Diversified Agri Food Production Systems For Nutritional Security

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Diversified Agri-food Production Systems for Nutritional Security

Author : Anup Das
Publisher : Frontiers Media SA
ISBN 13 : 2832542743
Total Pages : 246 pages
Book Rating : 4.8/5 (325 download)

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Book Synopsis Diversified Agri-food Production Systems for Nutritional Security by : Anup Das

Download or read book Diversified Agri-food Production Systems for Nutritional Security written by Anup Das and published by Frontiers Media SA. This book was released on 2024-01-16 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nutritional security and ecosystem sustainability are the biggest challenges of the 21st century. Globally ~ 2.3 billion people suffer from malnutrition. According to estimates by the World Bank, malnutrition globally costs ~ $ 3.5 trillion per year. On the other hand, the production and availability of staple food is the major emphasis for conventional farming in developing and underdeveloped countries for assured food security. These staple foods are high in carbohydrates and energy availability but low in nutritional value, such as concerning micronutrient, phytochemical, and vitamin contents. Apart from adequate food, there should be consistent access, availability, and affordability of foods and beverages that are nutrient-dense, promote well-being, and minimize diseases. From the experience of the recent COVID-19 crisis, the importance of adequate dietary habits has been emphasized globally since food nutrients are considered inherent sources of immunomodulation.

Transforming Food Systems for a Rising India

Author : Prabhu Pingali
Publisher : Springer
ISBN 13 : 3030144097
Total Pages : 382 pages
Book Rating : 4.0/5 (31 download)

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Book Synopsis Transforming Food Systems for a Rising India by : Prabhu Pingali

Download or read book Transforming Food Systems for a Rising India written by Prabhu Pingali and published by Springer. This book was released on 2019-05-14 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book examines the interactions between India’s economic development, agricultural production, and nutrition through the lens of a “Food Systems Approach (FSA).” The Indian growth story is a paradoxical one. Despite economic progress over the past two decades, regional inequality, food insecurity and malnutrition problems persist. Simultaneously, recent trends in obesity along with micro-nutrient deficiency portend to a future public health crisis. This book explores various challenges and opportunities to achieve a nutrition-secure future through diversified production systems, improved health and hygiene environment and greater individual capability to access a balanced diet contributing to an increase in overall productivity. The authors bring together the latest data and scientific evidence from the country to map out the current state of food systems and nutrition outcomes. They place India within the context of other developing country experiences and highlight India’s status as an outlier in terms of the persistence of high levels of stunting while following global trends in obesity. This book discusses the policy and institutional interventions needed for promoting a nutrition-sensitive food system and the multi-sectoral strategies needed for simultaneously addressing the triple burden of malnutrition in India.

Food Security, Nutrition and Sustainability

Author : Geoffrey Lawrence
Publisher : Earthscan
ISBN 13 : 1849774498
Total Pages : 321 pages
Book Rating : 4.8/5 (497 download)

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Book Synopsis Food Security, Nutrition and Sustainability by : Geoffrey Lawrence

Download or read book Food Security, Nutrition and Sustainability written by Geoffrey Lawrence and published by Earthscan. This book was released on 2013 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers critical insights by international scholars, with chapters on global food security, supermarket power, new technologies, and sustainability. The book also assesses the contributions of diet and nutrition research in building socially just and environmentally sustainable food systems and provides policy recommendations to improve the health and environmental status of contemporary agri-food systems.

Towards Sustainable Global Food Systems

Author : Ruerd Ruben
Publisher : MDPI
ISBN 13 : 3038978140
Total Pages : 356 pages
Book Rating : 4.0/5 (389 download)

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Book Synopsis Towards Sustainable Global Food Systems by : Ruerd Ruben

Download or read book Towards Sustainable Global Food Systems written by Ruerd Ruben and published by MDPI. This book was released on 2019-04-30 with total page 356 pages. Available in PDF, EPUB and Kindle. Book excerpt: One of the major knowledge challenges in the domain of Resilient and Sustainable Food Systems refers to the integration of perspectives on consumption, patterns that support public health, inclusive value chains, and environmentally sustainable food production. While there is a long record of the analysis of separate interventions, this special issue generates integrated insights, provides cross-cutting perspectives, and outlines practical and policy solutions that address these global challenges.The collection of papers promotes the view that sustainable food systems require thorough insights into the structure and dynamics of agri-food production systems, the drivers for integrating food value chains and markets, and key incentives for supporting healthier consumer choices. On the production side, potential linkages between agricultural commercialization and intensification and their effects for food security and nutritional outcomes are analyzed. Value Chains are assessed for their contribution to improving exchange networks and markets for food products that simultaneously support efficiency, circularity, and responsiveness. Individual motives and market structures for food consumption need to be understood in order to be able to outline suitable incentives to enhance healthy dietary choice.The contributed papers focus on interfaces between food system activities and processes of adaptive change that are critical for overcoming key constraints and trade-offs between sustainable food and healthy diets.

Agriculture, Food and Nutrition for Africa

Author :
Publisher :
ISBN 13 :
Total Pages : 464 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Agriculture, Food and Nutrition for Africa by :

Download or read book Agriculture, Food and Nutrition for Africa written by and published by . This book was released on 1997 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Orphan Crops for Sustainable Food and Nutrition Security

Author : Stefano Padulosi
Publisher : Routledge
ISBN 13 : 1000450422
Total Pages : 466 pages
Book Rating : 4.0/5 (4 download)

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Book Synopsis Orphan Crops for Sustainable Food and Nutrition Security by : Stefano Padulosi

Download or read book Orphan Crops for Sustainable Food and Nutrition Security written by Stefano Padulosi and published by Routledge. This book was released on 2021-09-22 with total page 466 pages. Available in PDF, EPUB and Kindle. Book excerpt: Orphan Crops for Sustainable Food and Nutrition Security discusses the issues, challenges, needs and opportunities related to the promotion of orphan crops, known also as neglected and underutilized species (NUS). The book is structured into six parts, covering the following themes: introduction to NUS, approaches, methods and tools for the use enhancement of NUS, integrated conservation and use of minor millets, nutritional and food security roles of minor millets, stakeholders and global champions, and, building an enabling environment. Presenting a number of case studies at the regional and country levels, the chapters cover different but highly interlinked aspects along the value chains, from acquisition and characterization of genetic diversity, cultivation and harvesting to value addition, marketing, consumption and policy for mainstreaming. Cross-cutting issues like gender, capacity building and empowerment of vulnerable groups are also addressed by authors. Representatives from communities, research for development agencies and the private sector also share their reflections on the needs for the use enhancement of NUS from their own perspectives. This book will be of great interest to students and scholars of food security, sustainable agriculture, nutrition and health and development, as well as practitioners and policymakers involved in building more resilient food and production systems.

Diversifying Food and Diets

Author : Jessica Fanzo
Publisher : Routledge
ISBN 13 : 1136461469
Total Pages : 401 pages
Book Rating : 4.1/5 (364 download)

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Book Synopsis Diversifying Food and Diets by : Jessica Fanzo

Download or read book Diversifying Food and Diets written by Jessica Fanzo and published by Routledge. This book was released on 2013-06-26 with total page 401 pages. Available in PDF, EPUB and Kindle. Book excerpt: Currently 868 million people are undernourished and 195 million children under five years of age are stunted. At the same time, over 1 billion people are overweight and obese in both the developed and developing world. Diseases previously associated with affluence, such as cancer, diabetes and cardio-vascular disease, are on the rise. Food system-based approaches to addressing these problems that could enhance food availability and diet quality through local production and agricultural biodiversity often fall outside the traditional scope of nutrition, and have been under-researched. As a consequence, there remains insufficient evidence to support well-defined, scalable agricultural biodiversity interventions that can be linked to improvements in nutrition outcomes. Agricultural biodiversity is important for food and nutritional security, as a safeguard against hunger, a source of nutrients for improved dietary diversity and quality, and strengthening local food systems and environmental sustainability. This book explores the current state of knowledge on the role of agricultural biodiversity in improving diets, nutrition and food security. Using examples and case studies from around the globe, the book explores current strategies for improving nutrition and diets and identifies key research and implementation gaps that need to be addressed to successfully promote the better use of agricultural biodiversity for rural and urban populations and societies in transition.

Healthy and Sustainable Food Systems

Author : Mark Lawrence
Publisher : Routledge
ISBN 13 : 1351189018
Total Pages : 293 pages
Book Rating : 4.3/5 (511 download)

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Book Synopsis Healthy and Sustainable Food Systems by : Mark Lawrence

Download or read book Healthy and Sustainable Food Systems written by Mark Lawrence and published by Routledge. This book was released on 2019-10-18 with total page 293 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive text provides the latest research on key concepts, principles and practices for promoting healthy and sustainable food systems. There are increasing concerns about the impact of food systems on environmental sustainability and, in turn, the impact of environmental sustainability on the capacity of food systems to protect food and nutrition security into the future. The contributors to this book are leading researchers in the causes of and solutions to these challenges. As international experts in their fields, they provide in-depth analyses of the issues and evidence-informed recommendations for future policies and practices. Starting with an overview of ideas about health, sustainability and equity in relation to food systems, Healthy and Sustainable Food Systems examines what constitutes a food system, with chapters on production, manufacturing, distribution and retail, among others. The text explores health and sustainable diets, looking at issues such as overconsumption and waste. The book ends with discussions about the politics, policy, personal behaviours and advocacy behind creating healthy and sustainable food systems. With a food systems approach to health and sustainability identified as a priority area for public health, this text introduces core knowledge for students, academics, practitioners and policy-makers from a range of disciplines including food and nutrition sciences, dietetics, public health, public policy, medicine, health science and environmental science.

Transformation of Agri-Food Systems

Author : K. C. Bansal
Publisher : Springer Nature
ISBN 13 : 9819980143
Total Pages : 375 pages
Book Rating : 4.8/5 (199 download)

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Book Synopsis Transformation of Agri-Food Systems by : K. C. Bansal

Download or read book Transformation of Agri-Food Systems written by K. C. Bansal and published by Springer Nature. This book was released on 2023 with total page 375 pages. Available in PDF, EPUB and Kindle. Book excerpt: Zusammenfassung: This edited volume covers all major topics related to agri-food transformation towards sustainability in this era of climate change. The topics cover field crops, horticultural crops, livestock sector, nutritional aspects, application of latest field-based technologies, and agriculture related policies and institutions. Some of the key topics are: Innovations for Reconfiguring Food Systems; Transforming High-value Food Commodities; Demand-Supply of Agri-food Commodities; Balancing Human Demand and Ecological Sustainability; International Partnership for Transformation of Agri-Food Systems; Transforming Animal Health and Aquatic Food Systems for Food Security; Climate Resilient Agriculture; Addressing Nutritional Security through Natural Resource Management; Water Harvesting and Improving Water Productivity; Combating Micronutrient Deficiencies; Plant Genetic Resources for Food Security and Nutrition; Genome Editing for Crop Improvement; and Biosafety and Socioeconomic Considerations. Written by experts, this book serves in exchanging and sharing the latest research findings, ideas and experiences on all aspects of agri-food systems to enable the formulation of the ways forward to transform our agri-food system to meet the Sustainable Development Goals (SDGs) of the United Nations by 2030. The target audience include academicians, researchers, students, farmers, entrepreneurs, policy makers, and others

Encyclopedia of Food Security and Sustainability

Author :
Publisher : Elsevier
ISBN 13 : 0128126884
Total Pages : 1861 pages
Book Rating : 4.1/5 (281 download)

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Book Synopsis Encyclopedia of Food Security and Sustainability by :

Download or read book Encyclopedia of Food Security and Sustainability written by and published by Elsevier. This book was released on 2018-11-08 with total page 1861 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Encyclopedia of Food Security and Sustainability, Three Volume Set covers the hottest topics in the science of food sustainability, providing a synopsis of the path society is on to secure food for a growing population. It investigates the focal issue of sustainable food production in relation to the effects of global change on food resources, biodiversity and global food security. This collection of methodological approaches and knowledge derived from expert authors around the world offers the research community, food industry, scientists and students with the knowledge to relate to, and report on, the novel challenges of food production and sustainability. This comprehensive encyclopedia will act as a platform to show how an interdisciplinary approach and closer collaboration between the scientific and industrial communities is necessary to strengthen our existing capacity to generate and share research data. Offers readers a ‘one-stop’ resource on the topic of food security and sustainability Contains articles split into sections based on the various dimensions of Food Security and Food Sustainability Written by academics and practitioners from various fields and regions with a “farm to fork understanding Includes concise and accessible chapters, providing an authoritative introduction for non-specialists and readers from undergraduate level upwards, as well as up-to-date foundational content for those familiar with the field

Developing Sustainable Food Systems, Policies, and Securities

Author : Obayelu, Abiodun Elijah
Publisher : IGI Global
ISBN 13 : 1799826015
Total Pages : 292 pages
Book Rating : 4.7/5 (998 download)

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Book Synopsis Developing Sustainable Food Systems, Policies, and Securities by : Obayelu, Abiodun Elijah

Download or read book Developing Sustainable Food Systems, Policies, and Securities written by Obayelu, Abiodun Elijah and published by IGI Global. This book was released on 2020-04-17 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: A food system is sustainable if it delivers food and nutrition security for all without compromising the economic, social, and environmental bases to generate food security and nutrition for future generations. Sustainable food systems are vital in ensuring global health and ending malnutrition in all its forms. Assessing important dimensions of the food system such as nutrition, sustainable agriculture, food loss and waste can provide stakeholders with necessary information to evaluate the strength of their country’s food systems and determine where more support is needed. Developing Sustainable Food Systems, Policies, and Securities is a pivotal reference source that explores the nature, extent, and causes of nutrition problems across the world as well as the role that agricultural policy plays in these issues. The book supports the development of sustainable food systems, policy options, and securities by various countries in order to successfully maintain sustainable food production systems. Featuring research topics such as food security, carbon emissions, and nutrition, the book is ideally designed for economists, environmentalists, food producers, policymakers, researchers, academicians, and students seeking coverage on agricultural and sustainability issues.

Transforming Food Systems for a Rising India

Author : Prabhu Pingali
Publisher :
ISBN 13 : 9783030144104
Total Pages : 368 pages
Book Rating : 4.1/5 (441 download)

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Book Synopsis Transforming Food Systems for a Rising India by : Prabhu Pingali

Download or read book Transforming Food Systems for a Rising India written by Prabhu Pingali and published by . This book was released on 2019 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This book ... brings together high quality research, real world pragmatism and an understanding of the politics of Indian food systems."--Lawrence Haddad, Executive Director, GAIN and 2018 World Food Prize Laureate '[The authors] have done a masterful job of [demonstrating] paradoxes of India's rapid economic growth concurrently with ... persistent poverty, food insecurity and ... a triple burden of malnutrition.' - Uma Lele, President-Elect International Association of Agricultural Economics (IAAE) 'Using a broad food systems approach, this book presents [a] ... comprehensive analysis of the Indian food and agricultural system and its interaction with climate change, nutrition and health.' - Per Pinstrup-Andersen, Professor Emeritus, Cornell University and 2001 World Food Prize Laureate This open access book examines India's economic development, agricultural production, and nutrition through the lens of a "Food Systems Approach (FSA)." Despite economic progress, regional inequality, food insecurity and malnutrition persist. Simultaneously, recent trends in obesity and micro-nutrient deficiency indicate a future public health crisis. This book explores the challenges and opportunities to achieve a nutrition-secure future through diversified production systems, improved health and hygiene and greater individual capability to access a balanced diet. Within the context of developing countries, they highlight India's status as an outlier regarding high levels of stunting and global trends in obesity. This book discusses the policy and institutional interventions needed to promote a nutrition-sensitive food system and the multi-sectoral strategies needed to address malnutrition in India. Prabhu Pingali is Professor of Applied Economics and Founding Director of the Tata-Cornell Institute for Agriculture and Nutrition (TCI) at Cornell University. Anaka Aiyar is Post-Doctoral Associate with the Tata-Cornell Institute for Agriculture and Nutrition (TCI), Cornell University. Mathew Abraham is Assistant Director of the Tata-Cornell Institute for Agriculture and Nutrition (TCI), Cornell University. Andaleeb Rahman is Post-Doctoral Associate at the Tata-Cornell Institute for Agriculture and Nutrition (TCI), Cornell University.

From farm to table: Agrifood systems and trade challenges in the Southern Cone

Author : Piñeiro, Valeria
Publisher : Intl Food Policy Res Inst
ISBN 13 :
Total Pages : 142 pages
Book Rating : 4./5 ( download)

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Book Synopsis From farm to table: Agrifood systems and trade challenges in the Southern Cone by : Piñeiro, Valeria

Download or read book From farm to table: Agrifood systems and trade challenges in the Southern Cone written by Piñeiro, Valeria and published by Intl Food Policy Res Inst. This book was released on 2023-12-11 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: Food production includes a complex and varied set of agricultural and nonagricultural activities, involving a growing number of sectors and actors that influence the way food is produced, processed, distributed, and consumed. Recently, and especially after the 2021 United Nation Food Systems Summit (UNFSS), it has been proposed that this conglomerate of activities and socioeconomic actors be jointly identified as food systems. National food systems, which exist in each country, are interrelated through trade and other factors with regional food systems and finally with the global food system. The concept of food systems has been adopted as a useful tool for understanding the multiple and complex interrelations between different production, distribution, and trade partners and for adjusting policy analysis and design to this complex world. The discussions and documentation prepared during the UNFSS process brought to public attention not only the utility and complexity of this concept but also some of the shortcomings of current food production practices. The summit also highlighted an urgent need to establish processes for identifying such shortcomings, their relative importance, and possible measures that would lead to the transformation of national food systems and the global food system.

Small-scale producers in sustainable agrifood systems transformation

Author : Arulingam, I., Brady, G., Chaya, M., Conti, M., Kgomotso, P. K., Korzenszky, A., Njie, D., Schroth, G., Suhardiman, D.
Publisher : Food & Agriculture Org.
ISBN 13 : 9251365709
Total Pages : 45 pages
Book Rating : 4.2/5 (513 download)

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Book Synopsis Small-scale producers in sustainable agrifood systems transformation by : Arulingam, I., Brady, G., Chaya, M., Conti, M., Kgomotso, P. K., Korzenszky, A., Njie, D., Schroth, G., Suhardiman, D.

Download or read book Small-scale producers in sustainable agrifood systems transformation written by Arulingam, I., Brady, G., Chaya, M., Conti, M., Kgomotso, P. K., Korzenszky, A., Njie, D., Schroth, G., Suhardiman, D. and published by Food & Agriculture Org.. This book was released on 2022-07-26 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: If the world is to transition towards agrifood systems that are more sustainable and equitable, small-scale production systems will be key to progress. Large parts of the world depend on small-scale systems for maintaining food security and nutrition (Lowder, Sánchez and Bertini, 2021; Herrero et al., 2017). Despite this centrality, neither small-scale production systems nor small-scale producers have received due recognition under predominant agrifood systems paradigms. This paper analyzes the diversity of small-scale producers and demonstrates how understanding small-scale production can have consequences for how policies and investments are directed and how they impact small-scale producer livelihoods. The diverse roles and functions of small-scale production are presented as being essential to realizing sustainable agrifood systems transformations and respecting its social, environmental and economic dimensions. Constraints faced by small-scale producers in accessing the assets, financial and knowledge services and market positioning that can support profitable livelihoods are examined. This publication provides recommendations for expanding the potential of small-scale producers for sustainable agrifood systems transformations across the following areas: create an enabling environment to support the multifunctionality of small-scale production; address the economic and social marginalization of small-scale producers; ensure the political voice and participation of small-scale producers in agrifood systems governance; increase access of small-scale producers to natural and productive resources; improve access to financial services; improve the market positioning of small-scale producers; support the co-creation and exchange of knowledge and innovation for sustainable small-scale production.

Food Systems for Improved Human Nutrition

Author : Palit Kataki
Publisher : CRC Press
ISBN 13 : 9781560221036
Total Pages : 416 pages
Book Rating : 4.2/5 (21 download)

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Book Synopsis Food Systems for Improved Human Nutrition by : Palit Kataki

Download or read book Food Systems for Improved Human Nutrition written by Palit Kataki and published by CRC Press. This book was released on 2002-10-31 with total page 416 pages. Available in PDF, EPUB and Kindle. Book excerpt: Learn to produce crops with improved nutrition to alleviate malnourishment--using sustainable agriculture techniques! Utilizing complete food systems to improve nutrition has become a priority in the fight against malnutrition. This book examines all aspects of food systems, drawing on examples from various countries and geographical regions. Bringing together the most recent work of international experts, Food Systems for Improved Human Nutrition provides an important overview of the food systems approach. It also explores the extent of malnourishment in different areas; presents case studies from South Asia, China, India, Bangladesh, and East Africa; points to ways to improve food production and nutrient quality; and suggests directions for future research. Helpful charts and tables make the information in this well-referenced book easy to access and understand. Food Systems for Improved Human Nutrition brings you state-of-the-art information on: the potential benefits of agroforestry systems how to fortify food with micronutrients how to design population-appropriate nutrition interventions the ways that rapid economic change can affect human nutrition in a given area biotech approaches to improve nutrition in rice and maize crops crossbred cow technologies in the East African highlands and much more!

Biodiversity, Food and Nutrition

Author : Danny Hunter
Publisher : Routledge
ISBN 13 : 0429638264
Total Pages : 215 pages
Book Rating : 4.4/5 (296 download)

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Book Synopsis Biodiversity, Food and Nutrition by : Danny Hunter

Download or read book Biodiversity, Food and Nutrition written by Danny Hunter and published by Routledge. This book was released on 2020-04-29 with total page 215 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book examines the challenges and impacts of poor diets and nutrition from current food systems and the potential contribution of biodiversity and ecosystem services in addressing these problems. There is a strong need for a multi-level, cross-sectoral approach that connects food biodiversity conservation and sustainable use to address critical problems in our current food systems, including malnutrition. Building on research from the Biodiversity for Food and Nutrition Project (BFN), which aims to better link biodiversity, diets and nutrition, the book presents a multi-country, cross-sectoral analysis of initiatives that have promoted local food biodiversity in four countries: Brazil, Kenya, Turkey and Sri Lanka. This book offers a comprehensive summary of the BFN Project results in each of the four countries along with lessons learned and how this work could be upscaled or applied in other regions. It argues that the strategic promotion and use of food biodiversity is critical in uniting attempts to address conservation, nutrition and livelihood concerns. The book is structured around chapters and case studies encompassing the BFN Project with specific experiences related by partners who played key roles in the work being done in each country. By offering a comparative view capable of furthering dialogue between the respective countries, it is also meant to connect the individual cases for a “greater than the sum of its parts” effect. This means consideration of how localized activities can be adapted to more countries and regions. Therefore, the book addresses global issues with a foot planted firmly in the grounded case study locations. This book will be of great interest to policymakers, practitioners and NGOs working on food and nutrition, as well as students and scholars of agriculture, food systems and sustainable development.

Global Food Systems, Diets, and Nutrition

Author : Jessica Fanzo
Publisher : Springer Nature
ISBN 13 : 3030727637
Total Pages : 212 pages
Book Rating : 4.0/5 (37 download)

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Book Synopsis Global Food Systems, Diets, and Nutrition by : Jessica Fanzo

Download or read book Global Food Systems, Diets, and Nutrition written by Jessica Fanzo and published by Springer Nature. This book was released on 2021-06-05 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ensuring optimal diets and nutrition for the global population is a grand challenge fraught with many contentious issues. To achieve food security for all and protect health, we need functional, equitable, and sustainable food systems. Food systems are highly complex networks of individuals and institutions that depend on governance and policy leadership. This book explains how interconnected food systems and policies affect diets and nutrition in high-, middle-, and low-income countries. In tandem with food policy, food systems determine the availability, affordability, and nutritional quality of the food supply, which influences the diets that people are willing and able to consume. Readers will become familiar with both domestic and international food policy processes and actors, and they will be able to critically analyze and debate how policy and science affect diet and nutrition outcomes.