the positive deviance peace corps nutrition guide: a community-based approach to behavior change...

8/20/2019 The Positive Deviance Peace Corps Nutrition Guide: a community-based approach to behavior change for improve…

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Peoje Jfrps

Pumbkjotkfn Nf. G00;4

She Pfsktkve Cevkonje

Nutrktkfn Lukce dfr

Peoje Jfrps Tfbunteerso jfggunkty-mosec opprfojh tf mehovkfr jhonle

dfr kgprfvec nutrktkfn futjfges


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She Pfsktkve Cevkonje

Nutrktkfn Lukce

dfrPeoje Jfrps Tfbunteers

o jfggunkty-mosec opprfojh tf mehovkfr jhonle dfrkgprfvec nutrktkfn futjfges

Goy =0?3

Peoje Jfrps

Pumbkjotkfn Nf. G00;4


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KK Peoje Jfrps


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers k

Ojanfwbeclegents

Jfuntrkes servec my the Peoje Jfrps, portkjuborby thfse kn \est Odrkjo, hove meen dfrtunote tf hove o

sklnkjont ‒ckffuskfn fd knnfvotkfn‗ fd the Pfsktkve Cevkonje Nutrktkfn prflrog. Sf o borle extent, thks

ckffuskfn jon me ottrkmutec tf the frklknob Peoje Jfrps PC Heorth Nutrktkfn Lukce wrktten my Ogonco

Pobger, whf servec os o Tfbunteer kn Lukneo (=000-=00=). Kn =008, Orkeb \olner onc fther Peoje Jfrps

Tfbunteers servknl kn Gobk upcotec onc sklnkjontby enhonjec the lukce mosec fn thekr experkenjes.

Shks jurrent ecktkfn represents o jfbbomfrotkve efffrt thot knktkobby melon kn =0??.

She Peoje Jfrps ks lrotedub tf JF]E Lrfup gegmers whf prfvkcec jfnskcerombe tejhnkjob deecmoja

fn woys tf kgprfve eorby verskfns fd thks lukce onc tf jfbbeolues ot the Pfsktkve Cevkonje Knktkotkve

(PCK) dfr thekr thfulhtdub revkew, lukconje, onc potkenje.

She Peoje Jfrps obsf expresses kts lrotktuce tf ossfjkote Peoje Jfrps ckrejtfrs kn the Heobth sejtfr

onc thekr respejtkve Tfbunteers kn Gobk, Murakno Dosf, Zenelob, onc Lukneo. Shekr wfra fn thks

jfggunkty-mosec nutrktkfn prflrog onc wkbbknlness tf shore were vktob tf the prfcujtkfn fd thks

lukce.


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kk Peoje Jfrps

Exejutkve Zuggory

Gobnutrktkfn ks o jhobbenlknl prfmbeg kn gony Peoje Jfrps Tfbunteer jfggunktkes. Dfrtunoteby,

Tfbunteers enify o bkterob ‒seot ot the tombe‗ when kt jfges tf kgprfvknl nutrktkfn, meknl webjfgec kntf

hfges tf shore geobs wkth jfggunkty gegmers. Shks fffers theg o unkque fppfrtunkty tf goae on

kgpojt jfnjernknl anfwbecle, ottktuces, onc ubtkgoteby mehovkfrs kn rederenje tf dffc onc nutrktkfn.

Shks lukce ossksts Tfbunteers tf metter uncerstonc the gethfcfbfly fd Pfsktkve Cevkonje (PC) onc tf

exejute the vorkfus steps thot ensure ojtkvktkes ore pbonnec opprfprkoteby, use bfjobby cksjfverec PC

mehovkfrs, wfra wkth the jfrrejt portkjkponts, cfn‛t ckspboje fther effejtkve prflrogs, onc stress dfbbfw-

up onc jfggunkty enlolegent tf ensure bostknl sfbutkfns.

She lukce ks geont tf kndfrg Pfsktkve Cevkonje-Nutrktkfn ojtkvktkes. Pfsktkve Cevkonje kn the reobg

fd nutrktkfn hos fdten knjbucec Heorth ojtkvktkes, mut experkenje hos shfwn thot sujh ojtkvktkes kn

ksfbotkfn drfg prfper PC knqukrkes hove drequentby celenerotec kntf bffseby run suppbegentory deecknl

prflrogs.

Kn skgpbe tergs, the Heorth gfceb mrknls tflether o lrfup fd jorelkvers onc thekr yfunl jhkbcren tf eot

tflether kn o lrfup settknl. Essentkobby o suppbegentory deecknl ojtkvkty, the Heorth hos trocktkfnobbyknjbucec heobth ecujotkfn tfpkjs onc cksjusskfn fn jorknl projtkjes wkth onc metween the jorelkvers.

She lukce ks nftomby gfre tejhnkjob thon prevkfus verskfns usec my the Peoje Jfrps. Shks ks o resubt

fd the evfbutkfn fd treotgent dfr ojute gobnutrktkfn futskce fd the olenjy onc o stoncorckzotkfn

fd opprfprkote, evkcenje-mosec projtkje wkth on egphosks fn ‒Cf Nf Horg‗ prflroggknl. \hkbe

enlolknl kn thks woy requkres lreoter cetokb tf troknknl onc uncerstoncknl fd tejhnkjob nutrktkfn, kt ks

nejessory when ceobknl wkth jhkbcren whf hove on ebevotec rksa fd gobnutrktkfn.

Fne goifr jhonle drfg prevkfus lukconje ks strkjt rederrob dfr cetejtec joses fd severe ojute

gobnutrktkfn (ZOG). ZOG ks o jbknkjob jfncktkfn thot requkres prfdesskfnob jore onc treotgent thot ks

futskce the reobg fd Tfbunteers. Kn occktkfn tf thks, sjreenknl fd jhkbcren ks nfw ocvksec tf knvfbve

Gkc-Upper Org Jkrjugderenje (GUOJ) dfr sebejtknl portkjkponts, whkjh obklns the opprfojhwkth sjreenknl prftfjfb usec ebsewhere kn jfgmotknl ojute gobnutrktkfn. Shks jhonle stkbb obbfws

Tfbunteers tf obkln wkth Lrfwth Gfnktfrknl Prflrogs, kn occktkfn tf the weklhts thot ore typkjobby

jfbbejtec kn these wkcespreoc prflrogs.

She re-mroncknl fd PC-Nutrktkfn ks on kntentkfnob receckjotkfn tf the prknjkpbes fd PC onc on expbkjkt

efffrt tf ensure thot PC jon me egpbfyec wkth fr wkthfut Heorth. She Heorth ojtkvktkes occress

knocequote jfgpbegentory deecknl projtkjes, o sknlbe mut jfgpbkjotec crkver fd gobnutrktkfn. Zknje

gobnutrktkfn jon me jousec my gubtkpbe dojtfrs, thks ocoptotkfn enjfuroles the kgpbegentotkfn fd PC

tf expbfre PC mehovkfrs meyfnc ‒whot‛s kn the mfwb‗ dfr prfgftkfn onc projtkje.

PC stresses ojtkfn whkbe egpfwerknl jfggunktkes tf bffa knworc dfr sfbutkfns. She cynogkj jreotec

my jfggunktkes jffperotknl tf sfbve prfmbegs fn thekr fwn shfubc nft me uncerestkgotec. PC ksomfut egpfwergent onc lkves jfggunktkes fwnershkp fd the sfbutkfns tf thekr fwn prfmbegs.

Pbonners ore enjfurolec tf reejt moja fn the lukcknl prknjkpbes fd PC perkfckjobby thrfulhfut

kgpbegentotkfn onc regknc thegsebves fd hfw kgpfrtont the jfggunkty ks tf the prfjess.

\kth joredub pbonnknl onc menejkory sebejtkfn, PC Nutrktkfn jon hebp tf ojhkeve o tronsdfrgotkve

prfjess kn the jfggunktkes PJ serves. Shfulh jore gust me toaen tf gonole rksas when wfraknl kn

nutrktkfn, the reworcs jon me enfrgfus onc pftentkobby bkde jhonlknl.


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers kkk

Ojrfnygs

OPJC Ossfjkote Peoje Jfrps Ckrejtfr (jfggfnby anfwn os Prflrog Gonoler)

O]K Ojute ]espkrotfry Kndejtkfn

MJJ Mehovkfr Jhonle Jfggunkjotkfn

MNE Mreost-deecknl Nutrktkfn Ecujotfr

JH\ Jfggunkty Heobth \fraer

JGOG Jfggunkty Gonolegent fd Ojute Gobnutrktkfn

JZL Jfggunkty Zuppfrt Lrfup

CMJ Cesklnknl dfr Mehovkfr Jhonle

CHZ Cegflrophkj onc Heobth Zurveys

ENO Essentkob Nutrktkfn Ojtkfns

DLC Dfjus Lrfup Cksjusskfn

LDC Lenerob Dffc CkstrkmutkfnLGP Lrfwth Gfnktfrknl onc Prfgftkfn

HdO Heklht dfr Ole

KEJ Kndfrgotkfn onc Ecujotkfn Jfggunkjotkfn

GOG Gfcerote Ojute Gobnutrktkfn

GFH Gknkstry fd Heobth

GUOJ Gkc-Upper Org Jkrjugderenje

NLF Nfnlfverngentob Frlonkzotkfn

NPC Nfn Pfsktkve Cevkont

F]Z Frob ]ehycrotkfn Zfbutkfn

FSP Futpotkent Sheropeutkj Prflrog

FTJ Frphons onc Tubnerombe Jhkbcren

PC Pfsktkve Cevkonje

]USD ]eocy tf Use Sheropeutkj Dffcs

ZOG Zevere Ojute Gobnutrktkfn

ZC Ztoncorc Cevkotkfn

ZDP Zuppbegentory Deecknl Prflrog

SMO Srocktkfnob Mkrth Ottencont

SDJ Sheropeutkj Deecknl Jenter

TCJ Tkbbole Cevebfpgent Jfggkttee

THZL Tkbbole Heobth Zuppfrt Lrfup

\dO \eklht dfr Ole

\dH \eklht dfr Heklht

\DP \frbc Dffc Prflrog

\HF \frbc Heobth Frlonkzotkfn


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kv Peoje Jfrps

Sombe fd Jfntents

Zf \hot ks Pfsktkve Cevkonje Nutrktkfn6 ...........................................................................................?

She Pfsktkve Cevkonje Jfnjept ....................................................................................................................=

Pfsktkve Cevkonje Nutrktkfn & Pfsktkve Cevkonje Heorth ........................................................................3

PC Nutrktkfn onc the Peoje Jfrps ...............................................................................................................4

She Peoje Jfrps, Pfsktkve Cevkonje onc Mehovkfr Jhonle ....................................................................4

Cesklnknl dfr Mehovkfr Jhonle ...................................................................................................................<

Cesklnknl dfr Mehovkfr Jhonle onc the Peoje Jfrps .............................................................................<

She Lfobs fd PC Nutrktkfn ..............................................................................................................................;

Lukcknl Prknjkpbes fd the PC Opprfojh ................................................................................................... ?0

She Ethkjs fd PC Nutrktkfn ‚ Cf Nf Horg ................................................................................................ ?0

Gobnutrktkfn Moskjs ............................................................................................................................ ?:

Uncernutrktkfn ............................................................................................................................................. ?3

Jhrfnkj Gobnutrktkfn .................................................................................................................................................?3

Ojute Gobnutrktkfn .....................................................................................................................................................?3

Fvernutrktkfn ................................................................................................................................................ ?5

She Jyjbe fd Gobnutrktkfn ........................................................................................................................... ?5

Ojtkfns thot Prfgfte Fptkgob Nutrktkfn Futjfges ............................................................................. ?4

She ?,000 Coys…onc Meyfnc ................................................................................................................... ?4

Onthrfpfgetry ............................................................................................................................................ ?<

\eklht dfr Heklht .......................................................................................................................................................?<

Gkc-Upper Org Jkrjugderenje (GUOJ) ............................................................................................................. ?8

\eklht dfr Ole .............................................................................................................................................................?;

Heklht dfr Ole ..............................................................................................................................................................=0

PC Nutrktkfn Prflrog Pbonnknl onc Exejutkfn ............................................................................ =:

Phose ?9 Cenknl the Prfmbeg, Ossessknl Deoskmkbkty, onc Gfmkbkzknl the Jfggunkty ................ =3

Lrfwth Gfnktfrknl onc Prfgftkfn ‚ Cenknl the Prfmbeg .....................................................................=3

Cetergknknl the Deoskmkbkty dfr PC Nutrktkfn ‚ Jrktkjob Goss dfr Sronsdfrgotkve Jhonle fd PC ....=4

Goaknl Zense fd PC wkth Fther Prflrogs, Ojtfrs, onc Ojtkvktkes ............................................................ =<

Jfggunkty Zuppfrt..................................................................................................................................................=;

Mukbcknl the Knterventkfn Seog ............................................................................................................................. :0

Phose =9 Cksjfvery ‚ Cetergknknl Jfggfn Projtkjes onc Morrkers tf Jhonle.............................. :?

Dfjus Lrfup Cksjusskfns ......................................................................................................................................... :?


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers v

Jfncujtknl o \eobth ]onaknl Ojtkvkty kn Dfur Zteps .................................................................................... ::

Phose :9 Cetergknknl Portkjkponts, Pfsktkve Cevkonts, onc Jfncujtknl thePfsktkve Cevkonje Knqukry ........................................................................................................................... :4

Sorletknl onc Portkjkpont Zebejtkfn ....................................................................................................................:4

Kcentkjotkfn fd the Pfsktkve Cevkonts ................................................................................................................:0

Preporknl dfr Hfuse Tkskts ........................................................................................................................................30

PC Nutrktkfn onc the Exkstknl Evkcenje Mose ...................................................................................................3?

‒]kllknl‗ the PC Knqukry .......................................................................................................................................... 3=

Jorryknl fut the Pfsktkve Cevkonje Knqukry ......................................................................................................3:

Phose 39 Projtkjknl, Ckssegknotknl PC Mehovkfrs, onc Dfbbfw Up ..................................................... 35

Frlonkzknl onc ]fbbknl fut o PC Heorth Prflrog ......................................................................................... 35

Knjbuce the Bfjob Heobth Jbknkj ..............................................................................................................................3<

Ocgksskfn onc Cksjhorle Jrkterko ........................................................................................................................3<Ocgksskfns ..............................................................................................................................................................38

Cksjhorlknl ............................................................................................................................................................3;

\hen tf Hfbc PC Heorth Zesskfns .......................................................................................................................50

\here tf Hfbc PC Heorth Zesskfns ......................................................................................................................5=

PC Heorth Geobs .........................................................................................................................................................5=

Cevebfp o Zuppby Bkst ................................................................................................................................................ 55

\hf ]uns the PC Heorth Zesskfns .......................................................................................................................54

\hf ]uns the Heobth Cksjusskfns ........................................................................................................................54Obternotkve Fptkfns dfr Dojkbktotknl the Heorth Ojtkvktkes ............................................................................5<

She Tfbunteer Gfther Dojkbktotfr Opprfojh ...............................................................................................5<

She Portkjkpont-bec Opprfojh ..........................................................................................................................58

Heobth Cksjusskfn Sfpkjs .......................................................................................................................................... 58

Hfw Bfnl Zhfubc the PC Heorth Ojtkvktkes Bost .............................................................................................5;

Gfnktfrknl onc Evobuotkfn .....................................................................................................................................40

PC Heorth G&E ...................................................................................................................................................... 40

Gfnktfrknl Estombkshgent fd Projtkjes Usknl Hfge Tkskts ................................................................... 40Jfggunkty G&E...................................................................................................................................................4?

]epfrtknl Dkncknls Moja tf the Jfggunkty ....................................................................................................4=

Drequentby Osaec _uestkfns omfut PC Heorth ............................................................................. 4:

]esfurjes ............................................................................................................................................. 45


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vk Peoje Jfrps

Oppenckjes

O Zteps dfr Knktkotknl o Jfggunkty Lrfwth Gfnktfrknl onc Prfgftkfn Prflrog .................. 44

M-? \eklht dfr Benlth/Heklht Lrfwth Sombe Mfys 0-= ...................................................................... 48

M-= \eklht dfr Benlth/Heklht Lrfwth Jhort Mfys 0-= ......................................................................


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Zf \hot KsPfsktkve Cevkonje Nutrktkfn6


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= Peoje Jfrps

She Pfsktkve Cevkonje Jfnjept

Pfsktkve Cevkonje (PC) ks mosec fn the fmservotkfn thot kn every jfggunkty, there ore thfse whf hove

metter futjfges thon thekr neklhmfrs, cespkte skgkbor ejfnfgkj jkrjugstonjes onc drequentby bkgktec

ojjess tf resfurjes, servkjes, fr fther knputs. Shekr gfre sujjessdub futjfges ore cue, ot beost kn port,

tf utkbkzknl unjfggfn mut sujjessdub mehovkfrs onc strotelkes. Kn the jfntext fd nutrktkfn, there ore

sfge dogkbkes whf use exkstknl resfurjes gfre effejtkveby tf prfvkce thekr jhkbcren wkth o heobthy onc

nutrktkfus envkrfngent. Shekr jhkbcren thrkve onc lrfw whkbe gony fd thekr neklhmfrs strullbe tf aeep

thekr jhkbcren heobthy. Shks ks the PC jfnjept. Kt exksts kn noture onc evfbves noturobby os noture onc

hugons beorn tf gkgkj whot wfras mest. PC wfra strkves tf ojjeberote the ckssegknotkfn prfjess fd

thks beornknl onc ocoptotkfn os o geons tf ceskrombe futjfges.

She Pfsktkve Cevkonje opprfojh ks on osset-mosec, prfmbeg-sfbvknl prfjess dfjusec fn jfggunkty

fwnershkp. \hkbe beverolknl beocershkp onc bfjob expertkse, jfggunkty gegmers beorn onc cksjfver

exkstknl mut drequentby hkccen sfbutkfns tf o lkven prfmbeg. Shey use exkstknl resfurjes, sakbbs, onc

wkscfg. My dfbbfwknl the steps kn the PC opprfojh, jfggunkty gegmers beorn tf bksten onc fmserve

ckfferentby tf cksjfver eojh fther‛s strenlths. Shrfulhfut the prfjess, dogkbkes onc fther stoaehfbcers

ore osaec questkfns, fmservec, onc knvktec tf portkjkpote kn jfggunkty sebd-cksjfvery fd whot ksobreocy wfraknl dfr sfge fd kts gegmers.

Os vfbunteers steerknl the PC prfjess obfnl kn yfur jfggunkty, aeep kn gknc whot mehovkfrs onc

strotelkes ore cksjfverec onc jhobbenle jfggunkty gegmers tf jfge up wkth dun ojtkvktkes thot obbfw

theg tf projtkje the cksjfverec mehovkfrs onc strotelkes. Cf nft bkgkt thks exjbuskveby tf dffc, mut obsf

dfjus fn jorknl, hylkene, onc heobth seeaknl projtkjes.

She PC opprfojh dfr nutrktkfn prfvkces ‒bkvknl prffd‗ fd the effejts fd lffc deecknl, hylkene, jhkbc

jorknl, onc heobth seeaknl projtkjes fmservec kn dogkbkes whf obreocy hove webb-nfurkshec jhkbcren,

cespkte the dojt thot they ore nf weobthker fr ocvontolec thon fther jfggunkty gegmers. She

prfjess fd lrfwth gfnktfrknl my jfggunkty gegmers, onc then the jfbbejtkve vkew fd the heobth fd

obb jhkbcren rokses the jfnsjkfusness fd jfggunkty gegmers onc hebps theg gokntokn o heobthy stotusonc prevent duture gobnutrktkfn wkthkn thekr fwn jfggunkty.

She tronsdfrgotkve noture fd sujjessdub PC knterventkfns shfubc nft me uncerestkgotec. \kthfut

o jertokn sjobe fd the prfmbeg, the kssue dokbs tf lenerote knterest onc gftkvotkfn ogfnl lrfup

gegmers. Kd the futjfge fd knterest ks rebotkveby rore (very bfw rotes fd gobnutrktkfn kn the jfggunkty)

then the PC knqukry gethfcfbfly mfls cfwn os kt ks ckjubt tf cetergkne iust whf the pfsktkve

cevkonts ore (sknje they ore sf nugerfus) onc, theredfre, whkjh nfveb opprfojhes tf cokby tosas

(deecknl, dffc preporotkfn, hylkene, mreost-deecknl, etj.) ore tf me prfgftec.

Use fd o threshfbc fd joses, jfgmknec wkth quobktotkve wfra thot expbfres the rebotkve kgpfrtonje fd

the prfmbeg tf jfggunkty gegmers jon osskst pbonners kn cetergknknl the deoskmkbkty fd usknl the

PC opprfojh. Pfsktkve Cevkonje seeas tf jotobyze jhonle usknl qukja, fmservombe lokns thrfulh theoppbkjotkfn fd sgobb cf-ombe ojtkfns thot ore projtkjob kn noture dfr o goifrkty fd thfse kgpojtec.


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers :

She PC prfjess wkbb enhonje the sakbbs fd thfse whf goae up the ‒cksjfvery teog.‗ Jfggunkty heobth

wfraers (JH\s), trocktkfnob mkrth ottenconts (SMOs)1 gkcwkves, mreost-deecknl nutrktkfn ecujotfrs

(MNEs)1 jfggunkty suppfrt lrfups (JZLs), onc fthers wkbb projtkje bkstenknl onc jfggunkjotknl

ckfferentby. Shey wkbb beorn hfw tf goae hfge vkskts where bkstenknl ks gfre kgpfrtont thon the

prfvkskfn fd kndfrgotkfn. Eventuobby, thks knterventkfn wkbb kgpojt gony fd the jurrent lrfups obreocy

present onc ojtkve kn yfur jfggunkty.

Jfntrostknl Srocktkfnob Jfggunkty Ossessgent Opprfojhes tf the PC Opprfojh

Srocktkfnob Opprfojh PC Opprfojh

\hot ore yfur neecs6 \hot ore yfur strenlths6

\hot ks wrfnl6 \hot ks wfraknl here6

\hot ks bojaknl here6 \hot jon we prfvkce6 \hot ore yfur resfurjes6 \hot jon we mukbc fn6

\hot ks portkjuborby oppeobknl omfut the PC opprfojh ks thot kt beveroles bfjobby ovokbombe resfurjes

onc exkstknl sujjessdub mehovkfrs onc strotelkes, whkjh knjreose the jhonjes fd the dfjusec mehovkfrs

meknl sustoknec. She PC opprfojh obsf mrknls tflether stoaehfbcers onc jfggunkty gegmers whf

usuobby cfn‛t hove jfnversotkfns omfut kndont onc yfunl jhkbc heobth. Fpen cksjusskfn obbfws new

onc ckfferent rebotkfnshkps tf melkn onc rokses the oworeness fd hfw eojh persfn offejts the heobth

onc webb-meknl fd the jfggunkty‛s jhkbcren.

Kn the lht oloknst jhkbchffc gobnutrktkfn, thks opprfojh enombes the jfggunkty tf hklhbklht

sustoknombe woys obreocy meknl sujjessdubby usec tf prfgfte pfsktkve nutrktkfn futjfges.

Kgpbegentec opprfprkoteby, Pfsktkve Cevkonje os on opprfojh fffers o nugmer fd ocvontoles fver

fther kgpbegentotkfn gethfcfbflkes. Shfulh the opprfojh goy nft me suktec dfr every sktuotkfn oncks gfst sujjessdub when spejkj jrkterko ore get, the moskjs fd the opprfojh‛s ceskln jfnder ocvontoles

fver gony fther opprfojhes.

Pumbkj heobth nutrktkfnksts jfntknuobby hove tf regknc pfbkjy goaers onc fther stoaehfbcers thot

uncernutrktkfn ks NFS iust omfut dffc. \e anfw thot gobnutrktkfn resubts drfg o gyrkoc fd dojtfrs1

knjbucec ogfnl theg ore sum-fptkgob jorknl projtkjes. She PC gethfc occresses thks kssue os kt

seeas tf expbfre nft fnby deecknl projtkjes, mut obsf jorknl projtkjes (knjbucknl psyjhfsfjkob projtkjes,

jhkbc jore projtkjes, onc projtkjes thot suppfrt the physkjob onc egftkfnob cevebfpgent fd the yfunl

jhkbc). She PC opprfojh obsf jon torlet hylkene projtkjes (mfcy, dffc, onc envkrfngentob hylkene)

mejouse they pboy on kgpfrtont rfbe kn ckseose preventkfn (ckorrheo, wfrgs, goborko, etj.) onc

egerlknl evkcenje sullests perskstent expfsure tf unhylkenkj envkrfngents hos o nelotkve kgpojtfn the heobth fd the sgobb kntestknob wobb, offejtknl the mfcy‛s omkbkty tf effejtkveby omsfrm nutrkents onc

prevent kndejtkfn. Heobth seeaknl projtkjes ore obsf knjbucec mejouse they jrktkjobby offejt jhkbcren‛s

gfrmkckty onc gfrtobkty. She PC opprfojh hos o exkmbe tegpbote thot obbfws users tf ocopt the

opprfojh tf the bfjob jfntext.

She PC opprfojh kntencs tf knvfbve OBB jorelkvers fd yfunl jhkbcren. Prflrog ojtkvktkes ore

cesklnec tf reojh nfn-trocktkfnob jorelkvers (sujh os lroncgfthers, dothers skmbknls, etj.), os webb os

fthers whf suppfrt fr suppbegent jorelkvknl fd yfunl jhkbcren.

SOMBE ?9 PC OPP]FOJH JFGPO]KZFN


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3 Peoje Jfrps

PC vobues the jfggunkty os o true kgpbegentotkfn portner

onc seeas tf cksgkss the kceo fd portkjkponts os menejkorkes.

Gony PC prflrogs dokb mejouse the dojkbktotfrs ore heobth

stoff gegmers whf goy nft pfssess the sakbbs tf gfmkbkze the

jfggunkty. Kt ks vktob thot jfggunkty gfmkbkzers me knvfbvec

drfg the very melknnknl tf hebp jfggunktkes jreote the

quontktotkve mosebkne thot kndfrgs theg fd the ojtuob heobth

stotus fd thekr jhkbcren.

PC egphoskzes projtkje knsteoc fd anfwbecle–the ‒hfw‗

knsteoc fd the ‒whot‗ fr ‒why.‗ She PC gontro ks9 ‒[fu ore gfre

bkaeby tf ojt yfur woy kntf o new woy fd thknaknl thon tf thkna

yfur woy kntf o new woy fd ojtknl.‗

She PC prfjess vobues experts wkthkn the jfggunkty, nft

tejhnkjob experts drfg futskce the jfggunkty, tf prfvkce

kndfrgotkfn omfut whot wkbb kgpojt fn the kcentkec prfmbeg.

Shere ks on opprfprkote use fd tejhnkjob lukconje tf toaeocvontole fd o weobth fd jfbbejtkve anfwbecle fn kgprfvknl nutrktkfn futjfges, mut thks expertkse ks

lrfuncec kn the PC opprfojh my usknl bfjob ‒experts‗ tf hklhbklht hfw evkcenje-mosec projtkjes ore

ojhkevec ogkc the vorkfus jhobbenles presentec my o portkjubor shorec jfntext.

Mejouse the cksjusskfns onc wfra requkre obb jfggunkty gegmers tf mejfge knvfbvec onc jfntrkmute

thekr fwn stfrkes, rebotkfnshkps egerle, mukbcknl mfth dfrgob onc kndfrgob netwfras thot wkbb

strenlthen the jfggunkty onc bkna pefpbe tflether kn new woys.

Pfsktkve Cevkonje Nutrktkfn & Pfsktkve Cevkonje Heorth

She frklknob jfnjept fd the Heorth gfceb wos kntrfcujec kn the ?;80s kn Hoktk my Crs. Lretjhen onc

\orren Merllren. Up untkb then, severeby gobnfurkshec jhkbcren onc thekr dogkbkes were rederrec tf

o hfspktob settknl dfr treotgent. Fdten, thks wos nft ojjesskmbe fr nonjkobby pfsskmbe dfr dogkbkes onc

the Merllrens wktnessec gony jhkbcren cyknl mejouse they jfubc nft stoy kn the hfspktob dfr the

tkge requkrec tf jfgpbete treotgent. She Heorth gfceb jfnskstec fd lrfup deecknl ojtkvktkes kn the

jfggunkty dfr jorelkvers onc thekr gobnfurkshec jhkbcren. Ojtkvktkes knjbucec hovknl the jorelkvers

onc jfggunkty heobth wfraers jffa bfjob weonknl dffcs fd hklh jobfrkj onc prftekn vobue, prfvkcec

my the hfspktob fr fther okc frlonkzotkfns. Fnje the geob wos preporec, the jorelkvers wfubc deec

thekr jhkbcren tflether onc heor o heobth bessfn prfvkcec my the jfggunkty heobthjore wfraer.

She portkjkponts jfntknuec tf ottenc these jffaknl onc deecknl sesskfns untkb thekr jhkbcren were

rehomkbktotec.

She Heorth tffa fn new dfrgobkty kn ?;;0 when kt wos pkbftec kn Tketnog onc pokrec wkth o strfnl PCjfgpfnent. Shks efffrt wos jotobyzec my o lfverngent goncote thot sfulht tf cevebfp o sustoknombe

sfbutkfn. Kcentkec pfsktkve cevkonts were pffr dogkbkes wkth heobthy jhkbcren. Jfggunkty gegmers

kntervkewec these dogkbkes onc cksjfverec thekr unjfggfn mehovkfrs thot hoc o pfsktkve kgpojt

fn the heobth fd the kcentkec PC jhkbc. She jfggunkty then cesklnec o gfckec Heorth gfceb

mosec fn the cksjfverec unjfggfn mehovkfrs, strotelkes, onc dffc meknl dec tf the heobthy jhkbc.

Exogpbes fd bfjobprfverms thot hove

meen usec tf expboknthe PC jfnjept

Gfzogmkque ‚ Gojuo

prfverm drfg Nogpubo

prfvknje9 ‒She dorowoy stkja

cfes nft akbb the snoae.‗

Zenelob - \fbfd9 ‒bo dfubee cu

jfureur revekbbe jebuk quk cfrt

(the crodt drfg the runner

woaes thfse whf ore stkbb

osbeep)‗


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers 5

Portkjkponts get ot sfgefne‛s hfge eojh coy dfr ?0-?= coys wkth o coy fff kn the gkccbe tf bet the

jorelkvers projtkje the new mehovkfrs ot hfge fn thekr fwn. Shere were then twf weeas fff untkb the

next sesskfn tf olokn bet dogkbkes projtkje the mehovkfrs ot hfge.

Os the oppbkjotkfn fd PC/Heorth hos mejfge fperotkfnobkzec, the egphosks onc dfjus typkjobby

hos norrfwec tf the prfgftkfn fd Heorth ojtkvktkes kn ksfbotkfn fd the PC knqukry. Shks hos bec tf

on knopprfprkote knterpretotkfn fd the knterventkfn gfceb os o suppbegentory deecknl ojtkvkty fr,stkbb gfre conlerfus, o theropeutkj deecknl knterventkfn.

Ocvonjes fver the post cejoce hove kntrfcujec effejtkve, bkde-sovknl treotgents dfr jhkbcren (os webb

os ocubts) wkth severe ojute gobnutrktkfn (ZOG) onc the noture fd these ocvonjegents hos knjreosec

the jfverole dfr these jrktkjob knterventkfns. Shese Jfggunkty Gonolegent fd Ojute Gobnutrktkfn

(JGOG) prflrogs utkbkzknl ]eocy-tf-Use Sheropeutkj Dffcs (]USD), sujh os Pbugpy‛Nut, hove meen

dfunc tf me hklhby effejtkve, portkjuborby when joses ore cetejtec eorby, kn the rehomkbktotkfn fd

jhkbcren. Shey hebp jhkbcren tf rejfver qukjaby onc crogotkjobby recuje thekr rksa fd gfrtobkty. Cespkte

thekr cepencenje fn jfggfcktkes (the ]USD) drfg futskce the jfggunkty, they regokn the unrkvobec

mest projtkje dfr treotknl severe ojute gobnutrktkfn.

O new PC gfceb ks egerlknl tf ojjfunt dfr crogotkjobby kgprfvec jfverole fd hklhby effejtkvetreotgent prflrogs dfr ZOG joses onc the shorec experkenjes ossfjkotec wkth gkxec resubts fd

prflroggknl thot drequentby egphoskzec the Heorth wkthfut o strfnl PC jfgpfnent. Shot new

gfceb, PC Nutrktkfn, ks nft sf gujh o new phkbfsfphy os kt ks o re-ceckjotkfn tf the pfwer fd usknl

jfggunkty sujjesses tf dfster mehovkfr jhonle. Port fd thks shkdt tf PC Nutrktkfn ks on opprejkotkfn dfr

the gubtkpbe crkvers fd gobnutrktkfn onc thot fptkgob nutrktkfn futjfges ore omfut gfre thon skgpby

‒whot‛s kn the mfwb6‗ Dknobby, the evfbutkfn reejts the reobkty fd jurrent treotgent prftfjfbs dfr ZOG.

SOMBE ?9 PC OPP]FOJH JFGPO]KZFN


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4 Peoje Jfrps

PC Nutrktkfn onc the Peoje Jfrps

She PC Nutrktkfn knterventkfn hos meen jfncujtec kn vorkfus jfuntrkes onc jubtures orfunc the

wfrbc. Kt wos frklknobby ocoptec my Peoje Jfrps/Lukneo kn =000, dfbbfwec my Peoje Jfrps/Gobk kn =005

onc Peoje Jfrps/Murakno Dosf kn =008. \hkbe bfjob ocoptotkfns ore fdten nejessory onc jreotkvkty ks

enjfurolec, use fd the essentkob PC Nutrktkfn ebegents hove meen shfwn tf knjreose the bkaebkhffc

fd o sujjessdub knterventkfn. \hen wfraknl wkth jhkbcren wkth o heklhtenec rksa fd gfrtobkty, kt ks

kgpfrtont tf use sfunc tejhnkjob lukconje. Shks gonuob wkbb prfvkce o drogewfra dfr settknl up onc

kgpbegentknl ojtkvktkes usknl the PC opprfojh tf occress the kssue fd gobnfurkshec jhkbcren.

Peoje Jfrps experkenje shfws thot kt goy me hebpdub tf thkna kn tergs fd pfsktkve cevkont dogkbkes

rother thon pfsktkve cevkont gfthers fr jhkbcren sknje the ojtkfns fd the dother onc fther aey dogkby

gegmers jon pboy equobby jrktkjob rfbes kn the heobth onc upmrknlknl fd the jhkbc. Iust os the gfst

gftkvotec wfgon jon hove o ckjubt tkge deecknl her jhkbcren webb kd she hos on unsuppfrtkve

husmonc fr gfther-kn-bow, o wfgon whfse husmonc ks suppfrtkve onc jfnjernec omfut hks jhkbcren‛s

heobth ks dor gfre bkaeby tf aeep theg heobthy onc webb-dec.

Occktkfnobby, PJTs ore unkqueby sktuotec tf fffer fnlfknl gfnktfrknl onc suppfrt thrfulh hfuse vkskts

onc jfggunob events. Knterpersfnob rebotkfnshkps dfrgec wkthkn the jfggunkty fffer fppfrtunktkes

tf prfgfte jhonle onc tf enjfurole onc rejflnkze knjregentob lokns. Shese psyjhfbflkjob

jfgpfnents shfubc nft me uncerestkgotec kn thekr omkbkty tf dfster mfth knckvkcuob onc jfggunkty

jhonle.

She Peoje Jfrps, Pfsktkve Cevkonje, onc Mehovkfr Jhonle

She Peoje Jfrps cenes cevebfpgent kn tergs fd kts lreotest resfurje9 pefpbe–hebpknl pefpbe

cevebfp thekr jopojkty tf kgprfve thekr fwn bkves. My wfraknl wkthkn o hugon jopojkty-mukbcknl

drogewfra, the dfjus fd Tfbunteers‛ wfra ks strenlthenknl the jopojkty fd gen, wfgen, onc yfuth tf

ojtkveby portkjkpote kn thekr fwn cevebfpgent. Shks opprfojh seeas tf egpfwer bfjob pefpbe tf methekr fwn cejkskfn-goaers onc cevebfp the sakbbs, onc ubtkgoteby mehovkfrs, neecec tf kgprfve thekr

bkves.

PC Nutrktkfn ojtkvktkes fffer fppfrtunktkes tf offejt mehovkfr jhonle. She PC opprfojh jon me usec fn

kts fwn tf prfgfte jhonle thrfulh the sfjkob cynogkjs fd gfcebknl onc cegfnstrotkfn, os webb os

thrfulh repetktkfn, enjfurolegent, onc rekndfrjegent. My hklhbklhtknl ojhkevombe mehovkfrs thot ore

prftejtkve oloknst gobnutrktkfn, fr suppfrtkve fd heobthy nutrktkfn futjfges, PC Nutrktkfn jon mukbc

gfgentug ojrfss o jfggunkty thot jhonles mehovkfrs.

Shfulh PC jon me usec os on opprfojh tf mehovkfr jhonle fn kts fwn, kt jon obsf me pokrec wkth

fther mehovkfr jhonle gethfcs tf kndfrg ojtkvkty pbonnknl. \hkbe there ore gony thefrkes fd mehovkfr

jhonle onc tffbs usec my projtktkfners tf prfgfte mehovkfr jhonle, the Cesklnknl dfr MehovkfrJhonle (CMJ)? ks o tffb the Peoje Jfrps encfrses onc hos usec os o mosks dfr troknknl gfcubes fn

mehovkfr jhonle.

? Dffc Zejurkty onc Nutrktkfn Netwfra Zfjkob onc Mehovkfrob Jhonle Sosa Dfrje. Cesklnknl dfr Mehovkfr Jhonle dfr Olrkjubture, Noturob ]esfurje Gonolegent,

Heobth onc Nutrktkfn. \oshknltfn, CJ9 Sejhnkjob onc Fperotkfnob Perdfrgonje Zuppfrt (SFPZ) Prflrog, =0?:. http9//www.jfrelrfup.frl/stfrole/Sffbs/

CMJVJurrkjubugVDknob.pcd


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers <

Cesklnknl dfr Mehovkfr Jhonle

She CMJ drogewfra ks o ebc tffb thot fperotkfnobkzes mehovkfr jhonle thefry onc uses jfggunkty

beveb kndfrgotkfn tf kndfrg ojtkvktkes tf fverjfge fmstojbes tf thfse mehovkfrs. Kts vobue ks kn kts

projtkjobkty dfr ebc beveb use onc kts mobonje fd sfunc prknjkpbes dfr dfrgotkve reseorjh onc reobkstkj

expejtotkfns fd tkge, resfurjes, onc sakbbs.

She drogewfra uses o jotelfrkzotkfn systeg dfr the vorkfus cetergknonts fd mehovkfr. Shese

jotelfrkes jon me usec then tf cesjrkme jfncktkfns fr ottktuces thot cetergkne mehovkfrs.

Uncerstoncknl the cetergknonts fd mehovkfr ks kgpfrtont kn cesklnknl sfunc mehovkfr jhonle

ojtkvktkes rebotec tf kndont onc yfunl jhkbc nutrktkfn.

She dfur gfst knuentkob cetergknonts fd mehovkfr, ojjfrcknl tf the CMJ, ore9

• Perjekvec sebd-ejojy/sakbbs

‚ Og K ombe tf cf thks portkjubor mehovkfr6 Cf K hove the jopojkty, sakbbs, anfwbecle, resfurjes,

etj.6

• Perjekvec sfjkob nfrgs

‚ Cf fthers, whfse fpknkfn K vobue, thkna K shfubc ocfpt o portkjubor mehovkfr6• Perjekvec pfsktkve jfnsequenjes

‚ \hot ore the pfsktkve thknls thot wkbb fjjur kd K ocfpt o portkjubor mehovkfr6

• Perjekvec nelotkve jfnsequenjes

‚ \hot nelotkves ore there tf gy ocfptknl o portkjubor mehovkfr6

Fther cetergknonts knjbuce9

• Ojjess

• Jues dfr ojtkfn/regkncers

• Perjekvec susjeptkmkbkty/rksa

• Perjekvec severkty• Perjekvec ojtkfn ejojy

• Perjekvec ckvkne wkbb

• Pfbkjy

• Jubture

Sf oceptby egpbfy the CMJ gfceb, kt ks jrktkjob tf kcentkdy thfse whfse mehovkfr ks meknl torletec, os

webb os the jfggunkty gegmers fr lrfup(s) whf ore the gfst knuentkob kn thfse pefpbe‛s mehovkfr.

She tffb dfrjes projtktkfners tf expbfre the cetergknonts drfg the perspejtkve fd the torletec lrfup

onc tf cf sf thrfulh dfrgotkve reseorjh onc knqukry.

Odter the dfrgotkve reseorjh onc cenknl the vorkfus lrfups wkth whfg tf me jfnjernec, the tffbsystegotkjobby ossksts kn jfnvertknl these kndfrgec cksjfverkes kntf pfknts fd ojtkfn. Shrfulh thks

strujturec prfjess, projtktkfners ksfbote thfse fmstojbes thot prfve tf fmstrujt ocfptkfn fd ceskrec

mehovkfrs onc dfjus ojtkvkty pbonnknl fn fverjfgknl theg.


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8 Peoje Jfrps

Cesklnknl dfr Mehovkfr Jhonle (CMJ) onc Pfsktkve Cevkonje

Shese opprfojhes tf strujturec mehovkfr jhonle jon me usec kncepencentby, mut there ks o noturob

kntersejtkfn dfr the twf tf me gutuobby rekndfrjknl onc jfgpbkgentory. Zknje the CMJ requkres the

prfgftec mehovkfr tf me ANF\N ot the futset, the PC knqukry jon me utkbkzec kn ocvonje fd the CMJtf ksfbote the dfjus mehovkfr. Shks PC knqukry gethfckjobby expbfres o jfggunkty gegmer‛s hfge

bkde onc rfutkne projtkjes.= Kn the jose fd nutrktkfn, there ks o weobth fd anfwbecle fn mehovkfrs thot

prfgfte nfrgob lrfwth onc cevebfpgent dfr jhkbcren, sf usknl onejcftob expbfrotkfn tf nc truby

nfveb mehovkfrs egpbfyec my pfsktkve cevkont jorelkvers wkth jhkbcren whf ore webb nfurkshec ks

onejcftob onc jfubc me gksbeocknl. Hfwever, usknl the Essentkob Nutrktkfn Ojtkfns (ENO) drogewfra :

os o mojacrfp dfr hfw tf strujture thot PC knqukry hebps us tf jfujh the opprfojh kn jurrent mest

projtkjes onc evkcenje-mosec prflroggknl. Kgpfrtontby, mfth opprfojhes pboje o pregkug fn whot

ks cfne fr ojtkfn toaen rother thon skgpby the tronsder fd anfwbecle fr the jreotkfn fd oworeness.

She ENO drogewfra obbfws fne tf uncerstonc the lenerob nutrktkfn mehovkfr jotelfrkes tf me

prfgftec. \kth thot kndfrgotkfn kn gknc, the tffbs onc prfjess fd PC jon gkne dfr the hklhby

spejkj woys kn whkjh mehovkfrs thot prfgfte nutrktkfn ore ojhkevec. O bkgktotkfn fd usknl the ENO

drogewfra ks the exjbuskve dfjus fn ckrejt nutrktkfn ojtkfns.

= Zee sejtkfn fn PC knqukry onc sogpbe tffbs kn Oppenckjes P onc _.

: Zee ‒Gobnutrktkfn Moskjs‗ sejtkfn dfr the < Essentkob Nutrktkfn Ojtkfns..

DKLU]E =9 UNKJED D]OGE\F]A DF] GOBNUS]KSKFN

Jhkbc Gobnutrktkfn

Kggeckote JousesKnckvkcuob Beveb

Gonkdestotkfn

Unheobthdubenvkrfngent/

boja fd servkjes

Knocequote JoreProjtkjes

Kbbness/CkseoseKnocequote Cket

]esfurjes onc cejkenjkes fd jopktob (hugon, nonjkob,physkjob, noturob onc sfjkob)

Pfbktkjob/Zfjkob onc EjfnfgkjJfntext

Hfusehfbc DffcKnsejurkty

Uncerbyknl JousesHfusehfbc Beveb

Moskj JousesZfjketob Beveb

UNKJED ?;;0


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers ;

\e anfw drfg the jfnjeptuob drogewfra fd gobnutrktkfn kn Dklure =, cket onc dffc kntoae ks fnby o

port fd whot jon jouse gobnutrktkfn. Jore projtkjes onc ojjess tf servkjes/heobthdub envkrfngent obsf

jfntrkmute, fdten tf o stollerknl celree, tf gobnutrktkfn. Os ks cksjussec kn the PC knqukry sejtkfn

fd thks gonuob, PC pbonners ore enjfurolec tf bffa meyfnc skgpby ‒whot ks kn the mfwb‗ onc expbfre

mehovkfrs rebotec tf hylkene onc jore.

She Lfobs fd PC Nutrktkfn

PC Nutrktkfn ks o jfggunkty-mosec opprfojh tf occress gobnutrktkfn wkth three knextrkjombybknaec lfobs. She gethfc dfjuses fn jhonlknl fr prfgftknl new mehovkfr rother thon tronsderrknl

anfwbecle. Shfulh prflrog sujjess ks geosurec my kgprfvknl nutrktkfn futjfges, the egphosks

curknl the knterventkfn ks pbojec fn whot pefpbe cf rother thon whot pefpbe anfw fr hove beornec,

kn occktkfn tf knjregentob kgprfvegents tf nutrktkfn stotus (onc webb-meknl) thot fjjur obfnl the

woy. Jhonlknl fr prfgftknl new mehovkfr kn the jorelkvers fd jhkbcren ks ojhkevec my egpbfyknl the

dfbbfwknl beorner-jenterec strotelkes9

• Knvfbvknl the jorelkvers kn gfcebknl lffc projtkjes, k.e., ‒beornknl my cfknl‗ curknl o PC

Nutrktkfn ojtkvkty

• Usknl peer suppfrt tf enjfurole new homkts

Shese strotelkes enombe jorelkvers fd yfunl jhkbcren tf9

• Lokn the jfncenje nejessory tf egmroje o new homkt thrfulh ckrejt onc repeotec projtkje

• Soae respfnskmkbkty dfr prfvkcknl the jore onc nutrktkfn tf ojhkeve fptkgob jhkbc lrfwth onc

cevebfpgent

• Jfntknue tf projtkje the new homkts ot hfge mejouse they see pfsktkve jhonles kn the

gobnfurkshec jhkbc‛s physkjob oppeoronje onc mehovkfr, usuobby wkthkn =-: sesskfns fd the PC

Heorth ojtkvkty (=-: gfnths)3

She PC prfjess kgpojts gfre thon the nutrktkfnob stotus fd kndonts onc yfunl jhkbcren. Unontkjkpotec

pfsktkve resubts hove fjjurrec kn gony jfggunktkes thot hove usec the PC opprfojh. Mejouse

jfggunkty gegmers‛ rebotkfnshkps jhonle onc thekr gkncsets kp drfg cepencenje tf omunconje

onc pfwer, sebd-esteeg dfr knckvkcuobs onc the jfggunkty os o whfbe jon tronsdfrg the sfjkob domrkj fd

the jfggunkty.

3 Gorsh, Covkc, Gfnkque Zternkn, onc Ierry Zternkn. Cesklnknl o Jfggunkty-Mosec Nutrktkfn Prflrog Usknl the Heorth Gfceb onc the Pfsktkve Cevkonje Opprfojh -

O Dkebc Lukce. Zove the Jhkbcren Decerotkfn, Knj.9 Poles ?


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?0 Peoje Jfrps

Lukcknl Prknjkpbes fd the PC Opprfojh

]egegmer these moskj prknjkpbes when knktkotknl the PC opprfojh kn o jfggunkty9

• She jfggunkty fwns the entkre prfjess.

• Obb knckvkcuobs fr lrfups whf ore port fd the prfmbeg ore obsf port fd the sfbutkfn onc henje the

PC prfjess knvfbves obb portkes whf offejt the prfmbeg. ‒Cfn‛t cf onythknl omfut ge wkthfut ge.‗ • She jfggunkty cksjfvers exkstknl unjfggfn, sujjessdub mehovkfrs onc strotelkes (PC knqukry).

• She jfggunkty cesklns woys tf projtkje onc ogpbkdy sujjessdub mehovkfrs onc strotelkes onc

unbeoshes knnfvotkfn.

• Jfggunkty gegmers rejflnkze thot ‒sfgefne iust bkae ge‗ jon let resubts, even kn the wfrst

jose sjenorkfs (sfjkob prffd).

• PC egphoskzes projtkje knsteoc fd anfwbecle–the ‒hfw‗ knsteoc fd the ‒whot‗ fr ‒why.‗ She PC

gontro ks9 ‒[fu ore gfre bkaeby tf ojt yfur woy kntf o new woy fd thknaknl thon tf thkna yfur woy

kntf o new woy fd ojtknl.‗

• She jfggunkty jreotes kts fwn menjhgoras onc gfnktfrs prflress.

• PC prfjess dojkbktotkfn ks mosec fn ceep respejt dfr jfggunkty, kts gegmers, onc kts jubture,

dfjuses fn knterojtkve enlolegent, onc the jopojkty tf bet the jfggunkty beoc.

• She PC prfjess exponcs exkstknl netwfras onc jreotes new fnes.

She Ethkjs fd PC Nutrktkfn - Cf Nf Horg

Mfth egerlenjy geckjob onc hugonktorkon ethkjs drogewfras wkceby egmroje ‒Cf Nf Horg‗

bonluole. Nfn-gobejenje ks o terg cerkvec drfg the Botkn phrose prkgug nfn nfjere fr ‒rst, cf nf

horg.‗ Kn jfggfn bonluole, nfn-gobejenje jfckes the kceo thot the cejkskfn tf enlole fr prfvkce

jore gust me kndfrgec my on onobysks onc ojjeptonje fd pftentkob rksas. Ot kts jfre, the prknjkpbe

ojanfwbecles thot there ore gony sktuotkfns where on knterventkfn goy pfse sklnkjont rksa fdjousknl horg whkbe ffferknl o bess thon jertokn jhonje fd meknl menejkob. Uncerstoncknl thks, the

prknjkpbe kgpbfres fne tf uncerstonc the opprfprkoteness fd jfnskcerknl ‒nf ojtkfn‗ os prederombe tf

pftentkobby jousknl horg my kntervenknl.

Kn the cksjusskfn fd PC Nutrktkfn, onc spejkjobby Heorth ojtkvktkes, opprfprkote torletknl onc

sjreenknl ks kntelrob kn settknl the stole tf hove the lreotest pfsktkve kgpojt. Hfwever, opprfprkote

sebejtkfn fd portkjkponts ks obsf jrujkob tf ovfkc prfvkcknl knopprfprkote jore thot jon jouse horg.

Ossessknl rksa fd horg requkres bffaknl meyfnc the ojtkvkty ot honc onc expbfrknl the kgpojt fd

thot ojtkvkty kn o gfre hfbkstkj woy. Expbfrknl whot ojtkvktkes gklht me ckspbojec fr knterruptec, dfr

exogpbe, ks o jfggfn woy tf unjfver sfurjes fd rksa. Kn the jose fd Heorth, gkslukcec sebejtkfn fd

portkjkponts jfubc prevent jhkbcren drfg meknl pbojec kntf on effejtkve treotgent prflrog. Shks ks why

torletknl jhkbcren thrfulh joredub, tejhnkjobby sfunc sjreenknl gethfcfbfly ks kgpfrtont.

Shfulh the kgpbkjotkfns fd the Cf Nf Horg kgperotkve ore dor reojhknl, there ore twf prkgory,

projtkjob jfnskcerotkfns tf prftejt the pfpubotkfns servec.

She rst ks tf prftejt the perkfc fd exjbuskve mreost-deecknl. Curknl o jhkbc‛s rst skx gfnths fd bkde,

the exjbuskve jfnsugptkfn fd mreost gkba, kn omsenje fd fther sfbkc dffcs onc bkqukcs, jfnveys heobth

menets thrfulh kgprfvec lrfwth onc kggunkty.


20/125

She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers ??

She sejfnc jfnskcerotkfn ks tf ensure sufferers fd severe ojute gobnutrktkfn ore rederrec tf theropeutkj

prflrogs onc thot they ore nft knjbucec kn PC Nutrktkfn ojtkvktkes thot boja the theropeutkj

jfgpfnent. She lreotby knjreosec rksa fd ceoth ossfjkotec wkth ZOG joses ks the resubt fd on extrege

ceprkvotkfn fd jobfrkes, jf-kndejtkfns, onc pftentkob knterruptkfns tf nfrgob getomfbkj ojtkvkty onc,

theredfre, requkre theropeutkj jore.


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Gobnutrktkfn Moskjs


23/125

?3 Peoje Jfrps

Gobnutrktkfn Moskjs

Gobnutrktkfn jon me gfst moskjobby cenec os o jfncktkfn orksknl cue tf o sum-fptkgob kntoae fr

utkbkzotkfn fd nejessory vktogkns, gknerobs, onc jobfrkes tf gokntokn lrfwth onc gokntenonje fd

the mfcy‛s vorkfus systegs. She terg gobnutrktkfn ks fdten usec kn pboje fd uncernutrktkfn, mut

gobnutrktkfn knjbuces mfth uncernutrktkfn onc fvernutrktkfn. Uncerstoncknl thot gobnutrktkfn ks

nft iust o sknlbe thknl wkth o sknlbe sfbutkfn ks omsfbuteby porogfunt kn melknnknl wfra tf kgprfve

nutrktkfn futjfges.

Uncernutrktkfn

Kgprfper jore projtkjes, knocequote dffc kntoae, onc unheobthdub envkrfngents jon obb crkve

uncernutrktkfn, thfulh the gonkdestotkfns jon me vorkec. Dklure = vksuobby cegfnstrotes the vorkfus

pothwoys fd the crkvers fd gobnutrktkfn. Shfulh cejkenjkes fd vorkfus types fd jopktob tenc tf serve os

the gfst moskj jouses fd gobnutrktkfn, these gfre kggeckote dojtfrs ore thfse whkjh jon me offejtec

my knterventkfn wfra ot the jfggunkty beveb.

Jhrfnkj gobnutrktkfn resubts drfg nutrktkfnob cejkts sustoknec fver tkge, offejtknl lrfwthonc cevebfpgent fd the offejtec jhkbc. Shfulh gfrtobkty ks gujh gfre jbfseby bknaec tf ojute

gobnutrktkfn, jhrfnkj gobnutrktkfn offejts gony gfre jhkbcren lbfmobby. Cejkts fd jrktkjob nutrkents

kgpece o nugmer fd mkfbflkjob prfjesses thot cksrupt fr kgpokr jebbubor onc systegs dunjtkfnobkty kn

the mfcy, resubtknl kn sum-fptkgob lrfwth onc cevebfpgent. Shks kgpokrec bkneor lrfwth ks jobbec

stuntknl. Ztuntknl ks cetejtombe my geosurknl the heklht fr benlth fd o jhkbc rebotkve tf ole. Even

severe stuntknl ks sfgetkges nft opporent, sknje the ole fd the jhkbc goy nft me fmvkfus tf on

fnbffaer. Shfulh ojhkevegent fd fptkgob physkjob lrfwth ks kgpfrtont, sf tff ks the jfnjurrent

jflnktkve cevebfpgent os cegfnstrotec my the bknas tf bfwer ecujotkfnob ottokngent, cejreosec

bkdetkge eornknls, onc o nugmer fd jhrfnkj heobth kssues kn ocubts whf sufferec jhkbchffc stuntknl.5

Ojute gobnutrktkfn resubts drfg on kggeckote onc severe nutrktkfnob cejkt. Shks type fd gobnutrktkfngonkdests wkth ekther wostknl fr mkboterob ecego (mk-pecob nutrktkfnob swebbknl dfunc kn the deet onc

onabes onc jfntknuknl up the mfcy, cepencent upfn severkty) onc ks the dfrg fd gobnutrktkfn gfst

jbfseby bknaec tf jhkbc gfrtobkty. Fver o rebotkveby shfrt perkfc fd ceprkvotkfn, the mfcy cepbetes dot

stfres onc melkns tf mreoa cfwn prftekns dfunc kn beon mfcy tkssues resubtknl kn weklht bfss. Shks ks

jobbec wostknl. Kn sfge joses nfrgob jebbubor dunjtkfn ks cksruptec, jousknl on omnfrgob retentkfn

fd ukc, whkjh ks why mkboterob ecego knckjotes o severe nutrktkfnob jfnjern. Ojute gobnutrktkfn ks

ossessec my o bfw weklht-dfr-heklht geosuregent fr o bfw gkc-upper org jkrjugderenje (GUOJ)

geosuregent, onc/fr the presenje fd mkboterob ecego. Kt ks pfsskmbe dfr wostknl onc ecego tf

gonkdest jfnjurrentby. Shfulh thks dfrg fd gobnutrktkfn ks the gfst vkskmby shfjaknl, kt represents the

sgobbest nugmer fd joses jfgporec wkth gkjrfnutrkent gobnutrktkfn fr jhrfnkj gobnutrktkfn. She rksa

fd gfrtobkty knjreoses os the severkty fd the jfncktkfn fjjurs4

1 eorby cetejtkfn fd joses ks o hklh prkfrktydfr ojtkfn onc these joses ore mest treotec thrfulh effejtkve theropeutkj prflrogs kn ekther knpotkent

fr futpotkent


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers ?5

‒Hkccen hunler‗ fr gkjrfnutrkent gobnutrktkfn gonkdests ktsebd kn o nugmer fd ckfferent woys onc

resubts drfg o boja fd spejkj gkjrfnutrkents. Shks jon fjjur cue tf o boja fd kntoae, omsfrptkfn, fr

utkbkzotkfn fd vorkfus vktogkns onc gknerobs.

Fvernutrktkfn

Pffr nutrktkfnob stotus jon me jousec my wrfnl types fd dffcs, os gujh os kt jon me jousec my cejkts

fd dffc. Fverjfnsugptkfn fd dffcs thot ore ‒enerly cense‗ mut ‒nutrkent pffr‗ jon resubt kn fverweklht

fr fmese nutrktkfnob stotuses. Even kn joses fd on omunconje fd jobfrkes, cejkenjkes fd jertokn

gkjrfnutrkents jon me jfggfn. Occktkfnobby, the omunconje fd jobfrkes onc weklht lokn ore mfth rksa

dojtfrs dfr o nugmer fd jhrfnkj ckseoses, knjbucknl ckometes, hypertenskfn, heort ckseose, onc strfae.8

She Jyjbe fd Gobnutrktkfn

Iust os gobnutrktkfn jon roreby me ottrkmutec tf o sknlbe jouse, kt ks nft iust ksfbotec ot o pfknt kn tkge

ekther. She noture fd gobnutrktkfn ks jyjbkjob onc thks jhorojterkstkj ks port fd whot goaes the strullbe

sf jhobbenlknl. Dklure : cegfnstrotes hfw gobnutrktkfn ks prfpebbec dfrworc kn jfggunktkesthrfulh o bkde jyjbe fr knterlenerotkfnob bens. She bflkj ks stroklhtdfrworc mut nfnethebess kgpfrtont

tf jfnskcer onc uncerstonc when seeaknl tf jhonle mehovkfrs thot wkbb resubt kn bostknl, kgpojtdub

jhonles. She soge jhkbcren whf dokb tf reojh thekr lrfwth onc cevebfpgent pftentkob mejfge

ocfbesjents whf ore stuntec. Ztuntec teens ore gfre bkaeby tf me onegkj onc experkenje ocverse

heobth futjfges. Shey ore gfre bkaeby tf experkenje thekr rst prelnonjy ot o yfunler ole onc thekr

prelnonjkes, nf gotter ot whot ole they hove theg, ore gfre bkaeby tf resubt kn bfw mkrth weklht

momkes. Fverobb, bkdetkge ecujotkfn onc ejfnfgkj pfsskmkbktkes ore ckggec onc the jyjbe jfntknues.

8 Jhfproh, Gkjaey, Zoroh Lobmrokth, onc Kon Corntfn-Hkbb. ‒O lbfmob respfnse tf o lbfmob prfmbeg9 the epkcegkj fd fvernutrktkfn,‗ Mubbetkn fd the \frbc Heobth

Frlonkzotkfn 80 (=00=)9 Poles ;5=-;54..

DKLU]E :9 KNSE]LENE]OSKFNOB J[JBE FD GOBNUS]KSKFN


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?4 Peoje Jfrps

Ojtkfns thot Prfgfte FptkgobNutrktkfn Futjfges

She Essentkob Nutrktkfn Ojtkfns (ENO) ks

o drogewfra usec my projtktkfners onc

suppfrtec my mfth the =008 onc =0?: BonjetZerkes‛ fn Goternob onc Jhkbc Nutrktkfn. Shks

drogewfra syntheskzes mest projtkjes onc

uses jfntegpfrory evkcenje tf hklhbklht o

set fd mehovkfrs fr ojtkfns thot hove meen

cegfnstrotec tf prfgfte fptkgob nutrktkfn

futjfges, os webb os tf recuje gfrtobkty.

She ENO drogewfra ks jflnkzont fd o bkdejyjbe

opprfojh onc egmrojes the ?000 Coys,; o

pumbkj heobth nutrktkfn jogpokln mukbt fn the

anfwbecle fd o jrktkjob wkncfw dfr knterventkfn

drfg prelnonjy thrfulh o jhkbc‛s sejfncmkrthcoy. She drogewfra seeas tf jfnsfbkcote

the prkfrkty ojtkfn jotelfrkes thot offejt

uncernutrktkfn orfunc whkjh knterventkfns jon

me pbonnec tf kgprfve futjfges.

She ?000 Coys… onc Meyfnc

Mosec fn jurrent reseorjh, the kbb effejts

fd gobnutrktkfn fn lrfwth onc jflnktkve

cevebfpgent jon lenerobby me reversec when

the sktuotkfn ks regeckec kn the perkfc fd on

offejtec jhkbc‛s bkde prkfr tf thekr sejfnc mkrthcoy.

Shks dfjus fn the ?000 Coys ks mukbt fn o jrktkjob

wkncfw fd fppfrtunkty tf offfrc jhkbcren the

mest jhonje tf reojh thekr pftentkob kn lrfwth

onc cevebfpgent.?0 She evkcenje ks mosec

borleby fn the kbb effejts fd jhrfnkj uncernutrktkfn

onc kts gonkdestotkfn, stuntec bkneor lrfwth

Kn the jose fd ojute gobnutrktkfn, fr wostknl,

jhkbcren fbcer thon = yeors fd ole jon gfst jertoknby me offejtec. \kth the knjreosec rksa fd gfrtobkty

ossfjkotec wkth ekther gfcerote fr severe ojute gobnutrktkfn, these jhkbcren neec tf me offfrcec thesoge jore os thfse jhkbcren 4 gfnths tf = yeors fd ole. \kth thks kn gknc, ony lrfwth gfnktfrknl onc/

fr sjreenknl prflrogs thot kcentkdy jhkbcren uncer 5 wkth severe ojute gobnutrktkfn shfubc reder theg

tf the neorest rederrob pfknt (jbknkj, hfspktob, etj.), onc joses fd gfcerote ojute gobnutrktkfn jon me

rederrec tf ony suppbegentory deecknl prflrogs, kd ovokbombe, onc/fr knjbucec kn PC Heorth ojtkvktkes

where opprfprkote.

; Zee http9//www.thfusonccoys.frl/omfut/

?0 Mboja, ]E et ob. Goternob onc jhkbc uncernutrktkfn onc fverweklht kn bfw-knjfge onc gkccbe-knjfge jfuntrkes. She Bonjet Zerkes fn Goternob onc Jhkbc Nutrk-

tkfn. Iune =0?:.

She Essentkob Nutrktkfn Ojtkfns

Prfgftkfn fd fptkgob nutrktkfn dfr wfgen

Prfgftkfn fd ocequote kntoae fd krfn onc

dfbkj ojkc onc preventkfn onc jfntrfb fdonegko dfr wfgen onc jhkbcren

Prfgftkfn fd ocequote kntoae fd kfckne my

obb gegmers fd the hfusehfbc

Prfgftkfn fd fptkgob mreostdeecknl curknl

the rst skx gfnths

Prfgftkfn fd fptkgob jfgpbegentory

deecknl stortknl ot 4 gfnths wkth jfntknuec

mreostdeecknl tf = yeors fd ole onc meyfnc

Prfgftkfn fd fptkgob nutrktkfnob jore fd skjaonc gobnfurkshec jhkbcren

Preventkfn fd vktogkn O cejkenjy kn wfgen

onc jhkbcren

She ]klht Nutrktkfncurknl the ?000 Coys

• Zove gfre thon o gkbbkfn bkves eojh yeor

• Zklnkjontby recuje the hugon oncejfnfgkj murcen fd SM, goborko, onc HKT/

OKCZ

• ]ecuje rksa fd nfnjfggunkjombe

ckseoses boter kn kn bkde

• Kgprfve ecujotkfnob ojhkevegent onc

duture eornknl pftentkob

• Knjreose LCP my =-: perjent onnuobby


26/125

She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers ?<

Onthrfpfgetry

Onthrfpfgetry ks the geosuregent fd the hugon mfcy. Dfr nutrktkfnob purpfses there ks o shfrtbkst

fd usedub getrkjs tf kndfrg prflroggknl rebotkve tf vorkfus types fd gobnutrktkfn. Os wkth ony

geosuregent, jore shfubc me toaen drfg twf perspejtkves. She rst ks tf ensure thot the gfst

opprfprkote type fd geosuregent ks meknl usec dfr the ojtkvktkes meknl jfncujtec. Occktkfnobby, on

ojjurote onc prejkse geosuregent tejhnkque ks kgpfrtont dfr vobkc ncknls.

She gfst jfggfn type fd onthrfpfgetry kn knternotkfnob nutrktkfn ks weklht dfr ole. She goifrkty

fd lrfwth gfnktfrknl prflrogs dfjus exjbuskveby fn geosuregent fd weklht. \eklht dfr ole ks the

nutrktkfn knckjotfr upfn whkjh the goifrkty fd lbfmob repfrtknl dfjus dfr trojaknl prflress fn hunler

onc gobnutrktkfn recujtkfn. Shks knjbuces the Gkbbennkug Cevebfpgent Lfobs.

\eklht dfr Heklht (\dH)

Cesjrkptkfn9 Shks type fd geosuregent ks jfncujtec my jfbbejtknl mfth the heklht onc weklht fd o jhkbc.

She weklht rebotkve tf heklht ks then jfgporec oloknst o rederenje pfpubotkfn tf cegfnstrote the rebotkve

‒nfrgobjy.‗ Jhorts usec my ebc wfraers hebp tf jbosskdy the geosuregents. Shfulh these ore expressec osz-sjfres, the tombes ovokbombe dfr ebc use (see resfurjes mebfw) ensure thot there ks nf neec dfr jobjubotkfns

os cetergknotkfns jon me goce usknl the geosuregents onc the tombes onc/fr jhorts exjbuskveby.

\hot kt tebbs us9 \eklht dfr heklht z-sjfre ks usec tf cetejt ojute gobnutrktkfn. Zhfrt-terg cejkts fd

prftekn onc jobfrkes jon resubt kn the cepbetkfn fd sumjutonefus dot tkssue, resubtknl kn wostknl fr thknnknl.

Hfw tf geosure9 Geosuregent fd \dH requkres equkpgent. O benlth mforc fr heklht mforc ks neecec

tf ojjuroteby rejfrc the benlth/heklht fd o jhkbc. She mforc shfubc hove o heoc mforc thot ks usec tf

geosure drfg the tfp fd the heoc. \eklht jon me geosurec usknl vorkfus ckfferent cevkjes, cepencknl

fn the jfntext onc the ole fd the jbkent.

**Zee the sejtkfns mebfw fn weklht dfr ole onc heklht dfr ole dfr knstrujtkfns fn hfw tf ojjurotebygeosure weklht onc heklht**

JOZE CEDKNKSKFNZ9

Nutrktkfn Knckjotfr Gfcerote Ojute Gobnutrktkfn Zevere Ojute Gobnutrktkfn

\eklht dfr Heklht ≥ -: ZC & 2-= ZC 2 -:ZC

Gkc-Upper Org Jkrjugderenje (GUOJ) ≥??5 & 2?=5gg 2??5gg

Mkboterob Ecego (Nutrktkfnob Zwebbknl)?? Nf [es

]EDE]ENJEZ9

Oppenckx M-?9 \eklht dfr Benlth/Heklht Lrfwth Sombe Mfys 0-=yrs

Oppenckx M-=9 \eklht dfr Benlth/Heklht Lrfwth Jhort Mfys 0-=yrs

Oppenckx J-?9 \eklht dfr Benlth/Heklht Lrfwth Sombe Lkrbs 0-=yrs

Oppenckx J-=9 \eklht dfr Benlth/Heklht Lrfwth Jhort Lkrbs 0-=yrs

Oppenckx C-?9 \eklht dfr Benlth/Heklht Lrfwth Sombe Mfys =-5yrs

Oppenckx C-=9 \eklht dfr Benlth/Heklht Lrfwth Jhort Mfys =-5yrs

Oppenckx E-?9 \eklht dfr Benlth/Heklht Lrfwth Sombe Lkrbs =-5yrs

Oppenckx E-=9 \eklht dfr Benlth/Heklht Lrfwth Jhort Lkrbs =-5yrsVVVVVVVVVVVVVVVVVVV

?? O jhkbc ks jfnskcerec tf hove nutrktkfnob ecego kd there ks nftkjeombe pkttknl thot regokns drfg nfrgob thugm pressure pbojec fn the drfntob port fd mfth

onabes onc hebc dfr three sejfncs.


27/125

?8 Peoje Jfrps

Gkc-Upper Org Jkrjugderenje (GUOJ)?=

Cesjrkptkfn9 Shks type fd geosuregent ks jfncujtec my geosurknl the jkrjugderenje fd the upper

bedt org. Geosuregent fd GUOJ jon me usec tf sfge celree dfr obb pfpubotkfns omfve the ole fd 4

gfnths, thfulh kt ks gfst jreckmbe dfr jhkbcren 4 gfnths tf 5 yeors fbc. GUOJ dfr ocubts jon me usec tf

sjreen dfr ojute gobnutrktkfn

fn kts fwn fr os o resubt fd HKT/OKCZ kndejtkfn. GUOJ ks the

gfst opprfprkote ebc tffb tf

sjreen dfr ojute gobnutrktkfn

cue tf kts eose onc speec

fd use, os webb os kts bkna tf

gfrtobkty.

\hot kt tebbs us9 GUOJ

knckjotes the nutrktkfnob

stotus fd o jbkent rebotkve tf

ojute gobnutrktkfn. Cue tfsevere nutrktkfnob cejkts,

the mfcy jon cepbete the

sumjutonefus dot resubtknl kn

wostknl fr thknnknl. Use fd

GUOJ onc weklht dfr heklht

ore mfth geosures fd ojute

gobnutrktkfn, mut GUOJ ks the

prederrec geosure.

Hfw tf geosure9

Geosuregent fd GUOJ

requkres o gknkgob sakbbset onc

knexpenskve GUOJ topes. She

topes ore gfst drequentby jfbfr

jfcec, ffferknl the exkmkbkty

tf trokn ebc projtktkfners

relorcbess fd nugerojy fr

bkterojy, wkth rec knckjotknl

severe ojute gobnutrktkfn,

yebbfw knckjotknl gfcerote

ojute gobnutrktkfn, onc lreen

knckjotknl o nfrgob nutrktkfnob

stotus.

Jflkbb, Mruje, Onthrfpfgetrkj Knckjotfrs Geosuregent Lukce. DONSO onc DHK :40. Gorjh =00:.

DKLU]E 39 GEOZU]KNL GKCUPPE] O]G JK]JUGDE]ENJE

VVVVVVVVVVVVVVVVVVVV

?= Gkc Upper Org Jkrjugderenje ks the prkgory sjreenknl prftfjfb dfr sebejtkfn fd jhkbcren tf o Heorth fr ony fther ojtkvkty thot torlets gfcerote ojute gobnu-

trktkfn (GOG) fr ot-rksa jhkbcren tf prevent severe ojute gobnutrktkfn (ZOG) onc seeas neor terg, kggeckote, onc geosurombe resubts.


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers ?;

JOZE CEDKNKSKFNZ9

Nutrktkfn Knckjotfr Gfcerote Ojute

Gobnutrktkfn

Zevere Ojute

Gobnutrktkfn

\eklht dfr Heklht ≥ -: ZC & 2-= ZC 2 -:ZC

Gkc-Upper Org Jkrjugderenje (GUOJ) ≥??5 & 2?=5gg 2??5gg

Mkboterob Ecego (Nutrktkfnob Zwebbknl)?: Nf [es

]EDE]ENJEZ9

http9//www.unkjed.frl/nutrktkfn/troknknl/:.?.:/4.htgb

\eklht dfr Ole (\dO)

Cesjrkptkfn9 Shks type fd geosuregent

ks jfncujtec my geosurknl the weklht

fd o jbkent onc then pbfttknl thot weklht

oloknst hks/her ole. Shks weklht rebotkvetf ole ks then jfgporec oloknst o

rederenje pfpubotkfn tf cetergkne

nfrgobjy. Shfulh these ore expressec

os z-sjfres, the tombes ovokbombe dfr

ebc use (see resfurjes mebfw) ensure

thot there ks nf neec dfr jobjubotkfns

os cetergknotkfns jon me goce usknl

the geosuregents onc the tombes

exjbuskveby.

\hot kt tebbs us9 \eklht dfr ole z-sjfre

ks usec tf cetejt uncerweklht, mut

geosures mfth ojute onc jhrfnkj

uncernutrktkfn. Shks ks the resubt fd the

dojt thot mfth stuntec (jhrfnkj) onc

wostec (ojute) jhkbcren goy obsf hove o

bfw weklht dfr ole geosure os o resubt

fd thekr jfncktkfn. Shfulh thks ks o bess

spejkj geosure, kt ks the gfst jfggfn

knckjotfr dfr whkjh coto ore jfbbejtec

onc kt lenerotes o lenerob pkjture fd

nutrktkfn stotus.Hfw tf geosure9 \eklht jon me

geosurec usknl vorkfus ckfferent

cevkjes cepencknl fn the jfntext onc

the ole fd the jbkent, thfulh Dklure 3, ot

rklht, shfws the use fd o honlknl sjobe

drequentby usec tf weklh sgobb jhkbcren.


DKLU]E 59 GEOZU]KNL JHKBC \EKLHS


?: O jhkbc ks jfnskcerec tf hove nutrktkfnob ecego kd there ks nftkjeombe pkttknl thot regokns drfg nfrgob thugm pressure pbojec fn the drfntob port fd mfth

onabes onc hebc dfr three sejfncs.


29/125

=0 Peoje Jfrps

JOZE CEDKNKSKFNZ9

Nutrktkfn Knckjotfr Gfcerote Uncerweklht Zevere Uncerweklht

\eklht dfr Ole ≥ -: ZC & 2-= ZC 2 -:ZC

]EDE]ENJEZ9

http9//www.whf.knt/jhkbclrfwth/stoncorcs/jhtVwdoVlkrbsVzV0V5.pcd http9//www.whf.knt/jhkbclrfwth/stoncorcs/jhtVwdoVmfysVzV0V5.pcd

Heklht dfr Ole (HdO)

Cesjrkptkfn9 Shks type fd

geosuregent ks jfncujtec

my geosurknl the heklht fr

benlth fd o jbkent onc then

pbfttknl thot heklht oloknst hks/

her ole. Shks heklht rebotkve tf

ole ks then jfgporec oloknsto rederenje pfpubotkfn tf

cetergkne nfrgobjy. Shfulh

these ore expressec os z-sjfres,

the tombes ovokbombe dfr ebc use

(see resfurjes mebfw) ensure thot

there ks nf neec dfr jobjubotkfns

os cetergknotkfns jon me goce

usknl the geosuregents onc the

tombes exjbuskveby.

\hot kt tebbs us9 Heklht dfr olez-sjfre ks usec tf cetejt jhrfnkj

uncernutrktkfn. Zustoknec

nutrktkfnob cejkenjkes jon

suppress nfrgob cevebfpgent,

gonkdestknl os lrfwth dokbure.

Shks ks jobbec stuntknl.

Hfw tf geosure9 O benlth

mforc fr heklht mforc ks neecec

tf jfbbejt the ojjurote benlth/

heklht fd o jhkbc. She mforc

shfubc hove o heoc mforc thot ks

usec tf geosure drfg the tfp fd

the heoc.


DKLU]E 49 GEOZU]KNL JHKBC BENLSH


30/125

She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers =?

JOZE CEDKNKSKFNZ9

Nutrktkfn Knckjotfr Gfcerote Uncerweklht Zevere Uncerweklht

Heklht dfr Ole ≥ -: ZC & 2-= ZC 2 -:ZC

]EDE]ENJEZ9

http9//www.whf.knt/jhkbclrfwth/stoncorcs/jhtVbhdoVmfysVzV0V5.pcd http9//www.whf.knt/jhkbclrfwth/stoncorcs/jhtVbhdoVlkrbsVzV0V5.pcd


DKLU]E


31/125


32/125

PC Nutrktkfn Prflrog Pbonnknlonc Exejutkfn


33/125

=3 Peoje Jfrps

Phose ?9 Cenknl the Prfmbeg, Ossessknl Deoskmkbkty oncGfmkbkzknl the Jfggunkty

Lrfwth Gfnktfrknl onc Prfgftkfn ‚ Cenknl the Prfmbeg

Lrfwth Gfnktfrknl onc Prfgftkfn (LGP) prflrog

ojtkvktkes goy me ojtkve kn the jfggunkty. Shfulh wkceby

vorkombe kn tergs fd thekr reluborkty onc quobkty, LGPs ore

dokrby wkcespreoc. Shey serve os on exjebbent jfntojt pfknt

thrfulh whkjh o Tfbunteer jon knterojt wkth the torletec

lrfup. Oppenckx O jon me usec tf hebp knktkote o LGP

prflrog where thfse ojtkvktkes ore ekther nft dunjtkfnob fr

nfnexkstent.

Shese prflrogs presebejt dfr gfthers onc jorelkvers fd

jhkbcren uncer 5 yeors fbc. Zfge prflrogs goy torlet o

sgobber ole mrojaet (thrfulh =3 fr :4 gfnths), mut they oreobwoys joppec ot 5 yeors (40 gfnths). Shfulh LGP ojtkvktkes

goy knjbuce jhkbcren uncer 4 gfnths dfr geosuregent, ony

knterventkfn thot wfubc knterrupt exjbuskve mreostdeecknl dfr

the rst skx gfnths fd bkde gust me ovfkcec. Knjbuskfn fd gobe

beocers onc dothers, os webb os lroncgfthers onc gfthers-kn-bow, kn these ojtkvktkes jon prfve tf me o

jrktkjob jfgpfnent kn kgprfvknl thekr vkomkbkty, jfverole, sustoknomkbkty, onc rebevonje tf jfggunkty

gegmers.

Lrfwth Gfnktfrknl onc Prfgftkfn (LGP) ks on ojtkvkty tf troja the lrfwth fd jhkbcren kn o spejkj

jotjhgent oreo. Usuobby, the prflrogs geosure the weklht fd jhkbcren oloknst thekr ole kn gfnths.

Kt knvfbves relubor weklhknl (fptkgobby every gfnth) usknl on ojjurote weklhknl sjobe tf troja the

weklht fd the jhkbc ojjfrcknl tf hks/her ole kn gfnths. Knckvkcuob jhkbc coto ks rejfrcec fn o lrfwth

gfnktfrknl jorc thot ks gokntoknec my the jorelkver. Shks coto, jfbbejtec gfnthby, ks kgpfrtont tf the

jorelkver os kt lrophkjobby shfws fver tkge whether o jhkbc ks ojhkevknl ocequote lrfwth fr ks lrfwth

dobterknl. (Zee Oppenckjes D onc L dfr o sogpbe lrfwth jhort dfr weklht dfr ole ) Gony Gknkstrkes fd

Heobth troja onc repfrt fn these weklht dfr ole sjfres tf kndfrg prflress fn notkfnob lfobs, os webb

os the Gkbbennkug Cevebfpgent Lfobs, whkjh jfntknue tf use ‒uncerweklht‗ os the prkgory geosure

fd gobnutrktkfn. Kn sfge joses, fther onthrfpfgetrkjs ore geosurec os webb (knjbucknl heklht dfr ole,

weklht dfr heklht fr GUOJ), mut thks ks kndrequent.

Fmiejtkves fd the LGP Ojtkvkty9

• Sf knvfbve dogkbkes kn ossessknl onc gfnktfrknl the heobth onc nutrktkfnob webb-meknl fdthekr jhkbcren thrfulh lrfwth gfnktfrknl (the P dfr prfgftkfn goy knvfbve ony nugmer fd

knterventkfns thot seea tf kgprfve cketory kntoae fr recuje threots tf heobth thot gonkdest os

gobnutrktkfn).

• Sf kcentkdy gfcerote, ojuteby gobnfurkshec (GOG) jhkbcren tf knjbuce kn PC Nutrktkfn ojtkvktkes,

os webb os tf sjreen dfr ZOG joses dfr rederrob kntf theropeutkj prflrogs.

• Sf gfnktfr the nutrktkfnob stotus fd obb jhkbcren uncer =3, :4, fr 40 gfnths fver tkge.

Lrfwth Gfnktfrknl Prflrogs

ore gfst drequentby cesklnec

tf jopture weklht dfr ole

kndfrgotkfn (jfnotes

stuntknl onc wostknl). Use

the prflrogs os on entry

pfknt, mut dfjus fn sjreenknl

usknl Gkc Upper Org

Jkrjugderenje (GUOJ) tfkcentkdy wostec jhkbcren dfr

PC Nutrktkfn ojtkvktkes.


34/125

She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers =5

• Sf ossess prflrog kgpojt fn torletec gobnfurkshec jhkbcren, onc fn the entkre pfpubotkfn

uncer =3, :4, fr 40 gfnths fd ole.

• Kn the jose fd PC Nutrktkfn, on fmiejtkve fd the LGP ks tf enombe the sebejtkfn fd portkjkponts, os

webb os pfsskmbe PC dogkbkes fr hfusehfbcs.

O typkjob LGP jon kndfrg the sjobe fd the prfmbeg fd lenerob uncernutrktkfn. Hfwever, kt ks kgpfrtont

tf nfte thot kd fnby uncerweklht (weklht dfr ole) ks repfrtec, there regokns sfge unjertoknty fd

the nutrktkfn prfmbeg. Zknje uncerweklht jon jopture mfth wostknl (geosurec usknl weklht dfr

heklht/GUOJ) onc stuntknl (geosurec usknl heklht dfr ole), repfrtknl fn uncerweklht beoves sfge

unjertoknty os tf the noture fd the nutrktkfn prfmbeg. Jore shfubc me toaen tf verkdy the noture fd the

nutrktkfn sktuotkfn os pbonnknl on knterventkfn sujh os o PC Heorth goy me cestknec dfr cksoppfkntknl

resubts kd the kssue ks prkgorkby fne fd stuntknl onc jhrfnkj uncernutrktkfn. Shks ks o resubt fd o gksgotjh

metween the gethfcfbfly‛s rebkonje fn neor terg jhonles kn lrfwth tf stkgubote jfggunkty-wkce,

sfjkob jhonle onc the bfnl-terg, sbfw respfnse fd bkneor lrfwth tf kgprfvec nutrktkfn. Use fd ojute

gobnutrktkfn sjreenknl gethfcs, prkgorkby GUOJ, wkbb kndfrg the rebotkve severkty fd the prfmbeg kn

the jfggunkty.

Os o resubt, o typkjob LGP thot dfjuses fn weklht dfr ole wkbb serve os on exjebbent entry pfknt oncthe weklht dfr ole coto jon lukce ojtkvktkes fr troja prflress dfr gknkstrkes onc fther portners.

Shot soge weklht dfr ole coto jon serve os o mosebkne dfr the lenerob nutrktkfn sktuotkfn kn the

jfggunkty. Hfwever, dfr the soae fd PC Nutrktkfn, whkjh olokn rebkes fn tronsdfrgotkve sfjkob jhonle

pfwerec my neor terg, vkskmbe resubts, wostknl gust me ossessec tf sebejt prflrog portkjkponts. She

gfst opprfprkote tejhnfbfly dfr thks ks the geosure fd GUOJ (see the sejtkfn fn Gkc-Upper Org

Jkrjugderenje). Zjreenknl usknl GUOJ jon hebp kcentkdy prflrog portkjkponts dfr o PC Nutrktkfn fr

Heorth knterventkfn, mut obsf jon hebp tf kcentkdy joses fd ZOG thot ore tff ocvonjec dfr PJTs onc thot

requkre rederrob onc theropeutkj treotgent.

Sombe = ckolrogs o sogpbe rfster thot jon me repbkjotec tf jfbbejt kndfrgotkfn curknl the LGP. Kn

gony LGPs, kndfrgotkfn ks rejfrcec fn the jhkbc lrfwth jorc thot ks hebc my the gfther fr jorelkver.

Sf ensure thot kndfrgotkfn ks ovokbombe tf pbon PC Nutrktkfn ojtkvktkes, o seporote rfster goy hove tf me

jreotec.

Hfwever the kndfrgotkfn ks jfbbejtec onc rejfrcec, the kndfrgotkfn dfunc kn Sombe = ks seen os

the stoncorc thot wkbb pergkt the jfggunkty onc kts portners tf kcentkdy Pfsktkve Cevkont dogkbkes/

hfusehfbcs dfr the Pfsktkve Cevkonje Knqukry.

Fnje the rfster hos meen revkewec onc obb fd the jhkbcren relksterec, the weobth ronaknl jrkterko onc

ojtkvkty jon me cfne my o Cksjfvery Seog, fr o lrfup fd jfggunkty vfbunteers whf wkbb osskst wkth

hfuse vkskts onc jfbbejtkfn fd kndfrgotkfn fn jfggunkty projtkjes. O skgpbe gora fn thks bkst jon

knckjote kd the jhkbc ks drfg o weobthy dogkby fr pffr dogkby.

Kt ks kgpfrtont tf nftkje whf ks gkssknl drfg the LGP ojtkvktkes. Kt ks rore thot ?00 perjent fd the torletlrfup wkbb me portkjkpotknl kn the gfnthby LGP weklhknl sesskfns onc kt ks drequentby dogkbkes fd

gobnfurkshec jhkbcren whf gkss o lrfwth gfnktfrknl sesskfn. She jhkbcren reluborby ottencknl ore

fdten drfg gftkvotec, heobth-jfnsjkfus dogkbkes, thfulh thks cfes nft prejbuce theg drfg sufferknl

drfg gobnutrktkfn. \here lrfwth gfnktfrknl ks nft kn pboje, fr where jhkbcren ore meknl gkssec,

hfuse vkskts ore rejfggencec dfr obb hfusehfbcs wkth jhkbcren kn the torlet ole lrfup tf jfgpbete

LGP onc GUOJ sjreenknl ojtkvktkes.


35/125

=4 Peoje Jfrps

Cetergknknl the Deoskmkbkty dfr PC Nutrktkfn - Jrktkjob Goss dfrSronsdfrgotkve Jhonle fd PC

She tronsdfrgotkve noture fd sujjessdub PC knterventkfns shfubc nft me uncerestkgotec. Kt ks dfr thks

reosfn thot PC purksts put kn pboje menjhgoras dfr the sjobe fd the prfmbeg meknl occressec. She

opprfojh pfskts thot kt ks the oppbkjotkfn fd unkque mehovkfrs, fr woys fd ojhkevknl jertokn mehovkfrs,

thot wkbb serve tf occress the prfmbeg ot honc (kn thks jose gobnutrktkfn). ]ebotkveby unjfggfnprfmbegs wfubc fnby lenerote o sgobb sogpbe fd mehovkfrs onc o dfrgob knqukry wkbb fdten strullbe

tf prfcuje ‒unkque‗ mehovkfrs meknl usec tf ojhkeve metter futjfges. Os sujh, the pftentkob tf mukbc

jfggunktywkce gfgentug ks sklnkjontby bessenec my mfth thks projtkjob bkgktotkfn onc the boja fd o

shorec experkenje rebotec tf the severkty fd the prfmbeg.

Prevkfus lukconje fn PC onc PC Heorth hos stkpubotec o menjhgora fr jrktkjob goss me reojhec kn

tergs fd gobnutrktkfn kn o jfggunkty tf worront the knterventkfn.?5 Shrfulh the use fd menjhgoras,

o prfmbeg ks quontkec onc jon me evobuotec dfr kts rebotkve kgpfrtonje tf jfggunkty gegmers.

\hkbe uncerstoncknl thot Pfsktkve Cevkonje os on opprfojh goy nft me mest suktec dfr obb sktuotkfns,

jore shfubc me toaen tf nft fnby bffa ot the prevobenje fr drequenjy fd on kssue fr jfncktkfn kn the

tftob pfpubotkfn, mut tf obsf bffa ot the jfggunkty thrfulh o vubneromkbkty bens, expbfrknl the rebotkvekgpojt fd gobnutrktkfn upfn sum-lrfups. \here fne goy nc fnby o sgobb nugmer fd pefpbe offejtec

my o jfncktkfn kn the jfggunkty ot borle, o vubnerombe sum-lrfup goy vkew thks soge jfncktkfn tf

me o goifr kssue offejtknl o borler rebotkve prfpfrtkfn fd kts gegmers thot ks nelotkveby kgpojtknl

thekr bkves. Jhonlknl hfw fne bffas ot the pfpubotkfn jon hove o sklnkjont kgpojt fn the prfjess fd

Noge fd Tkbbole9 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV

Noge fd Hogbet fr Jbuster9 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV

Noge fd Bfjob Jhked fr Beocer9 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVNoge fd Persfn \eklhknl9 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV

Cote fd \eklhknl9 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV

# J h k b c

N o g e

D o t h e r

N o g e

G f t h e r

N o g e

B f j o t k f n

L e n c e r

C F M

G f n t h , [ r

O l e k n

g f n t h s

\ e k l h t

N u t r k t k f n o b

Z t o t u s

M k r t h r o n a ? 3

G U O J

?

=

:3

…

SOMBE =9 ZOGPBE ]FZSE] DF] PC NUS]KSKFN


?3 Shks ks skgpby the nugmer thot represents the frcer kn whkjh the jhkbc wos mfrn rebotkve tf ony skmbknls. ? represents rstmfrn, = sejfnc mfrn, etj.

?5 :0 perjent uncerweklht (2 -= ZC)


36/125

She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers =<

cetergknknl the rebotkve severkty fd the prfmbeg. Shfulh the nugerotfr goy stoy the soge (joses),

thknaknl omfut thks stotkstkjobby my bffaknl ot the cenfgknotfr (pfpubotkfn vs. sum-pfpubotkfn) kn

ckfferent woys jon hove on effejt fn the perjekvec rebotkve severkty fd thot prfmbeg fr jfncktkfn.?4

Kt ks kgpfrtont thot the kceo fd sjobe me jfntextuobkzec when cejkcknl whether fr nft tf enlole kn PC

Nutrktkfn ojtkvktkes. Shks ks mest kbbustrotec thrfulh the exogpbe fn the dfbbfwknl pole.

Goaknl Zense fd PC wkth Fther Prflrogs, Ojtfrs, onc Ojtkvktkes

Tfbunteer-bec onc -suppfrtec ojtkvktkes ore drequentby bkgktec my tkge onc resfurjes. ]eobkstkj

bkgktotkfns exkst kn tergs fd the nugmer fd portkjkponts knjbucec onc tkge knvestec. Shfulh thks ks nft

unkque tf Peoje Jfrps Tfbunteers, kt ks portkjuborby rebevont cue tf restrkjtkfns fn resfurjes onc the

boja fd pokc suppfrt stoff kn o lkven Tfbunteer‛s ojtkvktkes.

Os sujh, kt ks kgpfrtont thot on uncerstoncknl fd the nutrktkfn boncsjope ojjfunt dfr the vorkfus

stoaehfbcers onc ojtkvktkes. Cetergknknl whkjh fther frlonkzotkfns onc knstktutkfns ore ojtkve onc

uncerstoncknl thekr prflroggknl fmiejtkves onc goncotes ks vktob tf pbon ojtkvktkes.

Sf dfrgobkze thks knqukry, expbfre the dfbbfwknl questkfns9

• Hfw ore joses fd gfcerote ojute gobnutrktkfn treotec bfjobby6 Dfrgob/kndfrgob gethfcs6

Ore there ony dffc ckstrkmutkfns kn the oreo6 Ore there Lenerob Dffc Ckstrkmutkfns (LDC) fr

Zuppbegentory Deecknl Prflrogs (ZDP) thot ore fdten spfnsfrec my the Lfverngent fr \frbc

Dffc Prflrog (\DP)

• Kd sf, whot dffc jfggfcktkes cf menejkorkes rejekve6 \hf rejekves theg6 Hfw bfnl ks the

prflrog expejtec tf jfntknue6

• \hot ks the neorest dojkbkty thot ks goncotec tf treot joses fd severe ojute gobnutrktkfn6

• Ks there o Sheropeutkj Deecknl Jenter (SDJ) fr Futpotkent Sheropeutkj Prflrog (FSP)6\hot

prfjecures ore kn pboje dfr dfbbfw up (kd ony) when jhkbcren ore cksjhorlec drfg o treotgent

prflrog6

• Ks there on ojtkve JGOG prflrog kn the oreo6 \hf gonoles kt6 \hot, kd ony, dfbbfw-up prftfjfb

exksts dfr joses when they ore ‒jurec‗6

• Ks there on ojtkve Lrfwth Gfnktfrknl onc Prfgftkfn (LGP)6 \hf gonoles kt6

Cetergknknl where tf reder jhkbcren wkth ZOG ks o jrktkjob step kn pbonnknl ojtkvktkes. Os jhkbcren ore

sjreenec dfr knjbuskfn kn ony PC Nutrktkfn ojtkvktkes (Zee sejtkfn fn torletknl onc sjreenknl), joses

fd ZOG goy me cetejtec. Shese jhkbcren hove o sumstontkobby knjreosec rksa fd gfrtobkty onc requkre

geckjob ottentkfn. Zknje the rksa fd gfrtobkty knjreoses prejkpktfusby rebotkve tf the severkty fd the

gobnutrktkfn, effejtkve sjreenknl onc kgprfvec eorby jose cetejtkfn jon lf o bfnl woy tf gktklotknl

the rksa fd gfrtobkty os jhkbcren let the treotgent they neec medfre jfgpbkjotkfns onc jfgfrmkcktkes?


37/125

=8 Peoje Jfrps

\fraknl wkth on Ksfbotec Lrfup where Gobnutrktkfn ks o

Bfjob Jfnjern

Bkz hoc spent neorby nkne gfnths kn her jfggunkty onc hoc melun tf uncerstonc mfth the sjobeonc jfgpbexkty fd the dffc onc nutrktkfn sejurkty prfmbeg kn her jfggunkty. \ontknl tf hebp, she

sfulht lukconje fn hfw tf kntervene fr pbon ojtkvktkes tf occress the prfmbeg.

\fraknl wkth her hfst jfuntry jfunterport, Bkz sfulht fut coto drfg the bfjob heobth jbknkj tfkndfrg thekr pbonnknl fd ojtkvktkes. She coto drfg the heobth jbknkj shfwec thot the gfst jurrent

estkgote dfr uncerweklht (2-= ZC) wos =3 perjent. \hen she osaec kd they hoc kndfrgotkfn fnon estkgote dfr the nugmer fd jhkbcren whf were stuntec they sokc they ckcn‛t hove thot

kndfrgotkfn. Shey obsf ckc nft hove on estkgote dfr the nugmer fd weoa jhkbcren.

Odter the geetknl wkth the bfjob heobth fddkjkobs, Bkz onc her jfunterport revkewec sfge lukconjenftes they hoc dfunc dfr Pfsktkve Cevkonje prflroggknl. Shey were jfnjernec my the dojt thot

they anew thks kssue fd gobnutrktkfn tf me o sklnkdkjont onc kgpfrtont prfmbeg kn the jfggunkty,mut the fddkjkob estkgotes sullestec thot the threshfbc fd :0 perjent uncerweklht kn uncer-dkves

hoc nft meen reojhec dfr pbonnknl o PC prflrog. Shot thks threshfbc hoc nft meen jrfssec ckcnft cksjfurole theg, os they reobkzec thot the reosfn dfr the threshfbc ks mosec upfn the nftkfn

thot PC ks o gethfcfbfly thot wfras mest when kt ks ombe tf jreote jfggunktywkce gfgentugorfunc on kssue. Zknje they pbonnec fn wfraknl wkth o sum-set fd the jfggunkty os o whfbe,

they hoc fnby tf cetergkne thot wkthkn thks sum-set the sjobe fd the prfmbeg wos sujh thot kt wosceegec o bfjob heobth prkfrkty onc wfubc theredfre hove the pftentkob tf lenerote the type fd

gfgentug sfulht dfr tronsdfrgotkve PC prflroggknl.

Bkz onc her hfst jfuntry jfunterport cejkcec tf knktkobby expbfre wkth o regfte leflrophkj jfrnerfd the jfggunkty, where there were anfwn tf me severob joses fd ojute gobnutrktkfn. She tftob

nugmer fd jfgpfuncs kn thot jfrner fd the jfggunkty wos o gonoleombe ?4 onc wos goce upfd hfusehfbcs fd yfunler porents wkth very yfunl jhkbcren onc even o dew degobe-heocec

hfusehfbcs. \hen they melon tf ossess onc jfncujtec sjreenknls they kcentkdkec the dfbbfwknl9

• ?0 jfgpfuncs wkth =< hfusehfbcs

• :: jhkbcren uncer 5 yeors fd ole

• ?4 joses fd uncerweklht

• 3 GOG joses, ? ZOG jose

\hot thks tfbc Bkz onc her jfunterport wos thot there wos neorby 50 perjent prevobenje fduncerweklht kn the lrfup onc, gfre tebbknl dfr the soae fd the PC ojtkvktkes tf me pbonnec, there

were o tftob fd dkve joses fd ojute gobnutrktkfn. Shks geont ?5 perjent fd jhkbcren were jbosskdkecos wostec, on oborgknlby hklh nugmer. Kgpfrtontby, Bkz‛s jfunterport sujjessdubby rederrec the

fne jhkbc sudderknl drfg ZOG tf o neormy hfspktob where she rejekvec theropeutkj jore. Sheregoknknl dfur GOG joses were torletec dfr knjbuskfn fd PC Nutrktkfn ojtkvktkes thot they melon

tf pbon. Shey knjbucec dfur gfre dogkbkes drfg the uncerweklht lrfup, usknl the dfbbfwknlvubneromkbkty prkfrkty jrkterko9

?. Degobe heocec hfusehfbc=. ]ejent (prevkfus :0 coys) mfut fd ckorrheo

\kth these twf jrkterko, os webb os the verkdkec GOG joses, they rfuncec the knterventkfn lrfupfut tf eklht joretoaers onc eklht jhkbcren. Odter kcentkdyknl o PC gfther/dogkby, they prfjeecec

wkth the lrfup fd nkne jorelkvers onc thegsebves tf pbon onc jorry fut o PC Nutrktkfn-Heorthprflrog.


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She Pfsktkve Cevkonje Nutrktkfn Lukce dfr Peoje Jfrps Tfbunteers =;

\fraknl kn jfniunjtkfn, rother thon

kn porobbeb tf lrfwth gfnktfrknl onc

prfgftkfn ojtkvktkes, wkbb hebp the PC

knterventkfn me seen os port fd on

kntelrotec strotely. Shks jon hebp

tf ovfkc jfnduskfn fn the port fd

menejkorkes os tf why gubtkpbe ojtfrs

ore knterestec kn ossessknl thekr

jhkbcren, mukbc trust ogfnl ojtfrs thot

ore bkaeby tf bfnl futbost o Tfbunteer

kn the jfggunkty, onc knjreose the

edjkenjy onc reojh fd ojtkvktkes.

Occktkfnobby, thks jffperotkfn prfvkces

o noturob venue thrfulh whkjh tf

mukbc jopojkty fd heobth wfraers onc

jfggunkty vfbunteers.

Jfggunkty Zuppfrt

She prfjess fd jfncujtknl the LGP

ks bkaeby tf beoc tf the cksjfvery fd

sfge jfggunkty gegmers whf ore

enthuskostkj onc knterestec kn mejfgknl

knvfbvec. Meskces hovknl o pfknt persfn

tf jfunt fn onc hebp beoc the woy, kt ks

obsf kgpfrtont tf knvfbve o vorkety fd

stoaehfbcers tf portkjkpote kn the next

steps dfr PC Nutrktkfn.

Ony sujjessdub knterventkfn thot seeas tf jhonle mehovkfrs gust hove suppfrt drfg jfggunkty

gegmers. Shks ks kgpfrtont os bfjob beocers

the positive deviance peace corps nutrition guide: a community-based approach to behavior change...

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