage with this highly cost-effective intervention indicates progress towards the child survival-related Millennium Development Goals. Health expenditure includes that for the provision of health services, family planning activities, nutrition activities and emergency aid designated for health, but excludes the provision of water and sanitation. Health financing is a critical component of health systems.
National health accounts provide a large set of indicators based on information on expenditure collected within an internationally recognized framework. National health accounts consist of a synthesis of the financing and spending flows recorded in the operation of a health system, from funding sources and agents to the distribution of funds between providers and functions of health systems and benefits geographically, demographically, socioeconomically and epidemiologically.
General government expenditure on health as a percentage of total government expenditure is the proportion of total government expenditure on health. General government expenditure includes consolidated direct and indirect outlays, such as subsidies and transfers, including capital, of all levels of government social security institutions, autonomous bodies and other extrabudgetary funds.
It consists of recurrent and capital spending from government central and local budgets, external borrowings and grants including donations from international agencies and nongovernmental organizations and social or compulsory health insurance funds.
GDP is the value of all final goods and services produced within a nation in a given year. Public health expenditure consists of recurrent and capital spending from government central and local budgets, external borrowings and grants including donations from international agencies and nongovernmental organizations and social or compulsory health insurance funds. Private health expenditure is the sum of outlays for health by private entities, such as commercial or mutual health insurance providers, non-profit institutions serving households, resident corporations and quasi-corporations not controlled by government involved in health services delivery or financing, and direct household out-of-pocket payments.
These indicators reflect total and public expenditure on health resources, access and services, including nutrition. Although increasing health expenditures are associated with better health outcomes, especially in low-income countries, there is no 'recommended' level of spending on health. The larger the per capita income, the greater the expenditure on health.
Some countries, however, spend appreciably more than would be expected from their income levels, and some appreciably less. When a government spends little of its GDP or attributes less of its total expenditure on health, this may indicate that health, including nutrition , are not regarded as priorities.
National health accounts - World Health Statistics, http: Human development report http: Core health indicators http: Human development report indicator glossary for indicator 3. Wealth, health and health expenditure.
General government expenditure on health as a percentage of total government expenditure is defined as the level of general government expenditure on health GGHE expressed as a percentage of total government expenditure.
The indicator contributes to understanding the weight of public spending on health within the total value of public sector operations. It includes not just the resources channelled through government budgets but also the expenditure on health by parastatals, extrabudgetary entities and notably the compulsory health insurance.
The indicator refers to resources collected and pooled by public agencies including all the revenue modalities. The indicator provides information on the level of resources channelled to health relative to a country's wealth.
These indicators reflect government and total expenditure on health resources, access and services, including nutrition, in relation to government expenditure, the wealth of the country, and per capita. When a government attributes less of its total expenditure on health, this may indicate that health, including nutrition , are not regarded as priorities. UNDAFs usually focus on three to five areas in which the country team can make the greatest difference, in addition to activities supported by other agencies in response to national demands but which fall outside the common UNDAF results matrix.
For each national priority selected for United Nations country team support, the UNDAF results matrix gives the outcome s , the outcomes and outputs of other agencies working alone or together, the role of partners, resource mobilization targets for each agency outcome and coordination mechanisms and programme modalities.
The nutrition component of the UNDAF reflects the priority attributed to nutrition by the United Nations agencies in a country and is an indication of how much the United Nations system is committed to helping governments improve their food and nutrition situation. The indicator is "strong", "medium" or "weak", depending on the degree to which nutrition is being addressed in the expected outcomes and outputs in the UNDAF. UNDAF documents follow a predefined format, with a core narrative and a results matrix.
The matrix lists the high-level expected results 'the UNDAF outcomes' , the outcomes to be reached by agencies working alone or together and agency outputs. The results matrix the UNDAF document was used to assess commitment to nutrition , because it represents a synthesis of the strategy proposed in the document and is available in the same format in most country documents. The outcomes and outputs specifically related to nutrition were identified and counted.
The outputs were compared with the evidence-based interventions to reduce maternal and child under nutrition recommended in the Lancet Nutrition Series Bhutta et al. The method and scoring are described in detail by Engesveen et al. What are the implications?
A weak nutrition component in the UNDAF document does not necessarily imply that no United Nations agency in the country is working to improve nutrition ; however, unless such efforts are mentioned in strategy documents like the UNDAF, they may receive inadequate attention from development partners to ensure the necessary sustainability or scale-up to adequately address nutrition problems in the country. The multisectoral nature of nutrition means that it must be addressed by a wide range of actors.
Basing such action in frameworks for overall development contributes to ensuring the accountability of United Nations partners. Interventions for maternal and child under nutrition and survival. The Lancet Engesveen K et al. SCN News , Nutrition component of poverty reduction strategy papers. The poverty reduction strategy approach was introduced in to empower governments to set their own priorities and to encourage donors to provide predictable, harmonized assistance aligned with country priorities.
The PRSP should state the development priorities and specify the policies, programmes and resources needed to meet the goals. It is prepared by governments in a participatory process involving civil society and development partners, including the World Bank and the International Monetary Fund, and should result in a comprehensive, country-based strategy for poverty reduction.
The indicator is "strong", "medium" or "weak", depending on the degree to which nutrition is addressed in the PRSP, in terms of recognition of under nutrition as a development problem, use of information on nutrition to analyse poverty and support for appropriate nutrition policies, strategies and programmes.
The papers were systematically searched for key words to identify the parts that concerned nutrition , food security , health outcomes and interventions that would be relevant for the World Bank method. In order to classify the commitments to nutrition in the PRSPs, a scoring system was developed, which is described in more detail by Engesveen et al. The emphasis given to nutrition in PRSPs reflects the extent to which the government considers it essential to improve nutrition for poverty reduction and national development.
In other words, it can be an indication of the government's priority for improving nutrition. A strong nutrition component in a PRSP means that the government considers nutrition a priority for poverty reduction and national development. A weak nutrition component in the document does not necessarily imply that no government department is working to improve nutrition ; however, unless such efforts are mentioned in strategy documents like PRSPs, they may not be sufficiently sustainable or be scaled-up to adequately address nutrition problems in the country.
Basing such action in frameworks for overall development contributes to ensuring the accountability of relevant government departments. Sources and further reading. Poverty reduction strategy papers. Assessing countries' commitment to accelerate nutrition action demonstrated in poverty reduction strategy paper, UNDAF and through nutrition governance.
SCN News , , Shekar M, Lee Y-K. Mainstreaming nutrition in poverty reduction strategy papers: What does it take? A review of the early experience. Health, Nutrition and Population Discussion Paper, Landscape analysis on countries' readiness to accelerate action in nutrition , This indicator is a description of the strengths and weaknesses of various aspects of nutrition governance in countries. The following 10 elements or characteristics are used to assess and describe the strength of nutrition governance: These elements were identified by countries as key elements for successful development and implementation of national nutrition policies and strategies during a review of the progress of countries in implementing the World Declaration and Plan of Action for Nutrition adopted by the International Conference on Nutrition, the first intergovernmental conference on nutrition Nishida et al.
The components of the composite indicator have been identified by countries as important for determining the completeness of national nutrition plans and policies Nishida, Mutru, Imperial Laue , For instance, a national nutrition plan and policy was considered to provide the political basis for initiating action. In many countries, official government endorsement or adoption of a national nutrition plan or policy facilitated its implementation.
The role of an intersectoral coordinating committee in implementing national nutrition plans and policies was also considered crucial, although the nature i. Another important element was considered to be regular surveys and other means of collecting data on nutrition. A periodically updated national nutrition information system and routinely collected data on food and nutrition were considered important for evaluating the effectiveness of national nutrition plans and policies and identifying subsequent actions.
Strategies for effective and sustainable national nutrition plans and policies. Modern aspects of nutrition , present knowledge and future perspective. Basel , Karger Forum for Nutrition 56 , This indicates whether a government has adopted legislation to monitor and enforce the International Code of Marketing of Breast-milk Substitutes, which helps create an environment that enables mothers to make the best possible feeding choice, based on impartial information and free of commercial influences, and to be fully supported in doing so.
This indicator is defined on the basis of whether a government has adopted legislation for effective national implementation and monitoring of the International Code of Marketing of Breast-milk Substitutes. The Code is a set of recommendations to regulate the marketing of breast-milk substitutes, feeding bottles and teats. The Code aims to contribute "to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution" Article 1.
Improper marketing and promotion of food products that compete with breastfeeding often negatively affect the choice and ability of a mother to breastfeed her infant optimally. The Code was formulated in response to the realization that such marketing resulted in poor infant feeding practices, which negatively affect the growth, health and development of children and are a major cause of mortality in infants and young children.
Breastfeeding practices worldwide are not yet optimal, in both developing and developed countries, especially for exclusive breastfeeding under 6 months of age. In addition to the risks posed by the lack of the protective qualities of breast milk, breast-milk substitutes and feeding bottles are associated with a high risk for contamination that can lead to life-threatening infections in young infants.
Infant formula is not a sterile product, and it may carry germs that can cause fatal illnesses. Artificial feeding is expensive, requires clean water, the ability of the mother or caregiver to read and comply with mixing instructions and a minimum standard of overall household hygiene.
These factors are not present in many households in the world. Frequently asked questions , These indicators provide information on national policies for legal entitlement to maternity protection, including leave from work during pregnancy and after birth, as well breastfeeding entitlements after return to work.
Since the International Labour Organization ILO was founded in , international labour standards have been established to provide maternity protection for women workers. Key elements of maternity protection include: The right to cash benefits during absence for maternity leave is intended to ensure that the woman can maintain herself and her child in proper conditions of health and with a suitable standard of living.
The source of benefits is important due to potential discrimination in the labour market if employers have to bear the full costs. The right to continue breastfeeding a child after returning to work is important since duration of leave entitlements generally is shorter than the WHO recommended duration of exclusive and continued breastfeeding. A composite indicator on maternity protection is included as a policy environment and capacity indicator in the core set of indicators for the Global Nutrition Monitoring Framework.
It currently uses the ILO classification of compliance with Convention on three key provisions leave duration, remuneration and source of cash benefits , but an alternative method taking into account higher standards as stated in Recommendation as well as breastfeeding entitlements is under development. The ILO periodically publishes information on the above key indicators, including the assessment of compliance with Convention No.
However, an alternative method is under development which may use a scale to indicate the degree of compliance is under development. This method will also take into account higher standards for leave duration and remuneration in Recommendation , as well as breastfeeding entitlements within both the Convention and Recommendation. Pregnancy and maternity are potentially vulnerable time for working women and their families.
Expectant and nursing mothers require special protection to prevent any potential adverse effects for them and their infants. They need adequate time to give birth, to recover from delivery process, and to nurse their children.
At the same time, they also require income security and protection to ensure that they will not suffer from income loss or lose their job because of pregnancy or maternity leave. Such protection not only ensures a woman's equal access and right to employment, it also ensures economic sustainability for the well-being of the family. Returning to work after maternity leave has been identified as a significant cause for never starting breastfeeding, early cessation of breastfeeding and lack of exclusive breastfeeding.
In most low- and middle-income countries, paid maternity leave is limited to formal sector employment or is not always provided in practice. The ILO estimates that more than million women lack economic security around childbirth with adverse effects on the health, nutrition and well-being of mothers and their children.
Maternity cash benefits for workers in the informal economy. Rollins et al Why invest, and what it will take to improve breastfeeding practices? Database of national labour, social security and related human rights legislation. The legislative data are collected by ILO through periodical reviews of national labour and social security legislation and secondary sources, such as the International Social Security Association and International Network on Leave Policies and Research; as well as consultations with ILO experts in regional and national ILO offices around the world.
The composite indicator on maternity protection included in the Global Nutrition Monitoring Framework is currently defined as whether the country has maternity protection laws or regulations in place compliant with the provisions for leave duration, remuneration and source of cash benefits in Convention Documentation for the maternity protection database http: Degree training in nutrition exists.
What does the indicator tell us? This indicator reflects the capacity of a country to train professionals in nutrition in terms of having national higher education institutions offering training in nutrition. This indicator is defined as the existence of higher education institutions offering training in nutrition in the country.
Higher education training institutions include universities and other schools offering graduate and post-graduate degrees in nutrition or dietetics, including public health nutrition, community nutrition, food and nutrition policy, clinical nutrition, nutrition science and epidemiology. Trained nutrition professionals work at facilities including health facilities as well as at population and community levels and may influence nutrition policies, and designing and implementation of nutrition intervention programmes at various levels.
They also play an important role in training of other health and non-health cadres to plan and deliver nutrition interventions in various settings. It is recognized that availability, within a country, of sufficient workforce with appropriate training in nutrition will lead to better outcomes for country-specific nutrition and health concerns.
A competency framework for global public health nutrition workforce development: World Public Health Nutrition Association. Registering as Registered Nutritionist. Building systemic capacity for nutrition: Nutrition is part of medical curricula. This indicator reflects the inclusion of maternal, infant and young child nutrition in pre-service training of health personnel.
This indicator is defined as the existence of pre-service training in maternal, infant and young child nutrition for health personnel. The survey investigates training in three key areas of maternal, infant and young child nutrition, namely growth monitoring and promotion, breastfeeding and complementary feeding, and management of severe or moderate acute malnutrition.
The first two of these three training topics are relevant for all forms of malnutrition, whereas the third topic only pertains to undernutrition. Training on other topics e. Adequate training of health professionals is essential to ensure that nutrition activities are included in their regular health care activities. Nutrition counseling training changes physician behavior and improves caregiver knowledge acquisition. Nutrition Journal ; Trained nutrition professionals density.
The focus of the nutrition professional indicator is on individuals trained to pursue a nutrition professional career, described in most countries as dieticians or nutritionists including nutrition scientists, nutritional epidemiologists and public health nutritionists. These individuals are trained sufficiently in nutrition practice to demonstrate defined competencies and to meet certification or registration requirements of national or global nutrition or dietetics professional organizations.
Dieticians and nutritionists may complete the same training and perform the same functions in some countries but not others. This indicator is defined as the number of trained nutrition professionals per , population in the country in a specified year.
Validation of the indicator has shown that it can predict several maternal, infant and young child nutrition outcomes. Global nutrition monitoring framework: Density of nurses and midwi ves. Nurse and midwife density indicates whether nurses and midwifery personnel are available to address the health care needs of a given population. It is the number of nursing and midwifery personnel and density per 10 population. These personnel include professional nurses, professional midwives, auxiliary nurses, auxiliary midwives, enrolled nurses, enrolled midwives and other personnel, such as dental nurses and primary care nurses.
Traditional attendants are not counted here but as community or traditional health workers. There is no gold standard for a sufficient health workforce to address the health care needs of a given population. It has been estimated, however, that countries with fewer than 25 health-care professionals counting only physicians, nurses and midwives per 10 population fail to achieve adequate coverage rates for selected primary health care interventions that are priorities in the Millennium Development Goals.
The World Health Report Working together for health. The World Health Report papers. G ross domestic product per capita and annual growth rate. GDP per capita purchasing power parity is the GDP divided by the midyear population, where GDP is the total value of goods and services for final use produced by resident producers in an economy, regardless of the allocation to domestic and foreign claims.
It does not include deductions for depreciation of physical capital or depletion and degradation of natural resources. Purchasing power parity indicates the rate of exchange that accounts for price differences across countries, allowing international comparisons of real output and incomes. Purchasing power parity rates allow standard comparisons of real prices among countries, just as conventional price indexes allow comparisons of real values over time; use of normal exchange rates could result in over - or undervaluation of purchasing power.
GDP per capita annual growth rate is defined as the least squares annual growth rate, calculated from constant price GDP per capita in local currency units. Higher income is usually associated with lower rates of mal nutrition. Improving income however, reduces mal nutrition to only a small degree World Bank On the basis of the correlation between growth and nutrition , it is estimated that a sustained per capita economic growth of 2. These estimates suggest that countries cannot depend on economic growth alone to reduce mal nutrition within an acceptable time.
Repositioning nutrition as central to development. A strategy for large-scale action , Human solidarity in a divided world , Official development assistance received net disbursements as a percentage of Gross Domestic Product GDP is a measure of the flow of aid, private capital and debt in comparison with the value of goods and services produced within the country. This indicator is official development assistance received as a percentage of the GDP. Net official development assistance consists of grants or loans to countries or territories from the official sector, with the main objective of promoting economic development and welfare, at concessional financial terms.
GDP is the total value of final goods and services produced within a country's borders in a year, regardless of ownership.
Concentrated urine can result from someone not drinking enough water, sweating a lot, or eating a rich diet or a combination of all these factors. This is because citrate inhibits calcium stones. We make citrate in the kidney when urinary pH is alkaline. Potassium citrate found in lemons and other fruits and vegetables can increase urinary citrate, which can protect against kidney stones.
Apple juice, grapefruit juice, cranberry juice, and cola drinks seem to increase the risk of forming stones. Naturally carbonated mineral water acquires carbonation from dissolved limestone and can contribute to kidney stone formation. You should get a minimum of 2 litres of liquid per day either from water or in foods to produce adequate urine volume you want about 2 litres of urine volume.
Hydration needs fluctuate with body size, climate, physical activity, etc. Beyond hydration, a high animal protein intake is probably the most important factor influencing kidney stone development.
Data has indicated that those who eat a plant-based diet tend to have a lower incidence of kidney stones, even when including more oxalate-rich plants. This may be due to the higher intake of citrate-rich foods on a plant-based diet, which can make the urine more alkaline and help prevent stone formation.
When we consume and absorb high levels of calcium, we must excrete the excess. One way to excrete calcium is via urine. Higher levels of calcium in the urine can increase the chances of kidney stones for certain individuals calcium is the most abundant mineral in kidney stones. Finally, a low calcium intake leads to bone breakdown and higher levels of calcium in the urine.
Further, the body might attempt to relieve itself of the elemental calcium by pushing it through the kidneys resulting in stones. If you supplement with calcium, balance your intake with foods, only use calcium citrate, make sure vitamin D status is controlled not too high or too low , and consume supplements with meals. About — mg per day of calcium should be plenty total — from food and supplements. Oxalic acid is a naturally occurring substance that can bind with minerals.
Oxalates are kind of boring, well, until they crystallize with calcium to form kidney stones. When someone has lots of oxalates in their urine, where the heck did they come from? Well, there are five potential sources of oxalates:. Oxalate content in plants can vary because of differences in climate, soil, ripeness, or section of the plant analyzed. Younger plants have more oxalic acid, which we absorb more of. Older plants have formed calcium oxalate salts, which we absorb less of.
Swap out kale for spinach. Only eat beets during the peak season. Seasonal eating can help control oxalate intake. Some people eat spinach and berries year round. Instead, each spinach and berries only during peak seasons. During the other months, switch to lower-oxalate foods like cauliflower and apples.
Oxalates from food are tricky. Some data even indicates no added risk for stone development from oxalate-rich food. Vitamin B6 pyridoxine is a cofactor in the conversion of glyoxylate to glycine, and its deficiency could increase oxalate production in the body.
So get enough vitamin B6 from sources like whole wheat, brown rice, green leafy vegetables, sunflower seeds, potato, garbanzo beans, banana, spinach, tomatoes, avocado, walnuts, peanut butter, lima beans, and bell peppers. When we use amino acids as an energy source, oxalate synthesis can result. Also, data indicates that a precursor to oxalate, called glycolate, might increase as we consume more animal protein.
Still, these results are variable based on what type of stones the person tends to form. Cola soft drinks may lead to higher levels of oxalates in urine, while decreasing magnesium and citrate.
Bad news if you like your kidneys. Those who drink small amounts of coffee, alcohol, and tea may have a lower risk of kidney stones, even though these beverages can contain oxalates. Green teas, rooibos teas, and herbal teas tend to contain less oxalate than black teas.
Excessive sugar consumption from food or drink may lead to increased oxalate, calcium, and uric acid in the urine. As we increase sodium in the diet, urinary calcium excretion increases, and this can influence stone formation.
By now, most everyone knows I hope that we get most of our sodium from processed foods. Limiting sodium to less than mg per day — simply by switching to unprocessed, whole foods — can greatly decrease the amount of oxalate and calcium in the urine, both extremely helpful in preventing stones.
A note on sodium: We know that yo-yo diets are a great way to form gallstones, but risk for kidney stones also goes up. Large meals and binge eating, especially at night before sleep, can lead to very concentrated urine.
Further, with yo-yo dieting we repeatedly break down stored body fat for energy, leading to metabolic by-products including ketones that must filter through the kidneys. These by-products tend to make the urine more acidic, which can lead to stones. Kidney stones tend to run in families. If you have a relative with kidney stones, your risk is times higher of getting one. Specific factors have been associated with this. A genetic variation can result in more AGT in the mitochondria rather than perioxisomes.
Peroxisomes deal more effectively with plant-derived glycolate, whereas mitochondria handle meat-derived hydroxyproline — both sources of glyoxylate production. This may also explain why researchers are still figuring out which dietary factors are most relevant: Other genetic variations may directly influence oxalate absorption in the gut and sodium-phosphate transporters in the kidney.
There are various medical conditions that can lead to kidney stone formation. Drink at least 2 litres of water per day. Small amounts of coffee, tea, lemon water, and alcohol may also be helpful.
Overeating, overdrinking, and overmedicating can lead to more work for the kidneys. Big meals, yo-yo dieting, and binging put big demands on the kidneys and can promote stone formation. What goes in comes out of both. I have friends who almost never drink water but chug soda all day long, and they have developed big kidney stones that were incredibly painful and required surgery. The caffeine is just too much for the kidneys to handle. A little bit doesn't hurt, but when you don't consume any water to help your urinary system flush things out, you get a buildup of toxins in your kidneys.
Perdido Post 1 What you eat and drink affects your urinary system. I know that whenever I drink lots of tea or soda I have to urinate often. I try to avoid drinking a lot on long trips, because having to stop at a restroom every half hour or so makes the drive home a lot longer! Post your comments Post Anonymously Please enter the code: One of our editors will review your suggestion and make changes if warranted.
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