An Old Debate Bubbles Up – Should Soft Drinks or Sugar Sweetened Beverages be Prohibited for Purchase with Federal Food Stamps?

Food stamps are a food relief program that provides subsidies to needy Americans for the purchase of foods to supplement their diets in the interest of improving nutrition levels. The program currently allows the purchase of sugar-sweetened beverages (SSB) despite scientific research that has implicated consumption of these items in the incidence of a host of negative health outcomes including obesity, type 2 diabetes, cardiovascular disease, and dental cavities. Recently, the governments of Minnesota and New York have proposed the prohibition of SSB purchase with food stamps in order to address the bourgeoning obesity epidemic that has been linked with high consumption of SSB. While groups as diverse as anti-hunger organizations and beverage industry lobbyists have pushed back on these proposals, a compelling argument to continue allowing SSB purchase with food stamps has yet to be made. This paper lays out the history of the food stamp program to illuminate its current goals and trajectory, provides evidence of the health risks associated with SSB consumption, and deconstructs some of the most prevalent arguments against banning SSB purchase from the food stamp program. The proposal to ban SSB purchases with food stamps is in line with a growing body of empirical research and the clear aim of the food stamp program to improve nutrition and health, and opponents have yet to produce any clear and compelling arguments against its implementation. Pilot programs should be initiated and evaluated before this promising initiative goes flat

Aktivering av arbetslösa ungdomar - en kvalitativ studie om myndighetspersoners syn på aktiveringsprocessen

The aim of this study was to examine how social workers and employment agency advisers choose and evaluates activation programs addressed to unemployed young adults. To narrow down our research area, we chose to focus on the activation programs for young adults in the age of 18-24 who haven’t got any psychological or physical limitations to start working. Based on the purpose of this study, we narrowed it down to three main questions as following: How do workers perceive the function and purpose of the activation programs? How do workers evaluates which activation programs is suitable? How do the workers perceive the young adults influence and autonomy in the decision process for activation programs? To be able to answer our questions, we used qualitative research and semi-structured interviews followed by transcriptions and analyzing, based on Lipskys and Johanssons standpoint on street-level bureaucrats and the social construction of clients. We saw that the activation programs are vary in both function and purpose, though the aim for the young adults is not always to go straight out into the labor market, it’s about giving them resources to in the long term manage to enter the labormarket and become self-sufficient. For the street-level bureaucrats to be able to decide which activation program is accurate to a certain individual or group, street-level bureaucracies most first categorize the clients into different groups sorted by their ability to work. The street-level bureaucrats found it important to see the young adults for where they are in their life and have their best interest in mind. The young adults was someway involved in the decision process but was, just like the street-level bureaucrats restricted by limited access, organizational determinations and the changeable politics

Performance test of QU-fitting in cosmic magnetism study

QU-fitting is a standard model-fitting method to reconstruct distribution of magnetic fields and polarized intensity along a line of sight (LOS) from an observed polarization spectrum. In this paper, we examine the performance of QU-fitting by simulating observations of two polarized sources located along the same LOS, varying the widths of the sources and the gap between them in Faraday depth space, systematically. Markov Chain Monte Carlo (MCMC) approach is used to obtain the best-fit parameters for a fitting model, and Akaike and Bayesian Information Criteria (AIC and BIC, respectively) are adopted to select the best model from four fitting models. We find that the combination of MCMC and AIC/BIC works fairly well in model selection and estimation of model parameters in the cases where two sources have relatively small widths and a larger gap in Faraday depth space. On the other hand, when two sources have large width in Faraday depth space, MCMC chain tends to be trapped in a local maximum so that AIC/BIC cannot select a correct model. We discuss the causes and the tendency of the failure of QU-fitting and suggest a way to improve it.Comment: 8 pages, 9 figures, submitted to MNRA

Quality of routine health facility data used for newborn indicators in low- and middle-income countries: A systematic review

Background High-quality data are fundamental for effective monitoring of newborn morbidity and mortality, particularly in high burden lowand middle-income countries (LMIC). Methods We conducted a systematic review on the quality of routine health facility data used for newborn indicators in LMIC, including measures employed. Five databases were searched from inception to February 2021 for relevant observational studies (excluding case-control studies, case series, and case reports) and baseline or control group data from interventional studies, with no language limits. An adapted version (19-point scale) of the Critical Appraisal Tool to assess the Quality of Cross-Sectional Studies (AXIS) was used to assess methodological quality, and results were synthesized using descriptive analysis. Results From the 19572 records retrieved, 34 studies in 16 LMIC countries were included. Methodological quality was high (>14/19) in 32 studies and moderate (10-14/19) in two. Studies were mostly from African (n = 30, 88.2%) and South-East Asian (n = 24, 70.6%) World Health Organization (WHO) regions, with very few from Eastern Mediterranean (n = 2, 5.9%) and Western Pacific (n = 1, 2.9%) ones. We found that only data elements used to calculate neonatal indicators had been assessed, not the indicators themselves. 41 data elements were assessed, most frequently birth outcome. 20 measures of data quality were used, most along three dimensions: 1) completeness and timeliness, 2) internal consistency, and 3) external consistency. Data completeness was very heterogeneous across 26 studies, ranging from 0%-100% in routine facility registers, 0%-100% in patient case notes, and 20%-68% in aggregate reports. One study reported on the timeliness of aggregate reports. Internal consistency ranged from 0% to 96.2% in four studies. External consistency (21 studies) varied widely in measurement and findings, with specificity (6.4%-100%), sensitivity (23.6%-97.6%), and percent agreement (24.6%-99.4%) most frequently reported

Effect of clinical pathways on antibiotic prescriptions in an emergency department: Italian pediatric antimicrobial stewardship starts here

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An Evaluation of the Effectiveness of Risk Minimization Measures for Tigecycline in the European Union

Background: Risk minimization measures (RMM) were implemented from February 2011 in the European Union to address risks of superinfection, off-label use and lack of efficacy associated with tigecycline. The objective of this study was to evaluate RMM effectiveness by describing prescription patterns among adults and children treated with any dose of tigecycline for any indication pre- and post-RMM implementation; incidence proportions of superinfection and lack of efficacy among adults treated with approved doses of tigecycline for complicated intra-abdominal infection and complicated skin and soft tissue infection were also evaluated. Methods: This was an observational, retrospective chart-abstraction study, including charts from 777 patients (399 pre-RMM, 378 post-RMM) at 13 sites across Austria, Germany, Italy, Greece and the United Kingdom (UK). Potential superinfection and lack of efficacy cases among those using tigecycline for on-label indication, age, dose, and duration were adjudicated. The distribution of indications for tigecycline was analyzed overall (i.e. across both study periods) and stratified by study period. Numbers and incidence proportions of superinfection and lack of efficacy cases (potential and adjudicated) were calculated overall and by study period. Results: Off-label use (indication or age) decreased from 54.2% [95% confidence interval (95% CI): 49.0, 59.3%] pre-RMM to 35.7% (95% CI 30.4, 41.2%) post-RMM. Overall, 45.7% (95% CI 41.9, 49.5%) of patients were prescribed tigecycline off-label; the most commonly reported off-label indications were characterized as \u201cother\u201d (25.5%), hospital acquired pneumonia (8.2%), other pneumonia (6.3%), bacteremia (5.2%) and diabetic foot infection (1.5%). Across study periods, incidence proportions of definite or probable superinfection and lack of efficacy in adults treated for approved indications, authorized treatment doses and duration were 4.5% (95% CI 2.1, 8.4%) and 5.5% (95% CI 2.8, 9.7%), respectively. Conclusions: Off-label use of tigecycline decreased following RMM implementation. Overall incidence proportions of definite or probable superinfection and lack of efficacy were low. EU PAS register number: EUPAS3674

Predictors of Treatment Failure in HIV-Positive Children Receiving Combination Antiretroviral Therapy: Cohort Data From Mozambique and Uganda

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Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study

Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes

Etiology and Outcome of Candidemia in Neonates and Children in Europe: An 11-year Multinational Retrospective Study

This is the final version. Available on open access from Lippincott, Williams & Wilkins via the DOI in this recordBackground: Data on Candida bloodstream infections in pediatric patients in Europe are limited. We performed a retrospective multicenter European study of the epidemiology and outcome of neonatal and pediatric candidemia. Material and Methods: All first positive blood cultures from patients ≤ 18 years of age with candidemia were registered. Patients' demographic and clinical characteristics and causative Candida species were collected and analyzed. Regression analysis was used to identify factors independently associated with mortality. Results: One thousand three hundred ninety-five episodes of candidemia (57.8% male) were reported from 23 hospitals in 10 European countries. Of the 1395 episodes, 36.4% occurred in neonates (≤ 44 weeks postmenstrual age), 13.8% in infants (> 44 weeks postmenstrual age to 1 year) and 49.8% in children and adolescents. Candida albicans (52.5%) and Candida parapsilosis (28%) were the predominant species. A higher proportion of candidemia caused by C. albicans was observed among neonatal patients (60.2%) with highest rates of C. parapsilosis seen among infants (42%). Children admitted to hematology-oncology wards presented the highest rates of non-albicans Candida species. Candidemia because of C. albicans was more frequent than non-albicans Candida in Northern versus Southern Europe (odds ratio, 2.3; 95% confidence interval, 1.8-2.9; P < 0.001). The all-cause mortality at 30 days was 14.4%. All-cause mortality was higher among patients admitted to the neonatal or pediatric intensive care units than other wards. Over time, no significant changes in species distribution were observed. Conclusions: This first multicenter European study shows unique characteristics of the epidemiology of pediatric candidemia. The insights obtained from this study will be useful to guide clinical management and antifungal stewardship.Penta FoundationWellcome TrustMedical Research Council (MRC)European Society for Pediatric Infectious Disease (ESPID

Etiology and Outcome of Candidemia in Neonates and Children in Europe: An 11-year Multinational Retrospective Study

This is the final version. Available on open access from Lippincott, Williams & Wilkins via the DOI in this recordBackground: Data on Candida bloodstream infections in pediatric patients in Europe are limited. We performed a retrospective multicenter European study of the epidemiology and outcome of neonatal and pediatric candidemia. Material and Methods: All first positive blood cultures from patients ≤ 18 years of age with candidemia were registered. Patients' demographic and clinical characteristics and causative Candida species were collected and analyzed. Regression analysis was used to identify factors independently associated with mortality. Results: One thousand three hundred ninety-five episodes of candidemia (57.8% male) were reported from 23 hospitals in 10 European countries. Of the 1395 episodes, 36.4% occurred in neonates (≤ 44 weeks postmenstrual age), 13.8% in infants (> 44 weeks postmenstrual age to 1 year) and 49.8% in children and adolescents. Candida albicans (52.5%) and Candida parapsilosis (28%) were the predominant species. A higher proportion of candidemia caused by C. albicans was observed among neonatal patients (60.2%) with highest rates of C. parapsilosis seen among infants (42%). Children admitted to hematology-oncology wards presented the highest rates of non-albicans Candida species. Candidemia because of C. albicans was more frequent than non-albicans Candida in Northern versus Southern Europe (odds ratio, 2.3; 95% confidence interval, 1.8-2.9; P < 0.001). The all-cause mortality at 30 days was 14.4%. All-cause mortality was higher among patients admitted to the neonatal or pediatric intensive care units than other wards. Over time, no significant changes in species distribution were observed. Conclusions: This first multicenter European study shows unique characteristics of the epidemiology of pediatric candidemia. The insights obtained from this study will be useful to guide clinical management and antifungal stewardship.Penta FoundationWellcome TrustMedical Research Council (MRC)European Society for Pediatric Infectious Disease (ESPID