Factors Associated with Prenatal Folic Acid and Iron Supplementation Among 21,889 Pregnant women in Northern Tanzania: A Cross-Sectional Hospital-Based Study.

Folate and iron deficiency during pregnancy are risk factors for anaemia, preterm delivery, and low birth weight, and may contribute to poor neonatal health and increased maternal mortality. The World Health Organization recommends supplementation of folic acid (FA) and iron for all pregnant women at risk of malnutrition to prevent anaemia. We assessed the use of prenatal folic acid and iron supplementation among women in a geographical area with a high prevalence of anaemia, in relation to socio-demographic, morbidity and health services utilization factors. We analysed a cohort of 21,889 women who delivered at Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania, between 1999 and 2008. Logistic regression models were used to describe patterns of reported intake of prenatal FA and iron supplements. Prenatal intake of FA and iron supplements was reported by 17.2% and 22.3% of pregnant women, respectively. Sixteen percent of women reported intake of both FA and iron. Factors positively associated with FA supplementation were advanced maternal age (OR = 1.17, 1.02-1.34), unknown HIV status (OR = 1.54, 1.42-1.67), a diagnosis of anaemia during pregnancy (OR = 12.03, 9.66-14.98) and indicators of lower socioeconomic status. Women were less likely to take these supplements if they reported having had a malaria episode before (OR = 0.57, 0.53-0.62) or during pregnancy (OR = 0.45, 0.41-0.51), reported having contracted other infectious diseases (OR = 0.45, 0.42-0.49), were multiparous (OR = 0.73, 0.66-0.80), had preeclampsia/eclampsia (OR = 0.48, 0.38-0.61), or other diseases (OR = 0.55, 0.44-0.69) during pregnancy. Similar patterns of association emerged when iron supplementation alone and supplementation with both iron and FA were evaluated. FA and iron supplementation are low among pregnant women in Northern Tanzania, in particular among women with co-morbidities before or during pregnancy. Attempts should be made to increase supplementation both in general and among women with pregnancy complications

Reproductive and family planning history, knowledge, and needs: A community survey of low-income women in Beijing, China

10.1186/1472-6874-9-23BMC Women's Health923-BWHM

Should foreign producers oppose domestic state aid?

Can subsidies to domestic producers, de facto, be subsidies to foreign producers? If so, state aid may distort competition to the advantage of the foreign producers. At the same time, governments often oppose subsidies elsewhere, claiming that their industry is hurt. The possibility that governments fight subsidies on these grounds, although the effects are to the contrary, constitutes what is called ‘the state aid paradox’ that is discussed throughout the paper. The dispute over regionally differentiated payroll tax rates between Norway and the surveillance authority of the European Free Trade Association (ESA) is used as a motivating example. The dispute is analysed by means of a simple general equilibrium model. The approach is partly analytical and partly numerical. There are three regions represented in the model: the assisted periphery, the assisting core, and the world outside, interpreted here as the European Union (EU). It will be demonstrated that although the assisted periphery will be losing market shares if state aid is ended, so will possibly EU in all markets

Laparoscopic Appendectomy Outcomes on the Weekend and During the Week are no Different: A National Study of 151,774 Patients

Background: The "weekend effect” is defined as increased morbidity and mortality for patients admitted on weekends compared with weekdays. It has been observed for several diseases, including myocardial infarction and renal insufficiency; however, it has not yet been investigated for laparoscopic appendectomy in acute appendicitis—one of the most prevalent surgical diagnoses. Methods: The present study is based on the Nationwide Inpatient Sample (NIS) from 1999 to 2008. The following outcomes were compared between patients undergoing laparoscopic appendectomy for acute appendicitis admitted on weekdays versus weekends: severity of appendicitis, intraoperative and postoperative complications, conversion rate, in-hospital mortality, and length of hospital stay. Unadjusted and risk-adjusted generalized linear regression analyses were performed. Results: Overall, 151,774 patients were included, mean age was 39.6years, 52.6% (n=79,801) were male, and 25.3% (n=38,317) were admitted on weekends. After risk adjustment, the conversion rate was lower [odds ratio (OR): 0.94, p=0.004, number needed to harm (NNH): 244], whereas pulmonary complications (OR: 1.12, p=0.028, NNH: 649) and reoperations (OR: 1.21, p=0.013, NNH: 1,028) were slightly higher on weekends than on weekdays. Overall postoperative complications (OR: 1.03, p=0.24), mortality (OR: 1.37, p=0.075) and length of hospital stay (mean on weekday: 2.00days, weekends: 2.01days, p=0.29) were not statistically different. Conclusions: The present investigation provides evidence that no clinically significant "weekend effect” for patients undergoing laparoscopic appendectomy exists. Therefore, hospital or staffing policy changes are not justified based on the findings from this large national stud

Cholecystectomy Concomitant with Laparoscopic Gastric Bypass: A Trend Analysis of the Nationwide Inpatient Sample from 2001 to 2008

Background: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. Methods: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. Results: A total of 70,287 patients were included: mean age was 43.1years and 81.6% were female. Concomitant cholecystectomy was performed in 6,402 (9.1%) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3% in 2001 to 3.7% in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4days; p < 0.001). Conclusions: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder diseas

From farm to fork and back again: An analysis of the debate about inclusion of environmental sustainability aspects in dietary guidelines

The transformation of the food system is an essential component of the shift towards a more sustainable future. One way to achieve this transformation is by encouraging people to adopt a more sustainable diet. How we grow, distribute, and consume food affects our well-being and has far-reaching consequences for our planet’s environment, climate, and future. Although there is growing awareness about the impact of our dietary choices on the environment, incorporating environmental sustainability aspects into dietary advice remains controversial. This research aims to understand how Norwegian food system stakeholders respond to and perceive the integration of sustainability aspects into dietary advice in the case of Nordic Nutrition Recommendations (NNR) and to grasp how discourses, political interests, and actors influence the policy process of formulating the new national dietary guidelines in Norway. This thesis has a case study as research design and use document analysis of Norwegian newspapers and key informant interviews. Through my research, I discovered that the dominant discourse among food and agricultural interest groups demonstrated resistance to changing sustainable practices due to the existing political and economic structures in the agri-food system. I call this discourse the status quo discourse. I observed that the debate was driven by political interests rather than scientific evidence, with particularly the political party Senterpartiet and the agricultural organisations exerting political influence over the outcome. I also found that a coalition of actor-networks, epistemic communities, including parts of the research community, and policy entrepreneurs amplified their stance against sustainability, and effectively, steered discussions in their favour, ultimately influencing the policy landscape. The results of this study offer valuable understanding into the intricate process of incorporating sustainability aspects into dietary recommendations. As a case, it also contributes to broader analyses of contestations in policy processes for sustainable transformation

Dehydrogenation of propane by carbon supported metal catalysts

In this thesis, the catalytic properties of carbon supported Pt catalysts were investigated for the dehydrogenation of propane. Using a polyol process, Pt/Carbon catalysts active for propane dehydrogenation were successfully prepared using carbon black, graphite and a conical platelet CNF as supports. The catalysts were characterized using BET surface area measurements, TGA, volumetric and pulse hydrogen chemisorption and CO stripping voltammetry. The BET measurements found surface areas in the order carbon black > CNF > graphite with good measurement accuracy. The three subsequent methods were found impractical for the catalysts investigated due to poor measurement accuracy for the TGA compared to the size of the target value. The volumetric chemisorption was found unable to produce linear isotherms, likely caused by hydrogen-carbon interactions and the pulse experiment failed to find an optimal adsorption temperature that combined a managable rate of desorption with a high rate of adsorption. The CO stripping voltammetric experiment was found able to determine the dispersion of the carbon black and graphite supported catalysts and found the dispersion of Pt/Carbon black > graphite, with some uncertainty associated with the results. Experimental work was put into optimizing the catalyst activity measurement conditions and achieve an acceptable trade-off between pressure drop, deactivation rate and conversion levels. This was found at 500 C, 50 mL/min feed flow rate, 50 mg sample mass diluted with inerts and 0.5 %wt. Pt content in the catalysts. A kinetic study was performed and on a Pt/Carbon black catalyst, the propane dehydrogenation reaction was found to follow power law kinetics with a propane order of 0.9 and hydrogen order of −1.1. The accuracy of the measurements were better for the propane order than for hydrogen. The three different supports were compared for catalytic activity and it was found that the activity of Pt/Carbon black > graphite > CNF. The likely cause was the lower dispersion of the graphite supported catalyst compared to that of the carbon black supported catalyst. As the CNF supported catalyst was found less active than the graphite supported catalyst, it is likely that the CNF supported catalyst also had a low dispersion. The low dispersions is most likely caused by a combination of the low surface areas and the surface chemistries of the CNF and graphite supports

Multinomial malware classification based on call graphs

Ever since the computer was invented, people have found ways to evolve interaction or simplify tasks with computational resources, this for both good and bad. For the known lifespan of the digital age, malicious software (malware) has been a constant threat to computer systems. Malware has been the cause of enormous damage related to both governmental and private sectors, but also for individuals. Malware has evolved to target different systems and environments and therefore there exists a vastly amount of different samples which differ in both attack methods and functionality. Furthermore, malware has been developed by attackers to exploit unknown vulnerabilities, evade detection techniques and include multiple functionalities, expanding the pool of malware even more. Because of this security expert has to keep up with the development of countermeasures to detect and alarm for this expanding threat. This thesis addresses one such approach where different malware families are executed, and the traces left from this is analyzed to classify what kind of malware family a sample is. More specifically this thesis utilizes expert knowledge to derive expert graphs describing a malware family, and the graph is then used to match unknown samples to search for likeness

Effects of a portion design plate on food group guideline adherence among hospital staff

Food group guideline adherence is vital to prevent obesity and diabetes. Various studies have demonstrated that environmental variables influence food intake behaviour. In the present study we examined the effect of a portion design plate with food group portion guidelines demarcated by coloured lines (ETE Plate™). A two-group quasi-experimental design was used to measure proportions of carbohydrate, vegetable and protein portions and user experience in a hospital staff lounge setting in Singapore. Lunch was served on the portion design plate before 12.15 hours. For comparison, a normal plate (without markings) was used after 12.15 hours. Changes in proportions of food groups from 2 months before the introduction of the design plate were analysed in a stratified sample at baseline (859 subjects, all on normal plates) to 1, 3 and 6 months after (in all 1016 subjects on the design plate, 968 subjects on the control plate). A total of 151 participants were asked about their experiences and opinions. Between-group comparisons were performed using ___t___ tests. Among those served on the portion design plate at 6 months after its introduction, the proportion of vegetables was 4·71 % (P < 0·001) higher and that of carbohydrates 2·83 % (P < 0·001) lower relative to the baseline. No significant change was found for proteins (−1·85 %). Over 6 months, we observed different change patterns between the different food group proportions. While participants were positive about the portion design plate, they did not think it would influence their personal behaviour. A portion design plate might stimulate food group guideline adherence among hospital staff and beyond

Doublespeak? Sustainability in the Arctic—A Text Mining Analysis of Norwegian Parliamentary Speeches

This paper contributes to the recent literature on sustainability in the Arctic as a political concept. Parliamentary proceedings have increasingly been recognized as an important source of information for eliciting political issues. In this paper, we use unsupervised text mining techniques to analyze parliamentary speeches for Norway from the period from 2009 to 2016 to answer whether political coalitions talk differently about sustainability in the Arctic depending on being in opposition or government. We find that the difference between being in government and opposition, controlling for political label (left-right), is far more important than the difference between left and right, controlling for role (opposition-government). The results suggest that in the trade-off between political preferences and election success, the balance is tilted in favour of the latter. Our interpretation is that opportunistic behavior seems to dominate partisan behavior in the politics related to sustainability in the Arctic