The role of nursing staff in feeding a child with cystic fibrosis

Cystic fibrosis (CF) is a systemic chronic disease that is characterized by chronic obstructive changes, recurrent respiratory tract infections, and digestive disorders and their consequences. In CF, digestive tract disorders include three functions: digestion, absorption and motor activity. Education on the subject of modified nutrition principles and their impact on the course of the disease, prevention of complications, length and quality of life of the child is a function of the therapy set

“I saw a fox in Melbourne CBD”: Urban travel behaviour changes during COVID-19 and beyond

An unexpected outcome of the COVID-19 pandemic were the dramatic travel behaviour changes experienced in cities worldwide, which, could result in more sustainable transport systems. Consequently, there is a need for longer-term post-pandemic travel behaviour change research. This study aimed to investigate city-level travel behaviour changes during and post-pandemic. To our knowledge, this is the first qualitative study exploring the permanency of COVID-19 travel behaviour changes. This study involved a literature review of 41 studies and in-depth interviews with 19 transport stakeholders in metropolitan Melbourne, Australia. Melbourne is a valuable study area, given that it was the most locked-down city globally. Overall, the results of this study suggest that post-pandemic travel behaviour will be different to pre-pandemic, with working from home (WFH) an integral influence on travel behaviour. In addition, several overarching travel behaviour changes were identified: WFH significantly increased during the pandemic and is anticipated to continue post-pandemic. Both public transport and private motor vehicle (PMV) trips decreased during lockdowns; while PMV rebounded quickly, public transport remained low, and a long recovery is expected. Active transport (cycling and walking) increased during the pandemic and appear likely to endure. Finally, while shared travel modes have received less attention, modal variance is expected in the future. This study has made several key contributions. It consolidated our understanding of the wide range of urban travel behaviour changes experienced during and anticipated post-COVID-19. Secondly, it synthesised current knowledge of recent post-COVID-19 travel behaviour change research. Thirdly, this study demonstrated that complementary qualitative studies strengthen transport research by unearthing new insight into the reasons underpinning travel behaviours, which could be vital for developing solutions. Furthermore, this study identified critical future research topics. Given that most countries are learning to live with the virus, it is an opportune time to investigate whether these intended travel behaviours have endured

Riesgo de anomalías congénitas en grupos étnicos de Sudamérica

El objetivo del trabajo fue estimar el riesgo de defectos congénitos según condición étnica de los padres del recién nacido. Fueron seleccionados 20.940 neonatos con 10 anomalías congénitas específicas y un grupo similar de controles, clasificados según su condición étnica. Se estimaron los riesgos de las 10 anomalías congénitas aisladas mediante métodos de regresión logística, ajustando los riesgos por índices de propensión (Propensity Score) utilizando la prueba de Mantel-Haenszel. Los resultados del presente trabajo mostraron que en europeos latinos existe un mayor riesgo de tener un recién nacido con espina bífida, sindactilia 2-3 del pie e hipospadias; en judíos el riesgo mayor es para hipospadias; en nativos para microtia, labio leporino, polidactilia preaxial y atresia anal; en afrodescendientes para polidactilia postaxial e hipospadias y en árabes para espina bífida. En conclusión, en Sudamérica algunos grupos étnicos muestran un riesgo incrementado para ciertas anomalías congénitas, independientemente de la edad de los padres, el nivel socioeconómico y el número de embarazos, sugiriendo susceptibilidad de ciertos grupos étnicos para determinados defectos congénitos.The objective of this study was to estimate the risk of congenital anomalies according to the ethnicity of the newborn’s parents. A sample of 20,940 newborns with 10 specific congenital anomalies was selected, together with a similar group of controls, and separated by ethnic group. The risks for the 10 isolated congenital anomalies were estimated by logistic regression methods, adjusting for Propensity Score using the Mantel-Haenszel test. The results of the present study showed that Latin Europeans have a high risk for spina bifida, syndactyly 2-3 of toes, and hypospadias; Jews for hypospadias; natives (Amerindian) for microtia, oral clefts, preaxial polydactyly and anal atresia; African descendants for postaxial polydactyly and hypospadias, and Arabs for spina bifida. In conclusion, inSouth America some ethnic groups have an increased risk for some congenital defects, which are not attributable to parental age, socioeconomic status or the number of pregnancies, suggesting that certain ethnic groups are more susceptible to specific birth defects.Asociación de Antropología Biológica de la República Argentina (AABRA

Riesgo de anomalías congénitas en grupos étnicos de Sudamérica

El objetivo del trabajo fue estimar el riesgo de defectos congénitos según condición étnica de los padres del recién nacido. Fueron seleccionados 20.940 neonatos con 10 anomalías congénitas específicas y un grupo similar de controles, clasificados según su condición étnica. Se estimaron los riesgos de las 10 anomalías congénitas aisladas mediante métodos de regresión logística, ajustando los riesgos por índices de propensión (Propensity Score) utilizando la prueba de Mantel-Haenszel. Los resultados del presente trabajo mostraron que en europeos latinos existe un mayor riesgo de tener un recién nacido con espina bífida, sindactilia 2-3 del pie e hipospadias; en judíos el riesgo mayor es para hipospadias; en nativos para microtia, labio leporino, polidactilia preaxial y atresia anal; en afrodescendientes para polidactilia postaxial e hipospadias y en árabes para espina bífida. En conclusión, en Sudamérica algunos grupos étnicos muestran un riesgo incrementado para ciertas anomalías congénitas, independientemente de la edad de los padres, el nivel socioeconómico y el número de embarazos, sugiriendo susceptibilidad de ciertos grupos étnicos para determinados defectos congénitos.The objective of this study was to estimate the risk of congenital anomalies according to the ethnicity of the newborn’s parents. A sample of 20,940 newborns with 10 specific congenital anomalies was selected, together with a similar group of controls, and separated by ethnic group. The risks for the 10 isolated congenital anomalies were estimated by logistic regression methods, adjusting for Propensity Score using the Mantel-Haenszel test. The results of the present study showed that Latin Europeans have a high risk for spina bifida, syndactyly 2-3 of toes, and hypospadias; Jews for hypospadias; natives (Amerindian) for microtia, oral clefts, preaxial polydactyly and anal atresia; African descendants for postaxial polydactyly and hypospadias, and Arabs for spina bifida. In conclusion, inSouth America some ethnic groups have an increased risk for some congenital defects, which are not attributable to parental age, socioeconomic status or the number of pregnancies, suggesting that certain ethnic groups are more susceptible to specific birth defects

Riesgo de anomalías congénitas en grupos étnicos de Sudamérica

El objetivo del trabajo fue estimar el riesgo de defectos congénitos según condición étnica de los padres del recién nacido. Fueron seleccionados 20.940 neonatos con 10 anomalías congénitas específicas y un grupo similar de controles, clasificados según su condición étnica. Se estimaron los riesgos de las 10 anomalías congénitas aisladas mediante métodos de regresión logística, ajustando los riesgos por índices de propensión (Propensity Score) utilizando la prueba de Mantel-Haenszel. Los resultados del presente trabajo mostraron que en europeos latinos existe un mayor riesgo de tener un recién nacido con espina bífida, sindactilia 2-3 del pie e hipospadias; en judíos el riesgo mayor es para hipospadias; en nativos para microtia, labio leporino, polidactilia preaxial y atresia anal; en afrodescendientes para polidactilia postaxial e hipospadias y en árabes para espina bífida. En conclusión, en Sudamérica algunos grupos étnicos muestran un riesgo incrementado para ciertas anomalías congénitas, independientemente de la edad de los padres, el nivel socioeconómico y el número de embarazos, sugiriendo susceptibilidad de ciertos grupos étnicos para determinados defectos congénitos.The objective of this study was to estimate the risk of congenital anomalies according to the ethnicity of the newborn’s parents. A sample of 20,940 newborns with 10 specific congenital anomalies was selected, together with a similar group of controls, and separated by ethnic group. The risks for the 10 isolated congenital anomalies were estimated by logistic regression methods, adjusting for Propensity Score using the Mantel-Haenszel test. The results of the present study showed that Latin Europeans have a high risk for spina bifida, syndactyly 2-3 of toes, and hypospadias; Jews for hypospadias; natives (Amerindian) for microtia, oral clefts, preaxial polydactyly and anal atresia; African descendants for postaxial polydactyly and hypospadias, and Arabs for spina bifida. In conclusion, inSouth America some ethnic groups have an increased risk for some congenital defects, which are not attributable to parental age, socioeconomic status or the number of pregnancies, suggesting that certain ethnic groups are more susceptible to specific birth defects.Asociación de Antropología Biológica de la República Argentina (AABRA

Association of candidate gene polymorphisms with clinical subtypes of preterm birth in a Latin American population

Background. Preterm birth (PTB) is the leading cause of neonatal mortality and morbidity. PTB is often classified according to clinical presentation: Idiopathic (PTB-I), preterm premature rupture of membranes (PTB-PPROM), and medically induced (PTBM). The aim of this study was to evaluate the associations between specific candidate genes and clinical subtypes of PTB. Methods. 24 SNPs were genotyped in 18 candidate genes in 709 infant triads. Of them, 243 were PTB-I, 256 PTB-PPROM, and 210 PTB-M. These data were analyzed with a Family-Based Association. Results. PTB was nominally associated with rs2272365 in PON1, rs883319 in KCNN3, rs4458044 in CRHR1, and rs610277 in F3. Regarding clinical subtypes analysis, 3 SNPs were associated with PTB-I (rs2272365 in PON1, rs10178458 in COL4A3, and rs4458044 in CRHR1), rs610277 in F3 was associated with PTBPPROM, and rs883319 in KCNN3 and rs610277 in F3 were associated with PTB-M. Conclusions. Our study identified polymorphisms potentially associated with specific clinical subtypes of PTB in this Latin American population. These results could suggest a specific role of such genes in the mechanisms involved in each clinical subtype. Further studies are required to confirm our results and to determine the role of these genes in the pathophysiology of clinical subtypes

Alterations in the gut microbiome implicate key taxa and metabolic pathways across inflammatory arthritis phenotypes

Musculoskeletal diseases affect up to 20% of adults worldwide. The gut microbiome has been implicated in inflammatory conditions, but large-scale metagenomic evaluations have not yet traced the routes by which immunity in the gut affects inflammatory arthritis. To characterize the community structure and associated functional processes driving gut microbial involvement in arthritis, the Inflammatory Arthritis Microbiome Consortium investigated 440 stool shotgun metagenomes comprising 221 adults diagnosed with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis and 219 healthy controls and individuals with joint pain without an underlying inflammatory cause. Diagnosis explained about 2% of gut taxonomic variability, which is comparable in magnitude to inflammatory bowel disease. We identified several candidate microbes with differential carriage patterns in patients with elevated blood markers for inflammation. Our results confirm and extend previous findings of increased carriage of typically oral and inflammatory taxa and decreased abundance and prevalence of typical gut clades, indicating that distal inflammatory conditions, as well as local conditions, correspond to alterations to the gut microbial composition. We identified several differentially encoded pathways in the gut microbiome of patients with inflammatory arthritis, including changes in vitamin B salvage and biosynthesis and enrichment of iron sequestration. Although several of these changes characteristic of inflammation could have causal roles, we hypothesize that they are mainly positive feedback responses to changes in host physiology and immune homeostasis. By connecting taxonomic alternations to functional alterations, this work expands our understanding of the shifts in the gut ecosystem that occur in response to systemic inflammation during arthritis

Determinantes sociales adversos y riesgo para anomalías congénitas seleccionadas

Introducción. Diferentes trabajos han relacionando condiciones sociales adversas a nivel familiar y regional con resultados perinatales (mortalidad neonatal, bajo peso y prematuridad); sin embargo, pocos estudiaron el efecto de la pobreza sobre anomalías congénitas. Objetivo. Evaluar el riesgo de ocurrencia de 25 anomalías congénitas y determinantes sociales adversos según el nivel socioeconómico de la familia y de la región. Población y métodos. Estudio caso-control exploratorio, en el que se utilizaron datos del Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC). La muestra consistió en 3786 recién nacidos vivos con una única malformación y 13 344 controles, seleccionados entre 546 129 nacimientos, ocurridos en 39 hospitales de Argentina durante el período 1992-2001. Se estimaron los riesgos (OR) directos, indirectos (a través de la región de residencia) y la interacción entre el nivel socioeconómico individual y residencial para cada uno de los 25 defectos congénitos. Resultados. Los defectos labio leporino con/sin paladar hendido (OR= 1,43) y comunicación interventricular (OR= 1,38) mostraron un riesgo significativamente mayor en el nivel socioeconómico más bajo. Los niveles socioeconómicos bajos se asociaron de manera significativa con una mayor frecuencia de consanguinidad parental, ancestros nativos, edad materna menor de 19 años, más de 4 embarazos, bajo número de visitas prenatales y residencia en regiones desfavorables. Conclusión. La fisura labial con o sin paladar hendido y los defectos del tabique interventricular estuvieron asociados significativamente con un nivel socioeconómico más bajo. La falta de planificación familiar, de control prenatal y la exposición a agentes ambientales o teratógenos pueden explicar estos hallazgos.Introduction.Different studies have related familiar and regional adverse social conditions to perinatal outcome (neonatal mortality, low birth weight and prematurity); however, few studies have studied the effect of poverty on congenital anomalies. Objective.To assess the hazard ratio of 25 congenital anomalies and adverse social determinants as per the socioeconomic level of families and regions. Population and methods.Exploratory, casecontrol study using data from the Latin-American Collaborative Study of Congenital Malformations (Estudio Colaborativo Latinoamericano de Malformaciones Congénitas, ECLAMC). The sample consisted of 3786live newborn infants with a single malformation and 13 344 controls selected among 546 129 births occurred in 39hospitals from Argentina in the 1992- 2001 period. Both direct and indirect (residence) risks (OR) were estimated, together with the interaction between the individual and residential socioeconomic levels for each of the 25 congenital anomalies. Results.Cleft lip with/without cleft palate (OR= 1.43) and ventricular septal defect (OR= 1.38) showed a significantly higher risk in the lower socioeconomic level. Low socioeconomic levels were significantly associated with a higher frequency of parental sibship (blood relationship), native descent, maternal age younger than 19 years old, more than four pregnancies, a low number of antenatal care visits, and residence in deprived regions. Conclusion. Cleft lip with/without cleft palate and ventricular septal defects were significantly associated with a lower socioeconomic level. Lack of family planning and antenatal care, and exposure to environmental or teratogenic agents may account for these findings

Effect of frequency difference on sensitivity of beats perception

Two vibrations with slightly different frequencies induce the beats phenomenon. In tactile perception, when two pins of different frequencies stimulate the fingertips, an individual perceives a beats caused by a summation stimulus of the two vibrations. The present study demonstrates experimentally that humans can perceive another vibration based on the beats phenomenon when two tactile stimuli with slightly different frequencies are stimulated on the finger pad with a small contactor in different locations at the same time. Moreover, we examined the amplitude of the detection threshold to be able to perceive beats phenomenon on the index finger with 5 carrier frequency (63.1, 100, 158.5, 251.2, and 398.1 Hz) and 4 beats frequency (2.5, 3.98, 6.31, and 10 Hz) when two stimuli 1 mm distance apart are vibrated at a slightly different frequency. From the experiments, it is concluded that the amplitude threshold to be able to perceive beats decreases as the standard frequency increases under 398 Hz. Furthermore, from comparing the absolute detection threshold and beats detection threshold, as the carrier frequency increases, the required amplitude at two pins for the detection of beats decreases compared to absolute vibration