Maternal Serum 25-Hydroxyvitamin D Concentrations during Pregnancy and Infant Birthweight for Gestational Age: a Three-Cohort Study: Maternal vitamin D and infant birthweight for gestational age

In response to inconsistent findings, we investigated associations between maternal serum 25-hydroxyvitamin D (25(OH)D) concentrations and infant birthweight for gestational age (BW/GA), including potential effect modification by maternal race/ethnicity and infant sex

Chapter 5: Food Security

The current food system (production, transport, processing, packaging, storage, retail, consumption, loss and waste) feeds the great majority of world population and supports the livelihoods of over 1 billion people. Since 1961, food supply per capita has increased more than 30%, accompanied by greater use of nitrogen fertilisers (increase of about 800%) and water resources for irrigation (increase of more than 100%). However, an estimated 821 million people are currently undernourished, 151 million children under five are stunted, 613 million women and girls aged 15 to 49 suffer from iron deficiency, and 2 billion adults are overweight or obese. The food system is under pressure from non-climate stressors (e.g., population and income growth, demand for animal-sourced products), and from climate change. These climate and non-climate stresses are impacting the four pillars of food security (availability, access, utilisation, and stability)

Seasonal Variation of 25-Hydroxyvitamin D among non-Hispanic Black and White Pregnant Women from Three US Pregnancy Cohorts: Seasonal variation of 25-hydroxyvitamin D among non-Hispanic Black and White pregnant women

Vitamin D deficiency during pregnancy has been associated with increased risk of complications and adverse perinatal outcomes. We evaluated seasonal variation of 25(OH)D among pregnant women, focusing on patterns and determinants of variation

Food security

Peer reviewe

Seasonal variation of 25-hydroxyvitamin D among non-Hispanic black and white pregnant women from three US pregnancy cohorts.

BACKGROUND: Vitamin D deficiency during pregnancy has been associated with increased risk of complications and adverse perinatal outcomes. We evaluated seasonal variation of 25-hydroxyvitamin D [25(OH)D] among pregnant women, focusing on patterns and determinants of variation. METHODS: Data came from three cohort studies in the US that included 2583 non-Hispanic Black and White women having prenatal 25(OH)D concentrations determined. Fourier time series and generalised linear models were used to estimate the magnitude of 25(OH)D seasonality. We modelled seasonal variability using a stationary cosinor model to estimate the phase shift, peak-trough difference, and annual mean of 25(OH)D. RESULTS: We observed a peak for 25(OH)D in summer, a nadir in winter, and a phase of 8 months, which resulted from fluctuations in 25(OH)D3 rather than 25(OH)D2. After adjustment for covariates, the annual mean concentrations and estimated peak-trough difference of 25(OH)D among Black women were 19.8 ng/mL [95% confidence interval (CI) 18.9, 20.5] and 5.8 ng/mL [95% CI 4.7, 6.7], and for non-Hispanic White women were 33.0 ng/mL [95% CI 32.6, 33.4] and 7.4 ng/mL [95% CI 6.0, 8.9]. CONCLUSIONS: Non-Hispanic Black women had lower average 25(OH)D concentrations throughout the year and smaller seasonal variation levels than non-Hispanic White women. This study's confirmation of 25(OH)D seasonality over a calendar year has the potential to enhance public health interventions targeted to improve maternal and perinatal outcomes

Ranked severe maternal morbidity index for population-level surveillance at delivery hospitalization based on hospital discharge data.

BackgroundSevere maternal morbidity (SMM) is broadly defined as an unexpected and potentially life-threatening event associated with labor and delivery. The Centers for Disease Control and Prevention (CDC) produced 21 different indicators based on International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) hospital diagnostic and procedure codes to identify cases of SMM.ObjectivesTo examine existing SMM indicators and determine which indicators identified the most in-hospital mortality at delivery hospitalization.MethodsData from the 1993-2015 and 2017-2019 Healthcare Cost and Utilization Project's National Inpatient Sample were used to report SMM indicator-specific prevalences, in-hospital mortality rates, and population attributable fractions (PAF) of mortality. We hierarchically ranked indicators by their overall PAF of in-hospital mortality. Predictive modeling determined if SMM prevalence remained comparable after transition to ICD-10-CM coding.ResultsThe study population consisted of 18,198,934 hospitalizations representing 87,864,173 US delivery hospitalizations. The 15 top ranked indicators identified 80% of in-hospital mortality; the proportion identified by the remaining indicators was negligible (2%). The top 15 indicators were: restoration of cardiac rhythm; cardiac arrest; mechanical ventilation; tracheostomy; amniotic fluid embolism; aneurysm; acute respiratory distress syndrome; acute myocardial infarction; shock; thromboembolism, pulmonary embolism; cerebrovascular disorders; sepsis; both DIC and blood transfusion; acute renal failure; and hysterectomy. The overall prevalence of the top 15 ranked SMM indicators (~22,000 SMM cases per year) was comparable after transition to ICD-10-CM coding.ConclusionsWe determined the 15 indicators that identified the most in-hospital mortality at delivery hospitalization in the US. Continued testing of SMM indicators can improve measurement and surveillance of the most severe maternal complications at the population level

Acciones educativas multidisciplinares para la mejora de la comunicación bilingüe mediada por intérprete en entornos sanitarios virtualizados

Las sociedades actuales, fruto de los incesantes flujos poblacionales derivados de factores de muy distinto signo (turismo, migraciones económicas, conflictos, etc.), tienen un acentuado carácter multicultural y multilingüístico. De ahí la necesidad de arbitrar soluciones que permitan a las poblaciones alófonas el acceso igualitario a servicios sanitarios y a los profesionales de la salud ofrecer unos cuidados de calidad sin que estos se vean afectados por las barreras a la comunicación. La interpretación profesional constituye una de estas soluciones, aunque encuentra dificultades para su debido reconocimiento en nuestro país, tanto por parte de los profesionales que podrían beneficiarse de ella como por las propias autoridades y entidades responsables de la gestión sanitaria. Ante esta situación el presente trabajo describe el desarrollo y la implementación de una experiencia educativa interdisciplinar e interuniversitaria que propicia el trabajo colaborativo y el conocimiento mutuo entre futuros profesionales de la Enfermería y de la Interpretación. El objetivo es que ambos colectivos tomen conciencia de las expectativas, necesidades y de las dificultades técnicas del otro en situaciones de prestación de cuidados en las que la comunicación con pacientes alófonos es mediada por intérprete, tanto en situaciones presenciales como virtuales, realidad esta última que parece haber experimentado un crecimiento exponencial debido a la pandemia. La experiencia educativa planteada ha consistido en el diseño e impartición de un seminario teórico-práctico en el que el alumnado participante se ha familiarizado con la comunicación mediada a través de intérprete en contextos sanitarios, ha trabajado de forma colaborativa en la preparación de encargos de interpretación y ha tenido oportunidad de poner en práctica habilidades no técnicas (en el caso de enfermería) y de interpretación a través de actividades simulación. La experiencia ha sido evaluada de forma muy positiva, si bien el análisis completo de los datos recopilados a través de los distintos instrumentos de evaluación creados aún sigue en curso. Los resultados preliminares muestran el interés y la utilidad que este tipo de experiencias interdisciplinares tiene para la formación de futuros profesionales