Looking for "The Equalizer" in antenatal care : developing and evaluating language-supported group antenatal care in Sweden

Group antenatal care (gANC) is an antenatal care (ANC) model that aims to empower women and has demonstrated potential to improve outcomes for groups of women with poorer reproductive health outcomes. The overall aim of this thesis was to develop and test the acceptability and impact of language-supported gANC for Somali-born women in Sweden. The purpose of the intervention was to improve experiences of antenatal care, emotional well-being, knowledge about childbearing and the Swedish healthcare system, and ultimately, pregnancy outcomes. Experiences of standard ANC were explored in focus group discussions with parents and midwives (Study I). Challenges and barriers in standard antenatal were described, both related to the encounters between midwives and parents-to-be, and organizational challenges. Utilising data from Study I, “language-supported group antenatal care” was developed and implemented in one clinic for 18 months. The intervention was evaluated, and women’s care experiences and emotional wellbeing were compared with those of women offered standard care (historical controls) and those subsequently offered gANC (intervention). Data were collected by means of questionnaires at baseline, in late pregnancy and at 6–8 weeks postpartum (Study II). The development, implementation, and feasibility of the intervention was assessed through a process evaluation using mixed data sources (observations, interviews, questionnaires, etc.) (Study III). In study II, no differences between the intervention group and the control group on the primary outcome of women’s overall rating of antenatal care were found. The reduction in mean EPDS score was greater in the intervention group when adjusting for differences at baseline (mean difference –1.89; CI 95% –3.73 to –0.07). Women in gANC were happier with received pregnancy and birth information; e.g., in the case of caesarean sections, where 94.9% believed the information was sufficient compared to 17.5% in standard care (p <0.001) in late pregnancy. In study III, women in language-supported gANC thought it was a positive experience as a complement to individual care, but the intervention was not successful at involving partners in ANC. In gANC, the midwives and women got to know each other better. The main mechanism of impact was more comprehensive care. The position of women was strengthened in the groups, and the way midwives expanded their understanding of the women, and their narratives, was promising. This evaluation suggests potential for language-supported gANC to improve information provision and knowledge acquisition for Somali–Swedish women during pregnancy (with residence in Sweden ˂10 years). Language-supported gANC is feasible and relevant if there is an adequate number of pregnant migrant or minority women in an uptake area who share a common language. To be feasible in other settings, gANC requires adaptations to local context. Reflection is called for when forming groups based on ethnicity or language, to avoid potential unintended consequences such as reinforcing stereotypes by grouping people according to country of birth or reducing privacy for individual women. The “othering” of women in risk groups should be avoided. There may also be a trade-off in gANC between peer-to-peer support and other important aspects such as the inclusion of partners and integration/inclusion in regular birth preparation and parenting activities. Person-centring seemed to be enhanced with gANC in this study with Somali–Swedish women. ANC interventions including gANC that target inequalities between migrants and non-migrants should adapt a culturally sensitive person-centred approach, as a means of providing individually tailored high quality care that counteracts stereotypes and biases

Malt in Combination with Lactobacillus rhamnosus Increases Concentrations of Butyric Acid in the Distal Colon and Serum in Rats Compared with Other Barley Products but Decreases Viable Counts of Cecal Bifidobacteria123

Several substances, including glutamine and propionic acid but in particular butyric acid, have been proposed to be important for colonic health. β-Glucans lead to the formation of comparatively high amounts of butyric acid, and germinated barley foodstuff obtained from brewer’s spent grain (BSG), containing high amounts of β-glucans and glutamine, has been reported to reduce the inflammatory response in the colon of patients with ulcerative colitis. The present study examines how 3 barley products, whole grain barley, malt, and BSG, affect SCFA in the hindgut and serum of rats and whether the addition of Lactobacillus rhamnosus 271 to each of these diets would have further effects. Amino acids in plasma and the cecal composition of the microbiota were also analyzed. The butyric acid concentration in the distal colon and serum was higher in the malt groups than in the other groups as was the serum concentration of propionic acid. The concentrations of propionic and butyric acids were higher in the cecum and serum of rats given L. rhamnosus than in those not given this strain. The proportion of plasma glutamine and the cecal number of bifidobacteria were lower in the malt groups than in the other groups. L. rhamnosus decreased the number of cecal bifidobacteria, whereas plasma glutamine was unaffected. We conclude that malt together with L. rhamnosus 271 had greater effects on propionic and butyric acid concentrations in rats than the other barley products. This is interesting when developing food with effects on colonic health

Exploiting the multiplexing capabilities of tandem mass tags for high-throughput estimation of cellular protein abundances by mass spectrometry

The generation of dynamic models of biological processes critically depends on the determination of precise cellular concentrations of biomolecules. Measurements of system-wide absolute protein levels are particularly valuable information in systems biology. Recently, mass spectrometry based proteomics approaches have been developed to estimate protein concentrations on a proteome-wide scale. However, for very complex proteomes, fractionation steps are required, increasing samples number and instrument analysis time. As a result, the number of full proteomes that can be routinely analyzed is limited. Here we combined absolute quantification strategies with the multiplexing capabilities of isobaric tandem mass tags to determine cellular protein abundances in a high throughput and proteome-wide scale even for highly complex biological systems, such as a whole human cell line. We generated two independent data sets to demonstrate the power of the approach regarding sample throughput, dynamic range, quantitative precision and accuracy as well as proteome coverage in comparison to existing mass spectrometry based strategies

Effects of drying and pretreatment on the nutritional and functional quality of raisins

The close relationship between the consumption of fruits and health status stems from the nutritional and non-nutritional compounds found in fruits which play a key role in the prevention of different diseases. However, fruit processing and storage greatly affect fruit compounds. The aim of the present work was to study the influence of processing on the stability of macro and micronutrients present in grapes, with a view to recommending products that provide the highest nutritional quality and the best health conditions. The study focused on fruit dehydration treatments. Conventional and microwave-assisted air-drying processes were used to obtain raisins. Dehydration caused a decrease of all grape compounds studied excluding total phenols. Moreover, compared to conventional processing, microwave-assisted drying produced greater losses of ascorbic acid in the grape and increased pectin solubilization with a consequent change in texture. However the microwave-dehydrated samples showed higher antioxidant activity. © 2011 The Institution of Chemical Engineers.The translation of this paper was funded by the Universidad Politecnica de Valencia.Carranza Concha, J.; Benlloch Tinoco, M.; Camacho Vidal, MM.; Martínez Navarrete, N. (2012). Effects of drying and pretreatment on the nutritional and functional quality of raisins. Food and Bioproducts Processing. 90(2):243-248. https://doi.org/10.1016/j.fbp.2011.04.002S24324890

The Bretton Woods Institutions and the Environment: Organizational Learning within the World Bank and the International Monetary Fund (IMF)

Lindenthal A, Koch M. The Bretton Woods Institutions and the Environment: Organizational Learning within the World Bank and the International Monetary Fund (IMF). Administrative Science. 2013;3(4):166-201