A common framework for using and reporting consumer purchase data (CPD) in foodborne outbreak investigations in Europe

Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Consumer purchase data (CPD) can be a powerful tool in the investigation of foodborne outbreaks through analyses of electronic records of food that individuals buy. The objective of this study was to develop a common framework for use of CPD in foodborne outbreak investigations using the expertise of European public health professionals from 11 European countries. We also aimed to describe barriers and limitations preventing CPD utilization. CPD are mainly gathered from supermarket loyalty programmes, smaller consortia, and independent supermarkets. Privacy legislation governing CPD was perceived as the most crucial barrier for CPD usage, but still resolvable. The main practical challenges were obtaining consumer consent for CPD usage, the associated workload, data access, format, and analysis. Harmonising methods and reporting across countries, standardised consent forms and electronic consent methods were identified as solutions. This guideline was developed to support outbreak investigators in overcoming barriers in using CPD, thereby increasing public health professionals’ application and value of this powerful investigation tool. In addition, we hope this framework will lead to more public health institutions, in collaboration with food safety authorities, making use of CPD in outbreak investigations in the future.Peer reviewe

Evaluation of two dairy herd reproductive performance indicators that are adjusted for voluntary waiting period

<p>Abstract</p> <p>Background</p> <p>Overall reproductive performance of dairy herds is monitored by various indicators. Most of them do not consider all eligible animals and do not consider different management strategies at farm level. This problem can be alleviated by measuring the proportion of pregnant cows by specific intervals after their calving date or after a fixed time period, such as the voluntary waiting period. The aim of this study was to evaluate two reproductive performance indicators that consider the voluntary waiting period at the herd. The two indicators were: percentage of pregnant cows in the herd after the voluntary waiting period plus 30 days (PV30) and percentage of inseminated cows in the herd after the voluntary waiting period plus 30 days (IV30). We wanted to assess how PV30 and IV30 perform in a simulation of herds with different reproductive management and physiology and to compare them to indicators of reproductive performance that do not consider the herd voluntary waiting period.</p> <p>Methods</p> <p>To evaluate the reproductive indicators we used the SimHerd-program, a stochastic simulation model, and 18 scenarios were simulated. The scenarios were designed by altering the reproductive management efficiency and the status of reproductive physiology of the herd. Logistic regression models, together with receiver operating characteristics (ROC), were used to examine how well the reproductive performance indicators could discriminate between herds of different levels of reproductive management efficiency or reproductive physiology.</p> <p>Results</p> <p>The logistic regression models with the ROC analysis showed that IV30 was the indicator that best discriminated between different levels of management efficiency followed by PV30, calving interval, 200-days not-in calf-rate (NotIC200), in calf rate at100-days (IC100) and a fertility index. For reproductive physiology the ROC analysis showed that the fertility index was the indicator that best discriminated between different levels, followed by PV30, NotIC200, IC100 and the calving interval. IV30 could not discriminate between the two levels.</p> <p>Conclusion</p> <p>PV30 is the single best performance indicator for estimating the level of both herd management efficiency and reproductive physiology followed by NotIC200 and IC100. This indicates that PV30 could be a potential candidate for inclusion in dairy herd improvement schemes.</p

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Epidemiological studies of reproductive performance indicators in Swedish dairy cows

Reproductive efficiency in dairy cows is a key factor for milk producers, and numerous studies have identified impaired reproductive performance as a major cause of reduced production efficiency in the dairy industry. The overall aim of this thesis was to gain knowledge of factors affecting the reproductive performance indicators currently used by herd advisory services and to find other, possibly more efficient, ways to measure reproductive performance in dairy cows. The studies included in this thesis were based mainly on records from the Cattle Database at the Swedish Dairy Association, but also on data from a simulation model. The records used in the constituent studies of the thesis came from 2728 herds (Paper I), 483 herds (Paper II), 900 simulated herds (Paper III), and 132,721 individual cows (Paper IV). The statistical analyses were performed using multivariable linear and logistic regression models as well as survival analysis. Many statistically significant associations were found between herd and cow characteristics and reproductive performance. When allocating advisory service resources to improve reproductive performance, the focus should be on easily influenced herd characteristics, such as heat detection efficiency, nutritional status, do-it-yourself inseminations, and health deviations. Herd characteristics were also found to influence the degree of disagreements in reproductive performance indicators when data were updated after six months. Reproductive performance indicators that were adjusted for management strategy were evaluated, and percentage pregnant after the herd voluntary waiting period plus 30 days was found to be the best reproductive performance indicator with which to assess both reproductive management and reproductive physiology. Both percentage pregnant after the herd voluntary waiting period plus 30 days and percentage inseminated after the herd voluntary waiting period plus 30 days could be integrated for use in the herd advisory services. These indicators would be useful in providing information on herd performance and in establishing more efficient benchmarking between herds

Relationer mellan könsroller, syskonkonstellationer och modern sexism

In this study we investigated the relations between gender roles, siblings and sexism. We wanted to know if boys who spent more time with their sisters were less sexist than those who did not. Another question we asked was if girls who identified with their traditional gender roles were more sexist than those who did not. We sampled 127 high school students in the ages of 15 to 19. The results showed that time spent with sisters among boys, did not significantly correlate with sexism. However boys were more sexist than girls. Girls who identified with their traditional gender roles were less sexist than those who did not. Another important finding was that boys not identifying with the feminine gender role were more sexist than those who did. In conclusion, Contact with sisters did not have a relation to boys being sexist. However, gender and gender roles did. Unexpected findings included the importance of the feminine gender role. Where not identifying with feminine gender role traits for boys showed higher tendencies for sexism. Whereas girls who identified with the feminine traits showed lower tendencies for sexism.I denna studie undersökte vi relationen mellan könsroller, syskon och sexism. Vi ville veta om pojkar som spenderade mer tid med sina systrar var mindre sexistiska än dem som inte gjorde det. En annan fråga vi undersökte var om flickor som identifierade sig med sin traditionella könsroll var mer sexistiska än dem som inte gjorde det. Vårt urval bestod av 127 gymnasieelever i åldrarna 15 till 19 år. Resultaten visade att tid spenderad med systrar inte var signifikant korrelerat med sexism bland pojkar. Däremot var pojkar mer sexistiska än flickor. Flickor som identifierade sig med sin traditionella könsroll var mindre sexistiska än de som inte gjorde det. En annan viktig upptäckt var att pojkar som inte identifierade sig med den feminina könsrollen var mer sexistiska än de som gjorde det. Sammanfattningsvis, kontakt med systrar hade ingen relation till pojkars sexism. Däremot, hade kön och könsroller det. Oväntade resultat visade betydelsen av den feminina könsrollen där pojkar som inte identifierade sig med den feminina könsrollens egenskaper visade högre tendenser till sexism, medan flickor som identifierade sig med dessa egenskaper visade mindre tendenser till sexism.

To live with endometriosis : a literature study

Background: Endometriosis is an estrogen-dependent disease which means that the uterine mucosa grows outside the uterine cavity. The disease causes women' pain and affects the quality of life and it takes an average of five to seven years to get the diagnosis established. Aim: The aim of this study was to illustrate women's exeperiences of living with endometriosis. Method: This is a literature study where method to contribute to evidence-based nursing based on analysis of qualitative research was used. Results: Findings in the study showed that women with endometriosis experienced limitations in their daily life. Pain was the most described symptom and women experienced lack of knowledge of themselves and by their surroundings. They risked being misstrusted because of normalization of the symptoms. The women developed strategies to take back control over their lives which helped them to master the disease. Conclusion: In order to provide advice and support, the nurse needs increased knowledge about endometriosis and how it affects the women's lives. It would also reduce the time of delayed diagnosis.Kvinnor som lever med endometrios kan komma att behöva strukturera om sina liv då deras vardag begränsas. Somliga kvinnorna får inte gehör av den sociala omkretsen och hälso- och sjukvården för de symtom de upplever. För att återfå kontroll över livet utvecklar kvinnorna strategier i hopp om att bemästra sjukdomen. Denna litteraturstudie belyser kvinnors upplevelser av att leva med endometrios. Var tionde kvinna i fertil ålder drabbas av endometrios och sjukdomen är förknippad med sänkt livskvalitet där både kroppslig och psykisk belastning förekommer. I resultatet framkommer att det råder kunskapsluckor om endometrios hos både kvinnan och hälso- och sjukvården. Kvinnorna riskerar att inte bli trodda på då sjukdomen för andra inte är visuellt synlig. De symtomen kvinnan upplever och uttrycker sig om normaliseras i somliga fall av henne själv och hennes omgivning, då symtomen främst syftar till smärta i samband med menstruation. Kunskapsluckor i relation med normalisering av symtomen kan vara en orsak till försening av diagnos och kvinnan utsätts för ett långt vårdförlopp och försämrad livskvalitet. Förmågan att arbeta påverkas och kvinnan kan komma att vara i behov av vila och återhämtning. Ökad frånvaro leder till att kvinnan oroas över att förlora arbetet, då arbetsgivare och kollegor inte alltid tror på de symtom de beskriver. Även samlivet påverkas. På grund av försämrad sexuell funktion och smärtupplevelser vid samlag undviker kvinnor relationer. Kvinnorna oroas över sin fertilitet och risken för infertilitet i framtiden och de kan komma att bli lämnade av sin partner på grund av diagnosen endometrios eller infertilitet. Endometrios kan få kvinnan att känna sig mindre kvinnlig.  Med hjälp av utvecklade strategier återfås kontroll över vardagen. Strategierna ses som styrkande och kvinnan blir mer lyhörd på sin kropp med ökar sitt ansvar för den egna hälsan. Att bemästra sjukdomen hjälper kvinnorna att se på sina kroppar utifrån positiva vinklar och upplevelserna kunde de dela med sig av till andra.

People’s experiences of life after a kidney transplant – a literature review on the subject of nursing

Bakgrund: Cirka 1 100 svenskar drabbas varje år av en njursjukdom och ungefär 4 000 personer behandlas med dialys i Sverige. Antalet patienter som behandlas med dialys och/eller njurtransplantation ökar kraftigt. Tiden före en njurtransplantation är krävande och personerna lever med svåra biverkningar av sjukdomen och behandlingarna. Njurtransplantation är en eftertraktad behandlingsform som följs av livslång behandling med immunsuppressiva läkemedel. En njursjukdom medför en förändrad livsvärld och livsrytm för personerna. Syfte: Syftet med detta examensarbete var att belysa personers upplevelser av livet efter en njurtransplantation. Metod: Metoden som användes var en litteraturöversikt med tio kvalitativa artiklar. Resultat: I resultatet framkom fyra huvudteman. Dessa var; positiva upplevelser av livet efter en njurtransplantation, negativa upplevelser av livet efter en njurtransplantation, personer som genomgått en njurtransplantations upplevelse av det sociala stödets betydelse, personer som genomgått en njurtransplantations upplevda behov och brister kring information. Konklusion: Examensarbetet visade att personer upplevde ökad livskvalitet och förbättrad hälsa efter njurtransplantationen men att det fanns en ständig närvaro av oro och rädsla inför framtiden. Information, utbildning och kommunikation var faktorer som påverkade personernas upplevelser.Background: Around 1,100 Swedes suffer from a kidney disease every year and approximately 4,000 people are treated with dialysis in Sweden. The number of patients treated with dialysis and/or kidney transplantation is increasing sharply. The time before a kidney transplantation is demanding and the people live with severe side effects of the disease and the treatment. Kidney transplantation is a desirable form of treatment that is followed by life-long treatment with immunosuppressive drugs. A kidney disease may cause a changed world of life and rhythm of life for the persons. Aim: The aim of this bachelor’s essay was to highlight people’s experiences of life after a kidney transplantation. Method: The method used was a literature review with ten qualitative articles. Findings: Four main themes emerged in the results. These were; positive experiences of the time after a kidney transplantation, negative experiences of the time after a kidney transplantation, people who have gone through a kidney transplantations experience of the importance of social support, people who have gone through a transplantations experience of needs and lack of information. Conclusion: The bachelor’s essay showed that people experienced increased quality of life and improved health after the kidney transplantation but that there was a constant presence of worry and fear about the future. Information, education and communication were factors that influenced the people’s experiences