Axellus: entering the Singaporean health supplement market with high quality and innovative products

This research project is conducted for Axellus AS with the aim of evaluating the market potential for the company’s Möllers and Gerimax brands in Singapore. Axellus has not yet launched their products in this market, but plan to do so in the near future. An external analysis was conducted to identify opportunities and threats of the health supplement market in Singapore. Furthermore, an internal analysis helped identify if Axellus have the resources needed to enter the market. The external and internal analyses have been summarized in a SWOT to evaluate Axellus’ strengths, weaknesses, opportunities and threats. E-mail interviews with distributors, short interviews with pharmacists and a consumer survey have been conducted for the collection of primary data. From our analysis we have revealed that the market is fragmented and that the consumers embrace quality. We have recommended Axellus to follow a differentiation strategy when entering the Singaporean market, where quality should be their point of difference. Furthermore we recommend launching a few products in the entry phase with a premium price to emphasize the quality. The products should be distributed to pharmacies and promoted through different marketing channels, mainly newspapers and magazines. In addition, promotional campaigns would be effective

Fresh-frozen Plasma as a Source of Exogenous Insulin-like Growth Factor I in the Extremely Preterm Infant.

Context: Preterm birth is followed by a decrease in circulatory levels of IGF-I and IGF binding protein-3 (IGFBP-3), proteins with important neurogenic and angiogenic properties. Objective: To evaluate effects of intravenous administration of fresh frozen plasma (FFP) from adult donors on circulatory levels of IGF-I and IGFBP-3 in extremely preterm infants. Design, setting and patients: A prospective cohort study performed in twenty extremely preterm infants (mean (SD) gestational age 25.3 (1.3) weeks) with clinical requirement of FFP during the first postnatal week. Sampling was performed before initiation of transfusion, directly after and at 6, 12, 24 and 48h after completed FFP transfusion. Main outcome measures: Concentrations of IGF-I and IGFBP-3 before and after transfusion of FFP. Results: FFP with a mean (SD) volume of 11 (3.1) ml/kg, was administered at a postnatal age of median (range) 2 (1-7) days. Mean (SD) IGF-I and IGFBP-3 concentrations in administered FFP were 130 (39) and 2840 (615) microg/L, respectively. Immediately after FFP transfusion, mean (SD) concentrations of IGF-I increased by 133% from 11 (6.4) to 25 (9.3) microg/L, p<0.001 and IGFBP-3 by 61% from 815 (451) to 1311 (508) microg/L, p<0.001. Concentrations of IGF-I and IGFBP-3 remained higher at 6 h, p<0.001, p=0.009 and at 12 h, p=0.017, p=0.018, respectively, as compared to concentrations before FFP transfusion. Typical half-life of administrated IGF-I was 3.4 h for a 1 kg infant. Conclusion: Transfusion of FFP to extremely preterm infants during the first postnatal week elevates levels of IGF-I and IGFBP-3

Circulating Interferon-gamma and White Matter Brain Damage in Preterm Infants.

The fetal inflammatory response has been suggested as causal in neonatal morbidity. Serial levels of circulating cytokines were evaluated in 74 infants with a mean gestational age (GA) of 27.1 wk. Pro-inflammatory and modulatory (IL-4, IL-10) cytokines were analyzed from cord blood, and at 6, 24, and 72 h postnatal age. Measure of cytokine burden over time was assessed by calculating the area under curve (AUC) for analyzed levels (0-72 h). Premature rupture of membranes (PROM) was associated with higher levels of IL-2 at birth and at 6 h, of IFN-gamma at 6 and 24 h postnatal age and of TNF-alpha at 6 and 24 h. Levels of IFN-gamma at 6, 24, and 72 It were increased in infants developing white matter brain damage (WMD) compared with those without WMD. Infants with arterial hypotension requiring dopamine treatment had an increase in IL-6 with a peak at 6 It of age. Severe intraventricular hemorrhage (IVH) was associated with increase in AUC, whereas WMD was associated with increase in AUC. A fetal immune response with increased postnatal levels of IFN-gamma was associated with development of WMD. PROM was associated with a T-helper I cytokine response with increased levels of IFN-gamma. Type of inflammatory response appears of importance for subsequent morbidity

Lower stress responses after newborn individualized developmental care and assessment program care during eye screening examinations for retinopathy of prematurity: A randomized study

OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses; recordings of heart rate, respiration, and oxygenation; pain scores (premature infant pain profile); and salivary cortisol at defined time points up to 4 hours after the eye examination. The nursing support given during the eye examinations (intervention score) were scored using predefined criteria. RESULTS. Altogether, 68 examinations were evaluated. Newborn Individualized Developmental Care and Assessment Program care was associated with better behavioral scores during the examination but there was no difference in heart rate, respiratory rate, oxygenation, or premature infant pain profile score between the 2 care strategies before or after the eye examination. Salivary cortisol increased from baseline to 30 minutes after the eye examination independent of care strategy and decreased significantly between 30 and 60 minutes when infants were subjected to Newborn Individualized Developmental Care and Assessment Program care but not after standard care. During the study period the intervention score for standard care increased and approached the score for Newborn Individualized Developmental Care and Assessment Program care at the later eye examinations. CONCLUSION. A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period

Årsrapport. Utbrudd av smittsomme sykdommer i Norge i 2020. Vevbasert system for utbruddsvarsling (Vesuv)

Sammendrag I 2020 ble det varslet 561 utbrudd med totalt 7 430 rapporterte sykdomstilfeller. Dette tilsvarer en stor økning i antall varslede utbrudd sammenlignet med 2019 (223 utbrudd). Økningen skyldes varsler om utbrudd av SARS-CoV-2 (453 av totalt 561 varslede utbrudd). Det vil si at antall varsler om utbrudd for andre agens ble halvert i 2020. Varsler om utbrudd av SARS-CoV-2 dominerte blant varsler fra helseinstitusjoner (141 utbrudd) etterfulgt av norovirus (43 utbrudd). For helseinstitusjoner var det langt færre varsler om utbrudd av norovirus i 2020 sammenlignet med de to forutgående årene (43 mot henholdsvis 82 og 98 i 2018 og 2019). Antall varslede næringsmiddelbårne utbrudd var halvert i 2020 (23 utbrudd) sammenlignet med 2019 (46 utbrudd). Av alle varslede utbrudd var 40 % (222 utbrudd) varslet fra helseinstitusjoner, mens det for kun 4 % av varslene i 2020 (23 utbrudd) var mistanke om smitte fra næringsmidler. De resterende 56 % (316 utbrudd) var varsel om andre utbrudd hvorav majoritet var varsel om utbrudd av SARS-CoV-2 (312 av 316 utbrudd). Antallet syke registrert i hvert utbrudd varierte fra 2 til 203 personer (median 8 personer)