379 research outputs found

    Enhanced circularity in aftermarkets: logistics tradeoffs

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    Purpose: The purpose of this paper is to identify requirements and tradeoffs on logistics services for enhanced circularity of materials and resources. Design/methodology/approach: Based on multiple case study design and abductive reasoning, the study investigates 13 different product categories. The data were analyzed based on theoretical, a priori codes from the literature review. Inductive, emerging codes were added to the coding scheme during the analysis. Findings: Requirements of logistics services to support slowing of resource flows are categorized with respect to initiator, location of the service, single or multiple actors, and transportation of parts, products and people. Moreover, the study identifies new logistics tradeoffs: material and people, knowledge and people, and information and knowledge. Transportation of product, people and parts can be reduced by increasing local knowledge and improve information sharing. Research limitations/implications: This review contributes to the understanding of the relationship between logistics services and enhancement of circularity by highlighting requirements on logistics services in the aftermarket supply chain that support slowing of resource flows. To enhance circularity, logistics services must extend the traditional material information flow with the flow of people and knowledge, respectively. Practical implications: The categorization provides practitioners and researchers with an overview of requirements and tradeoffs on logistics services to enhance circularity of a particular circular cycle. The implications will provide an opportunity to address environmental impact of transportation and improve the utilization of scarce materials. Social implications: Variety of tradeoffs in logistics services can enhance slowing and hence circularity of scarce materials. Originality/value: First, the authors illustrate how traditional tradeoffs in logistics such as flow of materials, resources and people need to be addressed to enhance circularity through slowing. Second, the authors identify two new tradeoffs in logistics services: knowledge flow and degree of customer involvement

    Customer Information Usage: Improving Supply Chain Performance and Advancing Logistics Services in Construction Projects

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    This study investigates how continuous improvement of logistics services in a project- based context such as construction can be enhanced by a “priority matrix for service improvements”. Construction services in general, and logistic services in specific, have great impact on efficiency and sustainability (environmental as well as social). Solutions and experience from e.g. manufacturing and retailing that have undergone major transformation through industrialization and, more recently, servitization, to improve the quality and novelty of their offerings, there is a great potential in addressing the complex coordination, inefficient processes, and waste of materials in the project-based context of the construction industry. Whilst improvement initiatives concerning product quality are important inspiration of such transformation, they are based on continuous production processes and become a challenge when this experience is transferred to the project-based, construction industry. As response, this study draws upon the concept of service quality as the basis for improvement initiatives – a concept based on relations between actors that last beyond individual projects

    Sociodemographic characteristics and food habits of organic consumers--a study from the Danish National Birth Cohort.

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    To access publisher's full text version of this article click on the hyperlink at the bottom of the pageTo develop a basis for building models that can examine the impact of organic food (OF) choices on maternal and offspring health, including identification of factors associated with OF consumption and underlying dietary patterns.Dietary intake was collected for the preceding month from an FFQ in mid-pregnancy and information on sociodemographic characteristics was collected from telephone interviews during pregnancy. From a question about OF consumption in the FFQ, including six food categories, an OF preference index was calculated. Latent variables that captured the variability in OF choices in relation to dietary intake were defined.The Danish National Birth Cohort (DNBC), 1996-2002.Pregnant women from DNBC (n 60,773).We found that frequent OF use was highly associated with age, occupational status, urbanization, smoking and vegetarianism. By principal components analysis we identified two eating patterns, a ‘Western dietary pattern’ and a ‘Prudent dietary pattern’, that explained 14.2% of the variability in data. Frequent OF users consumed a more ‘prudent’ diet compared with non-users and had significantly higher intakes of vegetables (167%), fibre (113%) and n-3 fatty acids (111%) and less saturated fat (28%).Frequent OF users seemed to have a healthier lifestyle than non-users. These findings highlight a major challenge in observational studies examining the impact of OF consumption on health due to potentially irremediable confounding factors.Danish Fund for Organic Agriculture European Union Integrated Research Project EARNEST/FOOD-CT-2005-007036 Danish Council for Strategic Research 09-067124 March of Dimes Birth Defects Foundation Danish Heart Association Danish Medical Research Council Sygekassernes Helsefond Danish National Research Foundation Danish Pharmaceutical Association Ministry of Health National Board of Health Statens Serum Institu

    Relative validity of a web-based food frequency questionnaire for Danish adolescents

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    Background: With increased focus on dietary intake among youth and risk of diseases later in life, it is of importance, prior to assessing diet-disease relationships, to examine the validity of the dietary assessment tool. This study’s objective was to evaluate the relative validity of a self-administered web-based FFQ among Danish children aged 12 to 15 years. Methods: From a nested sub-cohort within the Danish National Birth Cohort, 124 adolescents participated. Four weeks after completion of the FFQ, adolescents were invited to complete three telephone-based 24HRs; administered 4 weeks apart. Mean or median intakes of nutrients and food groups estimated from the FFQ were compared with the mean of 3x24HRs. To assess the level of ranking we calculated the proportion of correctly classified into the same quartile, and the proportion of misclassified (into the opposite quartile). Spearman’s correlation coefficients and de-attenuated coefficients were calculated to assess agreement between the FFQ and 24HRs. Results: The mean percentage of all food groups, for adolescents classified into the same and opposite quartile was 35 and 7.5%, respectively. Mean Spearman’s correlation was 0.28 for food groups and 0.35 for nutrients, respectively. Adjustment for energy and within-person variation in the 24HRs had little effect on the magnitude of the correlations for food groups and nutrients. We found overestimation by the FFQ compared with the 24HRs for fish, fruits, vegetables, oils and dressing and underestimation by the FFQ for meat/poultry and sweets. Median intake of beverages, dairy, bread, cereals, the mean total energy and carbohydrate intake did not differ significantly between the two methods. Conclusion: The relative validity of the FFQ compared with the 3x24HRs showed that the ranking ability differed across food groups and nutrients with best ranking for estimated intake of dairy, fruits, and oils and dressing. Larger variation was observed for fish, sweets and vegetables. For nutrients, the ranking ability was acceptable for fatty acids and iron. When evaluating estimates from the FFQ among Danish adolescents these findings should be considered.The study was supported by grants from The Danish Research Council 09–067124 (Center for Fetal Programming), 09–075611; and the Intramural Research Program of The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract # HHSN275201000020C). The funding bodies had no role in the design of the study, collection, analysis, interpretation of data or in writing the manuscript.Peer Reviewe

    Urban–rural differences in pediatric traumatic head injuries: A prospective nationwide study

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    Jonas G Halldorsson1, Kjell M Flekkoy2, Kristinn R Gudmundsson3, Gudmundur B Arnkelsson4, Eirikur Orn Arnarson1,51Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; 2Department of Psychology, University of Oslo, Oslo, Norway; 3Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; 4Faculty of Social Science, University of Iceland, Reykjavik, Iceland; 5Faculty of Medicine, University of Iceland, Reykjavik, IcelandAims: To estimate differences in the incidence of recorded traumatic head injuries by gender, age, severity, and geographical area.Methods: The study was prospective and nationwide. Data were collected from all hospitals, emergency units and healthcare centers in Iceland regarding all Icelandic children and adolescents 0–19 years old consecutively diagnosed with traumatic head injuries (N = 550) during a one-year period.Results: Annual incidence of minimal, mild, moderate/severe, and fatal head injuries (ICD-9 850–854) was 6.41 per 1000, with 95% confi dence interval (CI) 5.9, 7.0. Annual incidence of minimal head injuries (ICD-9 850) treated at emergency units was 4.65 (CI 4.2, 5.1) per 1000, mild head injuries admitted to hospital (ICD-9 850) was 1.50 (CI 1.3, 1.8) per 1000, and moderate/severe nonfatal injuries (ICD-9 851–854) was 0.21 (CI 0.1, 0.3) per 1000. Death rate was 0.05 (CI 0.0, 0.1) per 1000. Young children were at greater risk of sustaining minimal head injuries than older ones. Boys were at greater risk than girls were. In rural areas, incidence of recorded minimal head injuries was low.Conclusions: Use of nationwide estimate of the incidence of pediatric head injury shows important differences between urban and rural areas as well as between different age groups.Keywords: incidence, nationwide, pediatric, prospective, traumatic head injuries, urban-rural difference

    No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring.

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    To access publisher's full text version of this article click on the hyperlink at the bottom of the pageThe intake of marine n-3 PUFA has been shown to decrease the risk of CVD in a number of studies. Since the development of CVD is often a lifelong process, marine n-3 PUFA intake early in life may also affect the development of later CVD. The aim of the present study was to investigate the association between maternal intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring. The study was based on the follow-up of the offspring of a Danish pregnancy cohort who participated in a study conducted from 1988 to 1989. A total of 965 pregnant women were originally included in the cohort and detailed information about the intake of marine n-3 PUFA during the second trimester was collected. In 2008-9, the offspring were invited to participate in a clinical examination including anthropometric, blood pressure (BP) and short-term heart rate variability measurements. Also, a fasting venous blood sample was drawn from them. Multiple linear regression modelling, using the lowest quintile of marine n-3 PUFA intake as the reference, was used to estimate the association with all outcomes. A total of 443 offspring participated in the clinical examination. No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and offspring adiposity, glucose metabolism, BP or lipid profile was found. In conclusion, no association between the intake of marine n-3 PUFA during the second trimester of pregnancy and the factors associated with cardiometabolic risk in the 20-year-old offspring could be detected.Danish Council for Strategic Research 09-067124 2101-07-0025 2101-06-000

    The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

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    Jonas G Halldorsson1, Kjell M Flekkoy2, Gudmundur B Arnkelsson3, Kristinn Tomasson4, Kristinn R Gudmundsson5, Eirikur Orn Arnarson1,61Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; 2Department of Psychology, University of Oslo, and Department of Geriatric Medicine, Ulleval University Hospital, Oslo, Norway; 3Department of Psychology, University of Iceland, Reykjavik, Iceland; 4Administration of Occupational Safety and Health, Reykjavik, Iceland; 5Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; 6Faculty of Medicine, University of Iceland, Reykjavik, IcelandAims: To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later.Methods: Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent.Results: Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms.Conclusions: Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity.Keywords: follow-up, pediatric, symptoms, traumatic head injur

    Lung metastasis 21 years after initial diagnosis of osteosarcoma: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>To the best of our knowledge, this case report describes the longest disease-free interval between primary diagnosis and metastatic recurrence of an osteosarcoma.</p> <p>Case presentation</p> <p>A 35-year-old Caucasian American man presented with asymptomatic lung metastases 21 years after being diagnosed and treated for lower extremity osteosarcoma. He underwent curative lung resection, but 2 years thereafter developed metastatic disease in the scapula and tibia and, after resection and chemotherapy, is in remission 1 year later.</p> <p>Conclusion</p> <p>This case highlights the importance of long follow-up periods and continued surveillance of osteosarcoma patients after initial curative treatment.</p

    Hip fractures and bone mineral density in the elderly--importance of serum 25-hydroxyvitamin D.

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    To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.The significance of serum 25-hydroxyvitamin D [25(OH)D] concentrations for hip fracture risk of the elderly is still uncertain. Difficulties reaching both frail and healthy elderly people in randomized controlled trials or large cohort studies may in part explain discordant findings. We determined hazard ratios for hip fractures of elderly men and women related to serum 25(OH)D, including both the frail and the healthy segment of the elderly population.The significance of serum 25-hydroxyvitamin D [25(OH)D] concentrations for hip fracture risk of the elderly is still uncertain. Difficulties reaching both frail and healthy elderly people in randomized controlled trials or large cohort studies may in part explain discordant findings. We determined hazard ratios for hip fractures of elderly men and women related to serum 25(OH)D, including both the frail and the healthy segment of the elderly population.The AGES-Reykjavik Study is a prospective study of 5764 men and women, age 66-96 years, based on a representative sample of the population of Reykjavik, Iceland. Participation was 71.8%. Hazard ratios of incident hip fractures and baseline bone mineral density were determined according to serum concentrations of 25(OH)D at baseline.The AGES-Reykjavik Study is a prospective study of 5764 men and women, age 66-96 years, based on a representative sample of the population of Reykjavik, Iceland. Participation was 71.8%. Hazard ratios of incident hip fractures and baseline bone mineral density were determined according to serum concentrations of 25(OH)D at baseline.Mean follow-up was 5.4 years. Compared with referent values (50-75 nmol/L), hazard ratios for hip fractures were 2.24 (95% CI 1.63, 3.09) for serum 25(OH)D <30 nmol/L, adjusting for age, sex, body mass index, height, smoking, alcohol intake and season, and 2.08 (95% CI 1.51, 2.87), adjusting additionally for physical activity. No difference in risk was associated with 30-50 nmol/L or ≥75 nmol/L in either model compared with referent. Analyzing the sexes separately, hazard ratios were 2.61 (95% CI 1.47, 4.64) in men and 1.93 (95% CI 1.31, 2.84) in women. Values <30 nmol/L were associated with significantly lower bone mineral density of femoral neck compared with referent, z-scores -0.14 (95% CI -0.27, -0.00) in men and -0.11 (95% CI -0.22, -0.01) in women.Mean follow-up was 5.4 years. Compared with referent values (50-75 nmol/L), hazard ratios for hip fractures were 2.24 (95% CI 1.63, 3.09) for serum 25(OH)D <30 nmol/L, adjusting for age, sex, body mass index, height, smoking, alcohol intake and season, and 2.08 (95% CI 1.51, 2.87), adjusting additionally for physical activity. No difference in risk was associated with 30-50 nmol/L or ≥75 nmol/L in either model compared with referent. Analyzing the sexes separately, hazard ratios were 2.61 (95% CI 1.47, 4.64) in men and 1.93 (95% CI 1.31, 2.84) in women. Values <30 nmol/L were associated with significantly lower bone mineral density of femoral neck compared with referent, z-scores -0.14 (95% CI -0.27, -0.00) in men and -0.11 (95% CI -0.22, -0.01) in women.Our results lend support to the overarching importance of maintaining serum 25(OH)D above 30 nmol/L for bone health of elderly people while potential benefits of having much higher levels could not be detected.Our results lend support to the overarching importance of maintaining serum 25(OH)D above 30 nmol/L for bone health of elderly people while potential benefits of having much higher levels could not be detected.National Institutes of Health, USA N01-AG-12100 National Institute on Aging Intramural Research Program, the National Eye Institute USA Z01-EY000401 National Institutes of Health, Hjartavernd (The Icelandic Heart Association) Althingi (Icelandic Parliament

    Maternal Dietary Patterns during Pregnancy in Relation to Offspring Forearm Fractures: Prospective Study from the Danish National Birth Cohort

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    Limited evidence exists for an association between maternal diet during pregnancy and offspring bone health. In a prospective study, we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures. In total, 101,042 pregnancies were recruited to the Danish National Birth Cohort (DNBC) during 1996–2002. Maternal diet was collected by a food frequency questionnaire. Associations were analyzed between seven dietary patterns extracted by principal component analysis and offspring first occurrence of any forearm fracture diagnosis, extracted from the Danish National Patient Register, between time of birth and end of follow-up (<16 year) (n = 53,922). In multivariable Cox regression models, offspring of mothers in the fourth vs. first quintile of the Western pattern had a significant increased risk (Hazard ratio, 95% confidence interval: 1.11, 1.01–1.23) of fractures, and there was a borderline significant positive trend (p = 0.06). The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups, except for the intake of artificially sweetened soft drinks, which was positively associated with offspring forearm fractures (p = 0.02). In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future research
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