Raskaana olevan keskeisimpiä ravintoainepuutoksia Afrikassa, Saharan etelänpuoleisissa kehitysmaissa : kirjallisuuskatsaus

Opinnäytetyömme on osa DeCliTu-hanketta, jonka yhteistyökumppaneina ovat Metropolia Ammattikorkeakoulu, Pohjois-Karjalan ammattikorkeakoulu, University of Malawi, Malawi College of Health Sciences ja Lusaka School of Nursing.Tämän opinnäytetyön tarkoitus oli tuottaa tekstikokonaisuus raskaana olevien ravitsemuksesta Afrikan Kehitysmaissa. Opinnäytetyön tavoite oli tuottaa laadukasta ja ajantasaista tietoa DeCliTu-hankkeelle. Toteutimme opinnäytetyössämme systemaattisen kirjallisuuskatsauksen periaatteita. Aineisto kerättiin lääke- ja hoitotieteellisistä tietokannoista ja analysoitiin induktiivisen sisällönanalyysin menetelmällä. Keskeisin tulos oli ravintoaineiden puutokset, sekä niiden tärkeys raskauden aikana. Energian saanti odottavilla naisilla oli parhaimmillaan 7,5MJ eli 1800kcal, joka on huomattavan matala raskasta työtä tekevälle raskaana olevalle. Käytetyimpiä ruoka-aineita olivat maissi ja kasvikset. Tutkimuksissa sinkin ja raudan saannilla oli yhteys malariaan ja anemiaan. Päättelimme, että matala koulutustaso ja vähäinen ehkäisytietous osaltaan lisäävät raskauksia nuorilla naisilla, jotka ovat vielä kasvuiässä. Lisäksi lapsuudesta asti jatkunut yksipuolinen ruokavalio ja ravintoaineiden puutokset ovat voineet aiheuttaa epämuodostumia. Kehittämistarpeita Afrikan kehitysmaissa ovat naisten koulutuksen mahdollistaminen, terveyden- ja äitiyshuollon kehittäminen sekä erhesuunnittelun mahdollistaminen. Näin saavutettaisiin parempi ravitsemus ja raskauden aikainen hyvinvointi.The final project is part of the DeCliTu project, which is a cooperation project of Helsinki Metropolia University of Applied Sciences, Finland, North Karelia University of Applied Sciences, Finland, University of Malawi, Malawi, Malawi College of Health Sciences, Malawi and Lusaka School of Nursing, Zambia. The purpose was to produce current and high quality information on the nutrition of pregnant women in the developing countries of Africa for the DeCliTu project. Our method was a literature review. It was based on data collected from medical databases and was analysed by the methods of inductive analysis. The main result was deficiency of nutrient and its importancy during pregnancy. Energy intake in pregnant woman was at its best 7.5MJ, which is significantly low among pregnant women working physically hard. The most used food were maize and vegetables. In the analysed studies, zinc and iron had a connection to malaria and anemia. We conclude that low education and lack of contraception increase pregnancies among young women who are still in formative age. Also, continual unvaried nutrition and lack of nutrient may induce malformations. There are some development needs such women education, development of health and maternal care and empowerment of family planning. This way it is possible to improve nutrition and maternal well-being in the developing world

Re-design of Toledo Riverfront

Effects of climate change, urbanization and global homogenization are resulted in the degradation of land and losses of natural habitats. Ecological design integrates nature into urban environment by respecting natural ecological principles and processes and creating resilient urban biotopes which also can be used by local urban communities. The aim of the thesis is to answer the research questions: How ecological design principles can be applied for re-design of Toledo Riverfront (with requirements of the design competition)? and What is the ecological design in landscape architecture? I participated in the USA design competition with the aim to create a vision and redesign of Toledo Riverfront in Ohio State, USA. The site is located in the south point of Lake Erie. As a result of a long industrial activity, riverfront of Toledo had been transformed into inaccessible and abandoned brownfields. In my proposal I applied ecological design principles on three scales: the city of Toledo by reinforcing of ecological connection and creating green corridors along the river; the intermediate scale by suggesting public parks along the river front and on the fine level by proposing detailed design including remediation of the site and use of dredged material. One of the key suggestions was to recreate native ecosystems which are typical for Toledo and Ohio State. The inspiration of my design came from successful case studies in Germany, USA and China

Landskapsarkitektens möjligheter att delta inom ekoturismen

Ekoturism är en form av turism som bidrar till skyddet av natur- och kulturmiljöer och gynnar lokalbefolkningens välbefinnande. Ekoturism uppkom som en revolt mot massturismen som orsakade både social, ekologisk och ekonomisk negativ påverkan på natur, kultur och samhälle. För att garantera att en anläggning/arrangör bedriver verksamheten utefter ekoturismens principer finns ekoturismmärkningen Naturens Bästa. Svenska Ekoturismföreningen certifierar ekoturismanläggningar/-arrangörer samt skapar riktlinjer för hur verksamheten ska bedrivas i Sverige. Ekoturismen var när den uppkom en ny nisch för landskapsarkitekter och fortfarande idag är ekoturismen relativt outforskad inom landskapsarkitekturen. Uppsatsens syfte var att, genom en litteraturundersökning och ett samtal med Per Jiborn, ta reda på landskapsarkitektens möjlighet att delta inom arbetet med ekoturism. Som exempel studerades möjligheterna för landskapsarkitekten att förbättra arbetet vid uppbyggnad av en ekoturismanläggning samt dess utveckling . Uppsatsen beskriver utifrån detta två studentprojekt från Zambia respektive Filippinerna där landskapsarkitekten varit delaktig och hur landskapsarkitekterna arbetat fram gestaltningsförslag utifrån ekoturismens principer. För att skapa förståelse och visa på möjligheter för landskapsarkitekten att delta, sammanfattas hur arbetet med ekoturism fungerar i Sverige, landskapsarkitektens relation till ekoturism och vad landskapsarkitekter bidragit med inom ämnet idag. Genom att visa hur landskapsarkitektens kunskap och redskap så som inventering, analys och förmågan att se helhetslösningar kan bidra inom ekoturismen klargörs en koppling mellan de två begreppen; ekoturism och landskapsarkitektur.Landskapsarkitekten är idag inte aktivt deltagande inom ekoturism. De få projekt som gjorts med landskapsarkitekter innefattar till största delen utformning av ekoturismanläggningar. I ett samtal med Per Jiborn anställd hos svensk ekoturismförening menar Jiborn att landskapsarkitekten kan bidra inom ekoturism men att ekonomin inom ekoturism begränsar möjligheterna i Sverige. Företagen som utvecklar ekoturismanläggningar är ofta småskaliga med en begränsad budget varvid externa konsulter sällan hyrs in. För att försäkra att ekoturismanläggningar följer bestämmelserna och riktlinjerna för ekoturism bör uppföljning av verksamheten ske var tredje till femte år. Vid uppföljningen undersöks aspekter som bland annat natur- och kulturpåverkan. Uppsatsens slutsats visade på att landskapsarkitekten med sina kunskaper har möjlighet att delta inom arbetet med ekoturism på följande punkter; utformning och uppstart av ekoturismanläggning, utveckling och uppdatering av riktlinjer och verksamhetsplaner samt uppföljning hos ekoturismföretag.Ecotourism is a form of tourism that helps to protect natural and cultural environments and benefit the wellbeing of local populations. Ecotourism arose as a revolt against mass tourism, which caused social, ecological and economic negative impacts on nature, culture and society. The ecotourism label Nature’s Best guarantee that an ecotourism facility/organizer meets the requirements of ecotourism. The Swedish Ecotourism Society certifies ecotourism facilities/organizers as well as creating guidelines of ecotourism in Sweden. When ecotourism arose it was a new niche within landscape architecture, and still today ecotourism is a relatively unexplored subject by landscape architects. The purpose of this thesis was, by a literature survey and a dialogue with Per Jiborn, to determine the landscape architect's ability to participate in the process of ecotourism. The possibilities of landscape architect to improve the work of building ecotourism facilities was studied as an example. The paper describes two student projects from Zambia and the Philippines where landscape architects were involved and the work of the landscape architects based on ecotourism principles. To understand and demonstrate the opportunities for landscape architects to participate following will be summarized, the process of ecotourism in Sweden, the landscape architect's relation to ecotourism and what has been done by landscape architects within the subject today. The link between the two terms; ecotourism and landscaping is clarified by showing how the knowledge and tools of landscape architect's can help within ecotourism. The landscape architect is not currently participating within ecotourism. Few projects are done in conjunction with landscape architects who mostly comprise design of ecotourism facilities. Per Jiborn, employee of the Swedish Ecotourism Society says landscape architect can help within ecotourism but because of the financial limitation of ecotourism opportunities are limited. Companies developing ecotourism facilities are often small with limited budget in which external consultants are rarely hired. To ensure ecotourism facilities comply with the rules and guidelines of ecotourism follow-ups should be taking place every three to five years. Aspects such as natural and cultural impact examines in the follow-up. Conclusion of this essay showed that the landscape architect with their skills has the opportunity to participate within the process of ecotourism in following parts, design of ecotourism facility, development and updating of guidelines and operating plans, and followup of ecotourism businesses

Development of an in situ assay for simultaneous detection of the genomic and replicative form of PCV2 using padlock probes and rolling circle amplification

<p>Abstract</p> <p>Background</p> <p>In this study we utilized padlock probes and rolling circle amplification as a mean to detect and study the replication of porcine circovirus type 2 (PCV2) in cultured cells and in infected tissue. Porcine circovirus type 2 is a single-stranded circular DNA virus associated with several severe diseases, porcine circovirus diseases (PCVD) in pigs, such as postweaning multisystemic wasting syndrome. The exact reason and mechanisms behind the trigger of PCV2 replication that is associated with these diseases is not well-known. The virus replicates with rolling circle replication and thus also exists as a double-stranded replicative form.</p> <p>Results</p> <p>By applying padlock probes and rolling circle amplification we could not only visualise the viral genome but also discriminate between the genomic and the replicative strand in situ. The genomic strand existed in higher numbers than the replicative strand. The virus accumulated in certain nuclei but also spread into the cytoplasm of cells in the surrounding tissue. In cultured cells the average number of signals increased with time after infection.</p> <p>Conclusions</p> <p>We have developed a method for detection of both strands of PCV2 in situ that can be useful for studies of replication and in situ detection of PCV2 as well as of DNA viruses in general.</p

Närståendestöd och efterlevandestöd – under och efter vårdtid inom specialiserad Palliativ vård och ASIH i Skåne

Bakgrund: En av hörnstenarna i palliativ vård handlar om att ge stöd till alla närstående. Enligt lagstiftning har sjukvården även en skyldighet att speciellt beakta barns behov av information, råd och stöd om barnets föräldrar eller någon annan vuxen som barnet varaktigt bor tillsammans med har en livshotande sjukdom eller avlidit.Syfte: Alla närstående inom Palliativ vård och ASIH i Skåne ska erbjudas personcentrerad och jämlikt stöd under och efter vårdtiden.Metod: Uppdraget startades 2019 och beräknas vara klar under hösten 2022. All personal inom palliativ vård och ASIH i Skåne involverades genom att de fick göra nulägesanalys gällande närståendestöd. I nästa steg utfördes gapanalys för att identifiera likhet och olikhet kring närståendestöd. Vidare fick all personal ge förslag till att forma framtidens närståendestöd. Efter nulägesanalys och gapanalys bildades en multiprofessionell arbetsgrupp med representanter från alla verksamheterna i Skåne. Arbetsgruppens uppdrag var att framställa beslutsunderlag gällande närståendestöd under vårdtid och efterlevandestöd till närstående efter vårdtiden. Resultat: Nulägesanalys som utfördes 2019 visade att närstående med liknande behov har erbjudits olika professionella stöd. Gapanalys utfördes under 2020 för kartläggning av vilka former av stöd saknades/önskades samt var relevanta i nu tiden. Under 2021 arbetet har fortsatt med att definiera vad närståendestöd innefattar och under 2022 har arbete pågått med att ta fram beslutsunderlag för hur och vilka former av närståendestöd som ska erbjudas.Betydelse: Genom strukturerad arbetssätt identifiera närståendes förutsättningar, behov och önskemål ökar sannolikheten för att närstående erbjuds rätt stöd, i rätt tid och av rätt profession

Governing Antimicrobial Resistance (AMR) in a Changing Climate: A Participatory Scenario Planning Approach Applied to Sweden in 2050

Background: Antimicrobial resistance (AMR) is a growing global crisis with long-term and unpredictable health, social and economic impacts, with which climate change is likely to interact. Understanding how to govern AMR amidst evolving climatic changes is critical. Scenario planning offers a suitable approach. By envisioning alternative futures, stakeholders more effectively can identify consequences, anticipate problems, and better determine how to intervene. This study explored future worlds and actions that may successfully address AMR in a changing climate in a high-income country, using Sweden as the case.Methods: We conducted online scenario-building workshops and interviews with eight experts who explored: (1) how promising interventions (taxation of antimicrobials at point of sale, and infection prevention measures) could each combat AMR in 2050 in Sweden given our changing climate; and (2) actions to take starting in 2030 to ensure success in 2050. Transcripts were thematically analyzed to produce a narrative of participant validated alternative futures.Results: Recognizing AMR to be a global problem requiring global solutions, participants looked beyond Sweden to construct three alternative futures: (1) “Tax Burn Out” revealed taxation of antimicrobials as a low-impact intervention that creates inequities and thus would fail to address AMR without other interventions, such as infection prevention measures. (2) “Addressing the Basics” identified infection prevention measures as highly impactful at containing AMR in 2050 because they would contribute to achieving the Sustainable Development Goals (SDGs), which would be essential to tackling inequities underpinning AMR and climate change, and help to stabilize climate-induced mass migration and conflicts; and (3) ”Siloed Nations” described a movement toward nationalism and protectionism that would derail the “Addressing the Basics” scenario, threatening health and wellbeing of all. Several urgent actions were identified to combat AMR long-term regardless which future un-folds, such as global collaboration, and a holistic approach where AMR and climate change are addressed as interlinked issues.Conclusion: Our participatory scenario planning approach enabled participants from different sectors to create shared future visions and identify urgent actions to take that hinge on global collaboration, addressing AMR and climate change together, and achieving the SDGs to combat AMR under a changing climate

BRCA2 polymorphic stop codon K3326X and the risk of breast, prostate, and ovarian cancers

Background: The K3326X variant in BRCA2 (BRCA2*c.9976A&gt;T; p.Lys3326*; rs11571833) has been found to be associated with small increased risks of breast cancer. However, it is not clear to what extent linkage disequilibrium with fully pathogenic mutations might account for this association. There is scant information about the effect of K3326X in other hormone-related cancers. Methods: Using weighted logistic regression, we analyzed data from the large iCOGS study including 76 637 cancer case patients and 83 796 control patients to estimate odds ratios (ORw) and 95% confidence intervals (CIs) for K3326X variant carriers in relation to breast, ovarian, and prostate cancer risks, with weights defined as probability of not having a pathogenic BRCA2 variant. Using Cox proportional hazards modeling, we also examined the associations of K3326X with breast and ovarian cancer risks among 7183 BRCA1 variant carriers. All statistical tests were two-sided. Results: The K3326X variant was associated with breast (ORw = 1.28, 95% CI = 1.17 to 1.40, P = 5.9x10- 6) and invasive ovarian cancer (ORw = 1.26, 95% CI = 1.10 to 1.43, P = 3.8x10-3). These associations were stronger for serous ovarian cancer and for estrogen receptor–negative breast cancer (ORw = 1.46, 95% CI = 1.2 to 1.70, P = 3.4x10-5 and ORw = 1.50, 95% CI = 1.28 to 1.76, P = 4.1x10-5, respectively). For BRCA1 mutation carriers, there was a statistically significant inverse association of the K3326X variant with risk of ovarian cancer (HR = 0.43, 95% CI = 0.22 to 0.84, P = .013) but no association with breast cancer. No association with prostate cancer was observed. Conclusions: Our study provides evidence that the K3326X variant is associated with risk of developing breast and ovarian cancers independent of other pathogenic variants in BRCA2. Further studies are needed to determine the biological mechanism of action responsible for these associations

Helicobacter pylori Adapts to Chronic Infection and Gastric Disease via pH-Responsive BabA-Mediated Adherence

International audienceThe BabA adhesin mediates high-affinity binding of Helicobacter pylori to the ABO blood group antigen-glycosylated gastric mucosa. Here we show that BabA is acid responsive-binding is reduced at low pH and restored by acid neutralization. Acid responsiveness differs among strains; often correlates with different intragastric regions and evolves during chronic infection and disease progression; and depends on pH sensor sequences in BabA and on pH reversible formation of high-affinity binding BabA multimers. We propose that BabA's extraordinary reversible acid responsiveness enables tight mucosal bacterial adherence while also allowing an effective escape from epithelial cells and mucus that are shed into the acidic bactericidal lumen and that bio-selection and changes in BabA binding properties through mutation and recombination with babA-related genes are selected by differences among individuals and by changes in gastric acidity over time. These processes generate diverse H. pylori subpopulations, in which BabA's adaptive evolution contributes to H. pylori persistence and overt gastric disease

Environmental performance of blue foods

Fish and other aquatic foods (blue foods) present an opportunity for more sustainable diets1,2. Yet comprehensive comparison has been limited due to sparse inclusion of blue foods in environmental impact studies3,4 relative to the vast diversity of production5. Here we provide standardized estimates of greenhouse gas, nitrogen, phosphorus, freshwater and land stressors for species groups covering nearly three quarters of global production. We find that across all blue foods, farmed bivalves and seaweeds generate the lowest stressors. Capture fisheries predominantly generate greenhouse gas emissions, with small pelagic fishes generating lower emissions than all fed aquaculture, but flatfish and crustaceans generating the highest. Among farmed finfish and crustaceans, silver and bighead carps have the lowest greenhouse gas, nitrogen and phosphorus emissions, but highest water use, while farmed salmon and trout use the least land and water. Finally, we model intervention scenarios and find improving feed conversion ratios reduces stressors across all fed groups, increasing fish yield reduces land and water use by up to half, and optimizing gears reduces capture fishery emissions by more than half for some groups. Collectively, our analysis identifies high-performing blue foods, highlights opportunities to improve environmental performance, advances data-poor environmental assessments, and informs sustainable diets