Vitamin D intake and determinants of vitamin D status during pregnancy in The Norwegian Mother, Father and Child Cohort Study

BackgroundNorwegian data on vitamin D status among pregnant women indicate a moderate to high prevalence of insufficient vitamin D status (25-hydroxyvitamin D (25OHD) concentrations ≤50  nmol/L). There is a lack of population-based research on vitamin D intake and determinants of 25OHD in pregnant women from northern latitudes. The aims of this study were (1) to evaluate total vitamin D intake from both diet and supplements, (2) to investigate determinants of vitamin D status, and (3) to investigate the predicted response in vitamin D status by total vitamin D intake, in pregnant Norwegian women.MethodsIn total, 2,960 pregnant women from The Norwegian Environmental Biobank, a sub-study within The Norwegian Mother, Father and Child Cohort Study (MoBa), were included. Total vitamin D intake was estimated from a food frequency questionnaire in gestational week 22. Concentrations of plasma 25OHD was analyzed by automated chemiluminescent microparticle immunoassay method in gestational week 18. Candidate determinant variables of 25OHD were chosen using stepwise backward selection and investigated using multivariable linear regression. Predicted 25OHD by total vitamin D intake, overall and stratified by season and pre-pregnancy BMI, was explored using restricted cubic splines in an adjusted linear regression.ResultsOverall, about 61% of the women had a total vitamin D intake below the recommended intake. The main contributors to total vitamin D intake were vitamin D supplements, fish, and fortified margarine. Higher 25OHD concentrations were associated with (in descending order of the beta estimates) summer season, use of solarium, higher vitamin D intake from supplements, origin from high income country, lower pre-pregnancy BMI, higher age, higher vitamin D intake from foods, no smoking during pregnancy, higher education and energy intake. During October–May, a vitamin D intake according to the recommended intake was predicted to reach sufficient 25OHD concentrations >50  nmoL/L.ConclusionThe findings from this study highlight the importance of the vitamin D intake, as one of few modifiable determinants, to reach sufficient 25OHD concentrations during months when dermal synthesis of vitamin D is absent

Strategimodell för storhushåll - en anpassning till tjänstelogiken

Syftet med uppsatsen är att beskriva och analysera välkända strategimodellers applikationsförmåga för de specifika förutsättningar som tjänsteföretag inom storhushåll verkar inom. Metoden som vi valt är kvalitativ och materialet som används tar sin utgångspunkt i sekundärdata i form av offentliga och institutionella källor från kända strategiforskare och branschspecialister. Uppsatsen utgår teorimässigt från de tre strategiska analysmodellerna, Five Forces, SWOT och VRIO-modellen. Dessa analyseras i förhållande till den inriktning av storhushållsföretag som vi valt. Vi har i analys och slutsatser visat på vissa svagheter hos Five Forces-modellen, SWOT-modellen och VRIO-modellen när det gäller dessa modellers respektive applikationsförmåga på tjänsteföretag inom storhushåll. De svagheter som redovisats är att modellerna saknar viktiga yttre påverkansfaktorer som bör uppmärksammas av företag verksamma inom denna kategori samt att den mänskliga faktorn kommer i skymundan. Detta måste anses som viktigt i en strategimodell för storhushållsföretag då människan är utgångspunkten inom den serviceverksamhet som bedrivs. Slutsatserna har vidareutvecklats till en egenskapad modell som ska vara mer anpassad till tjänsteföretag inom storhushålls specifika förutsättningar

Validation of Dietary Vitamin D Intake from Two Food Frequency Questionnaires, Using Food Records and the Biomarker 25-Hydroxyvitamin D among Pregnant Women

Our objective was to validate vitamin D intake from a short vitamin D questionnaire (VDQ) and a longer online food frequency questionnaire (FFQ) against a food record and 25-hydroxyvitamin D (25OHD) as a biomarker of vitamin D status, among pregnant women in Sweden. The number of women included was 1125 with VDQ, FFQ and 25OHD, and of those, 64 also completed the food record. Median vitamin D intakes were 3.9 µg by VDQ (p < 0.001), and 5.3 µg by FFQ (p = 0.89), compared to 5.0 µg by food record. Correlations between vitamin D intake from food record and VDQ (rho = 0.51, p < 0.001) or FFQ (rho = 0.49, p < 0.001) were similar. The VDQ and FFQ also had a similar ability to rank the individuals according to vitamin D intake. However, only vitamin D intake from the VDQ was significantly associated with vitamin D status as assessed by 25OHD. The validation coefficient for the VDQ was 0.68 and 0.75 for the FFQ. In conclusion, assessing dietary vitamin D intake is challenging, regardless of the dietary assessment method. The VDQ, that includes only four food items, is a valid, simple and useful tool in assessing vitamin D intake of pregnant women in Sweden, while imposing a minimal burden on women and researchers

Vad betyder ledaren? -en studie om ledarskapets påverkan för en servicekultur

Sammanfattning Titel: Vad betyder ledaren? – en studie om ledarskapets betydelse för en servicekultur Författare: Anna Amberntsson, Philip Hjelt, Katja Johannesson Handledare: Anette Svingstedt, Filippa Säwe Kurs: SMT 302, kandidatuppsats 10 p, Institutionen för Service Management, Campus Helsingborg, Lunds Universitet Problemdiskussion: Ute i arbetslivet är det inte alla ledare inom servicesektorn som handlar såsom de borde för bibehållandet av en bra servicekultur inom organisationen. För att en servicekultur överhuvudtaget ska vara möjlig finns det en rad samverkande processer mellan ledare och personal som kan leda till att en god servicekultur skapas och bibehålls. Vi tyckte därför att det skulle vara intressant att närmare undersöka vilken betydelse och vilka möjligheter, färdigheter och tekniker för påverkan av servicekulturen en ledare egentligen har. Syfte: Syftet med undersökningen är att öka kunskapen kring ledningens möjligheter till att bibehålla en servicekultur. Detta genom att lyfta fram teoretiska begrepp som sedan illustreras utifrån två hotellföretag. Metod: Genom att utföra en rad kvalitativa djupintervjuer med ledare och personal på två hotell har vi fått fram hur dessa intervjupersoner ser på sin organisation när det gäller ledarskap och servicekultur. Teori: Teorin är i första hand hämtad från tjänsteforskningen och den nordiska skolans teorier. Andra ämnen, från vilka vi också hämtat litteratur är: beteendeforskning, företagsekonomi, organisationsteori och ledarskap, media och kommunikationsvetenskap. Empiri: De två hotell som undersökts är utvalda till stor del för att vi trodde oss kunna hitta både likheter och skillnader i organisation och ledningsstil vilket i sig skulle kunna färga servicekulturen samt då det handlar om en lite större och en lite mindre organisation. Hotellen är belägna i Lund/Malmö-området. Slutsatser: De viktigaste slutsatserna som vi kunnat dra utav vår undersökning är att ledarskapet och servicekulturen går hand i hand. En ledare som signalerar mjuka värden och inte sätter sig över sin personal utan väljer att se och kommunicera med dem har större chans att lyckas påverka servicekulturen i positiv riktning. Det finns en rad viktiga punkter i vilka ett ledarskap kan brista och på så sätt påverka servicekulturen och bemötandet gentemot gästen i olika grad. Nyckelord: servicekultur, kultur, ledarskap och kommunikatio

Nutritional intake and determinants of nutritional quality changes from pregnancy to postpartum—a longitudinal study

Nutrient requirements vary across the reproductive cycle, but research on changes in nutritional intake and quality from pregnancy to beyond the lactation period is limited. Thus, we aimed to study nutritional intake and quality changes, among Swedish pregnant participants from late pregnancy to 18 months postpartum and to study the determinants of nutritional quality changes. Participants (n = 72) were studied longitudinally from the third trimester of pregnancy and postpartum (2 weeks 4, 12, and 18 months postpartum). At each visit, participant characteristics and 4-day food diaries were collected. Nutritional quality was assessed by energy adjusted Nutrient Rich Food Index 11.3. Linear mixed models were used to analyze the determinants of change in nutritional quality. Intakes of carbohydrate energy percentage (E%), fiber, vitamin A, vitamin C, and potassium were higher in the third trimester compared to postpartum, whereas intakes of E% protein and monounsaturated fat were lower. Adherence to recommended intakes was low at all study visits for saturated fat (4%–11%), fiber (15%–39%), vitamin D (8%–14%), folate (0%–2%), and iron (6%–21%). Overall, nutritional quality did not differ significantly from third trimester to postpartum. Shorter duration (<4 months) of lactation was negatively related to nutritional quality changes, whereas higher age was positively related to changes. In conclusion, nutritional intake from pregnancy to postpartum changed, whereas quality remained relatively stable, with age and lactation duration as determinants. Identification of people at risk of adverse dietary changes from pregnancy to the postpartum period should be further addressed in future larger and more diverse study populations

Maternal vitamin D intake and BMI during pregnancy in relation to child's growth and weight status from birth to 8 years: a large national cohort study

Objectives: To examine the associations between maternal vitamin D intake and childhood growth and risk of overweight up to 8 years. We further examined the effect modification by maternal prepregnancy body mass index (BMI). Design: Prospective population-based pregnancy cohort study. Setting: The Norwegian Mother, Father and Child Cohort Study. Participants: In total, 58 724 mothers and 66 840 singleton children, with information on maternal vitamin D intake during the pregnancy and minimum one postnatal anthropometric measurement. Outcome measures: Predicted weight and height growth trajectories and velocities from 1 month to 8 years, rapid growth during infancy and toddlerhood, and risk of overweight in preschool and school age. Results: Overall, maternal vitamin D intake was associated with lower weight trajectory, lower odds of rapid weight growth and higher odds of childhood overweight. In children of mothers with prepregnancy normal weight, maternal vitamin D intake was negatively associated with weight trajectory and lower OR of a rapid weight growth during the first year, compared with reference (15 µg/day, also had 0.86 (95% CI 0.77 to 0.97) and 0.88 (95% CI 0.79 to 0.99) lower odds for overweight at 3 years, compared with reference. In contrast, in children of mothers with prepregnancy overweight (BMI ≥25 kg/m2), vitamin D intake was positively associated with weight trajectory. Children of mothers with overweight, with maternal vitamin D intake of 5-9.9 µg/day, also had (1.09 (95% CI 1.01 to 1.18) and 1.12 (95% CI 1.02 to 1.23)) higher odds for overweight at 5 years and 8 years, compared with reference. Conclusions: Maternal vitamin D intake affects postnatal growth and is inversely associated with childhood overweight in children of mothers with normal weight. Associations between maternal vitamin D intake and child growth and risk of overweight varied by prepregnancy BMI. Keywords: epidemiology; nutrition & dietetics; preventive medicine; public health; social medicine