Consumers' perceptions of sustainably produced food - a focus group study

The purpose of this study is to provide information on consumers' perceptions of sustainably produced food products and the main product attributes that influence consumer's buying behaviour in the case of organic, Fair Trade and locally produced food. The paper draws on data from four focus groups. The results provide empirical insight into the motivating as well as the restricting factors which influence consumers' purchasing behaviour in the case of sustainably produced food and introduce the emerging key themes associated with the attributes of sustainably produced food products

Prevalence of Double Burden of Malnutrition among Indian Pre-School Children : an Analysis of Cross-Sectional DLHS-4 Data from 23 States

Background: Double burden of malnutrition means co-existence of under- and overnutrition in a community, household or an individual. It is observed in countries undergoing nutrition transition. Research on double burden among Indian children aged under five has been scarce. I therefore aim to studythe prevalence of double burden of malnutrition in this age group. Methods: Cross-sectional population-based data from District Level Household and Facility Survey 4 conducted in 2012-2013 in 23 Indian States and Union Territories were used for the analysis. Prevalence of overweight, stunting and anaemia were examined as main outcomes at the community level. Simultaneous overweight and stunting or anaemia in same child were the main outcomes for individuallevel prevalence. Households with stunted child and overweight adult were also examined. Results: In this sample, 40.1 % of children were stunted, 74.2 % anaemic and 8.2 % overweight. Simultaneous overweight and stunting as well as overweight and anaemia both affected about 5.5 % of children. Stunted children had a higher prevalence of overweight than non-stunted children. No such association was seen for anaemia. At household level, 26.5 % of households had an overweight adult and a stunted child. Discussion: Double burden of malnutrition is emerging among Indian children aged under five and should be included in national nutrition policy. Undernutrition is still bigger concern than overnutrition, but overweight is spreading also to lower wealth quintiles. Further studies should be done to examine this phenomenon at the national level

Invasiiviset beta-hemolyyttiset streptokokki-infektiot PPSHP:n alueella vuosina 2012–2013

Beta-hemolyyttiset streptokokit ovat gram-positiivisia kokkibakteereita, jotka kykenevät aiheuttamaan pinnallisia ja syviä infektioita. Tämä Oulun yliopiston lääketieteellisen tiedekunnan syventävien opintojen tutkielma selvitti retrospektiivisen poikittaistutkimuksen avulla beta-hemolyyttisten streptokokkibakteerien aiheuttamia invasiivisia infektioita Pohjois-Pohjanmaan sairaanhoitopiirin (PPSHP) alueella vuosina 2012–2013. Tuona aikana Oulun yliopistollisen sairaalan (OYS) mikrobiologian laboratoriossa todettiin 138 invasiivista beta-hemolyyttistä streptokokkilöydöstä. Näistä 102:sta oli merkintöjä OYS:n potilasasiakirjoissa, jotka kattavat OYS:n ja Oulaskankaan aluesairaalat. Tutkimuksen lopullisena aineistona oli siis 102 potilasta. On mahdollista, että 36 potilaan tietojen puute luo tutkimukseen valikoitumisharhan. Potilasasiakirjojen perusteella kerättiin tiedot potilaiden infektioiden aiheuttajista, altistavista tekijöistä, kliinisistä ilmentymistä, komplikaatioista ja hoidosta. Löydöksiä verrattiin etupäässä viimeaikaisiin pohjoismaisiin tutkimuksiin. Yksi tutkimuksen merkittävimmistä tuloksista oli C- ja G-ryhmän streptokokkien ilmaantuvuuden nousu. Tätä selittää väestön ikääntyminen, sillä bakteeria esiintyy erityisesti iäkkäillä ja perussairailla, mikä todettiin myös tässä tutkimuksessa. Ilmaantuvuuden laskemista sotki kuitenkin tutkimussairaaloiden ulkopuolella hoidettujen potilaiden tietojen puute. Infektioden kliiniset ilmentymät vastasivat aiempien tutkimusten tuloksia. Aiheuttajaryhmistä Str. pyogenesiä esiintyi ennen kaikkea nuorilla potilailla. Tälle ryhmälle tyypillistä oli voimakas immunivaste infektiolle, mutta myös nopea paraneminen. Str. pyogenes aiheutti muita ryhmiä enemmän pneumonioita. Str. agalactiaeta todettiin vastasyntyneillä ja elimistön immunivaste näille infektioille oli muita ryhmiä lievempi. C- ja G-ryhmän infektioille tyypillistä oli perussairauksien ja iäkkyyden lisäksi muita pitempi hoitoaika. Merkittävä löydös oli myös aiempiin tutkimuksiin verrattuna korkeampi tehohoidon tarve ja matalampi kuolleisuus, mikä todettiin kaikissa bakteeriryhmissä. Myös vakavia komplikaatioita kuten nekrotisoivaa faskiittia ja streptokokin aiheuttamaa toksista shokkioireyhtymää esiintyi odotettua vähemmän erityisesti Str. pyogenes-ryhmässä. Näitä löydöksiä selittää osin tutkimusasetelmaan liittynyt valikoitumisharha. Huomioitavaa on myös kansallisten hoitokäytäntöjen vastainen antibioottien käyttö tutkimuksen kohteena olleissa sairaaloissa. Vain 22,5 % potilaista sai suositusten mukaisesti G-penisilliiniä. Str. pyogenesin hoidossa suositeltua klindamysiiniä annettiin vain 58,3 %:ssa tapauksista. Hoitoaika oli kaikilla aiheuttajabakteereilla keskimäärin ohjeiden yläkanttiin. Tutkimus perusteella jää auki vielä paljon kysymyksiä invasiivisten beta-hemolyyttisten streptokokki-infektioiden epidemiologiasta ja hoidosta PPSHP:n alueella. Jatkossa tulisi pyrkiä laajentamaan potilasaineisto myös muihin alueen terveydenhuollon yksiköihin ja pidemmälle aikavälille

Prevalence of Double Burden of Malnutrition among Indian Pre-School Children : an Analysis of Cross-Sectional DLHS-4 Data from 23 States

Background: Double burden of malnutrition means co-existence of under- and overnutrition in a community, household or an individual. It is observed in countries undergoing nutrition transition. Research on double burden among Indian children aged under five has been scarce. I therefore aim to studythe prevalence of double burden of malnutrition in this age group. Methods: Cross-sectional population-based data from District Level Household and Facility Survey 4 conducted in 2012-2013 in 23 Indian States and Union Territories were used for the analysis. Prevalence of overweight, stunting and anaemia were examined as main outcomes at the community level. Simultaneous overweight and stunting or anaemia in same child were the main outcomes for individuallevel prevalence. Households with stunted child and overweight adult were also examined. Results: In this sample, 40.1 % of children were stunted, 74.2 % anaemic and 8.2 % overweight. Simultaneous overweight and stunting as well as overweight and anaemia both affected about 5.5 % of children. Stunted children had a higher prevalence of overweight than non-stunted children. No such association was seen for anaemia. At household level, 26.5 % of households had an overweight adult and a stunted child. Discussion: Double burden of malnutrition is emerging among Indian children aged under five and should be included in national nutrition policy. Undernutrition is still bigger concern than overnutrition, but overweight is spreading also to lower wealth quintiles. Further studies should be done to examine this phenomenon at the national level

Swallowing difficulties in adolescents : A case report and suggestion of treatment model

Dysphagia or difficulty swallowing in childhood necessitates multi-disciplinary evaluation and management. This case report highlights the teamwork required for diagnostic work-up to distinguish functional dysphagia from organic and psychiatric conditions in an adolescent girl. Treatment model based on cognitive behavioral therapy is also presented

Incidence and outcomes of intrapartum-related neonatal encephalopathy in low-income and middle-income countries : a systematic review and meta-analysis

Aim: To examine the incidence of intrapartum-related neonatal encephalopathy, and neonatal mortality and neurodevelopmental outcomes associated with it in low-income and middle-income countries. Methods: Reports were included when neonatal encephalopathy diagnosed clinically within 24 hours of birth in term or near-term infants born after intrapartum hypoxia-ischaemia defined as any of the following: (1) pH <= 7.1 or base excess <=-12 or lactate >= 6, (2) Apgar score <= 5 at 5 or 10 min, (3) continuing resuscitation at 5 or 10 min or (4) no cry from baby at 5 or 10 min. Peer-reviewed articles were searched from Ovid MEDLINE, Cochrane, Web of Science and WHO Global Index Medicus with date limits 1 November 2009 to 17 November 2021. Risk of bias was assessed using modified Newcastle Ottawa Scale. Inverse variance of heterogenicity was used for meta-analyses. Results: There were 53 reports from 51 studies presenting data on 4181 children with intrapartum-related neonatal encephalopathy included in the review. Only five studies had data on incidence, which ranged from 1.5 to 20.3 per 1000 live births. Neonatal mortality was examined in 45 studies and in total 636 of the 3307 (19.2%) infants died. Combined outcome of death or moderate to severe neurodevelopmental disability was reported in 19 studies and occurred in 712 out of 1595 children (44.6%) with follow-up 1 to 3.5 years. Conclusion: Though there has been progress in some regions, incidence, case mortality and morbidity in intrapartum-related neonatal encephalopathy has been static in the last 10 years.PROSPERO registration numberCRD42020177928

Observational study comparing heart rate in crying and non-crying but breathing infants at birth

Background: Stimulating infants to elicit a cry at birth is common but could result in unnecessary handling. We evaluated heart rate in infants who were crying versus non-crying but breathing immediately after birth. Methods: This was single-centre observational study of singleton, vaginally born infants at = 33 weeks of gestation. Infants who were crying or non-crying but breathing within 30 s after birth were included. Background: demographic data and delivery room events were recorded using tablet-based applications and synchronised with continuous heart rate data recorded by a dry-electrode electrocardiographic monitor. Heart rate centile curves for the first 3 min of life were generated with piecewise regression analysis. Odds of bradycardia and tachycardia were compared using multiple logistic regression. Results: 1155 crying and 54 non-crying but breathing neonates were included in the final analyses. There were no significant differences in the demographic and obstetric factors between the cohorts. Non-crying but breathing infants had higher rates of early cord clamping <60 s after birth (75.9% vs 46.5%) and admission to the neonatal intensive care unit (13.0% vs 4.3%). There were no significant differences in median heart rates between the cohorts. Non-crying but breathing infants had higher odds of bradycardia (heart rate <100 beats/min, adjusted OR 2.64, 95% CI 1.34 to 5.17) and tachycardia (heart rate = 200 beats/min, adjusted OR 2.86, 95% CI 1.50 to 5.47). Conclusion: Infants who are quietly breathing but do not cry after birth have an increased risk of both bradycardia and tachycardia, and admission to the neonatal intensive care unit

Adherent-invasive Escherichia coli associated with granulomatous colitis and extraintestinal dissemination in a Sphynx cat

This case report describes a case of granulomatous colitis (GC) associated with adherent-invasive Escherichia coli (AIEC) with extension to cecum and ileum and dissemination to multiple lymph nodes, the spleen, and brain in a 10-year-old, male Sphynx cat. The cat had an episode of diarrhea 4 months prior to consultation due to sudden blindness. Signs rapidly progressed to ataxia, seizures, and death. Gross and histologic findings were consistent with granulomatous inflammation in all affected organs. In situ hybridization confirmed the presence of intracellular E. coli within enterocytes and infiltrating macrophages, and whole genome sequencing identified virulence traits commonly linked to AIEC strain. This is the first characterization of GC in a cat associated to AIEC resembling the metastatic form of Crohn's disease in humans and GC of dogs. Extraintestinal involvement might provide evidence of the ability of AIEC to promote granulomatous inflammation beyond the gut.Peer reviewe

A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

Background: Perinatal events which result in compromised oxygen delivery to the fetus can lead to Birth Asphyxia (BA). While the incidence, risk factors and outcomes of BA have been characterized, less is known in low resource settings. Aim: To determine the incidence of Birth Asphyxia (BA) in Nepal and to evaluate associated risk factors and outcomes of this condition. Methods: A nested observational study was conducted in 12 hospitals of Nepal for a period of 14 months. Babies diagnosed as BA at >= 37 weeks of gestation were identified and demographics were reviewed. Data were analyzed using binary logistic regression followed by multiple logistic regression analysis. Results: The incidence of BA in this study was 6 per 1000 term livebirths and was higher among women 35 years and above. Predictors for BA were instrumented vaginal delivery (aOR:4.4, 95% CI, 3.1-6.1), fetal distress in labour (aOR:1.9, 95% CI, 1.0-3.6), malposition (aOR:1.8, 95% CI, 1.0-3.0), birth weight less than 2500 g (aOR:2.0, 95% CI, 1.3-2.9), gestational age >= 42 weeks (aOR:2.0, 95% CI, 1.3-3.3) and male gender (aOR:1.6, 95% CI, 1.2-2.0). The risk of pre-discharge mortality was 43 times higher in babies with BA (aOR:42.6, 95% CI, 32.2-56.3). Conclusion: The incidence of Birth asphyxia in Nepal higher than in more resourced setting. A range of obstetric and neonatal risk factors are associated with BA with an associated high risk of pre-discharge mortality. Interventions to improve management and decrease rates of BA could have marked impact on outcomes in low resource settings