Factors linked to glucose metabolism are involved in the etiology of several cancers. High glycemic index (GI) or high glycemic load (GL) diets, which chronically raise postprandial blood glucose, ...may increase cancer risk by affecting insulin-like growth factor. We prospectively investigated cancer risk and dietary GI/GL in the EPIC-Italy cohort. After a median 14.9 years, 5112 incident cancers and 2460 deaths were identified among 45,148 recruited adults. High GI was associated with increased risk of colon and bladder cancer. High GL was associated with: increased risk of colon cancer; increased risk of diabetes-related cancers; and decreased risk of rectal cancer. High intake of carbohydrate from high GI foods was significantly associated with increased risk of colon and diabetes-related cancers, but decreased risk of stomach cancer; whereas high intake of carbohydrates from low GI foods was associated with reduced colon cancer risk. In a Mediterranean population with high and varied carbohydrate intake, carbohydrates that strongly raise postprandial blood glucose may increase colon and bladder cancer risk, while the quantity of carbohydrate consumed may be involved in diabetes-related cancers. Further studies are needed to confirm the opposing effects of high dietary GL on risks of colon and rectal cancers.
Objective
To report dietary free sugars consumption and their different types and food sources in European children.
Methods
The present study is based on the IDEFICS study, a European multicenter ...cohort study in children (2–9 years old) from eight countries, comprising 8308 children (51.4% males). Dietary intake of the previous 24 h was assessed using a computer-assisted 24-h dietary recalls (24-HDR) and the different types of sugars were assessed using the German food composition database.
Results
Mean total energy intake was 1720 (SD 477) kcal/d for boys and 1631 (SD 451) kcal/d for girls. Total sugars intake was 98 (SD 52) g/day for boys and 93 (SD 49) g/day for girls. Free sugars intake was 81 (SD 49) g/day for boys and 77 (SD 47) g/day for girls. Girls had significantly lower intakes of energy, total and free sugars compared with than boys but did not differ in terms of percent of energy from total (23%) or free sugars (18%). There were large variations between countries in average % energy from free sugars (ranging from 13% in Italy to 27% in Germany). Less than 20% of children were within the recommended intake of 10% of energy from free sugars. The food groups that contributed substantially to free sugars intakes were “Fruit juices”, “Soft drinks”, “Dairy” and “Sweets and candies”.
Conclusions
The contribution of free sugars to total energy intake in European children is higher than recommendations. The main food contributors to free sugars intake are sweetened beverages (“Fruit juices” and “Soft drinks”). It is especially important to reduce children’s intake of free sugars, focusing in target population on certain foods and food groups.
To investigate the reproducibility of food consumption frequencies derived from the food frequency section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) that was developed and used in the ...IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) project to assess food habits in 2- to 9-year-old European children.
From a subsample of 258 children who participated in the IDEFICS baseline examination, parental questionnaires of the CEHQ were collected twice to assess reproducibility of questionnaire results from 0 to 354 days after the first examination. Weighted Cohen's kappa coefficients (κ) and Spearman's correlation coefficients (r) were calculated to assess agreement between the first and second questionnaires for each food item of the CEHQ-FFQ. Stratification was performed for sex, age group, geographical region and length of period between the first and second administrations. Fisher's Z transformation was applied to test correlation coefficients for significant differences between strata.
For all food items analysed, weighted Cohen's kappa coefficients (κ) and Spearman's correlation coefficients (r) were significant and positive (P<0.001). Reproducibility was lowest for diet soft drinks (κ=0.23, r=0.32) and highest for sweetened milk (κ=0.68, r=0.76). Correlation coefficients were comparable to those of previous studies on FFQ reproducibility in children and adults. Stratification did not reveal systematic differences in reproducibility by sex and age group. Spearman's correlation coefficients differed significantly between northern and southern European countries for 10 food items. In nine of them, the lower respective coefficient was still high enough to conclude acceptable reproducibility. As expected, longer time (>128 days) between the first and second administrations resulted in a generally lower, yet still acceptable, reproducibility.
Results indicate that the CEHQ-FFQ gives reproducible estimates of the consumption frequency of 43 food items from 14 food groups in European children.
Background
Pandemic is a major global health threat in the present and the future as in the past. As Pre-Hospital Emergency Healthcare Workers (PHE-HCW) are at the front-line of pandemic, they should ...be well-equipped. The study was aimed to evaluate the knowledge, attitude and skills of PHE-HCW about pandemic preparedness.
Methods
This cross-sectional study conducted on 202 PHE-HCW selected by random sampling in Eskisehir. Of 40.6% the study group consisted of paramedic graduates of associate degree and 59.4% of emergency medical technicians (EMT) graduated from vocational high schools. A total of 111 cases were developed using the template of events for applied and critical healthcare simulation. The green (minor injuries), yellow (non-life-threatening injuries) and red (life-threatening injuries) coded COVID-19 positive cases were used to evaluate the simulated case scores of each participant. Each scenario consists of 6 steps (infection control measures, patient history-examination, medical treatment, diagnosis, communication, and delivering the patient to the healthcare institution) and 20 questions (min:0, max:40 points). The score that could be obtained according to the number of questions in the steps was standardized.
Results
Of 62.4% the study group was female and the mean age (SD) was 29.2 (5.5). The mean score (SD) that the study group had from the cases was 28.5 (5.6) in a green cases, 28.9 (5.6) in yellow cases, and 25.7 (6.5) in red cases.The mean score was lower in the red cases. Male than female (p = 0.001), paramedics than EMTs (p = 0.009) and those with 2-3 years of working time than those with one year of working time scored higher (p = 0.023). None of the participants obtained a full score in any of the steps, the highest score step was infection control measures (1.56), while the lowest score was medical treatment (1.27).
Conclusions
PHE-HCW have deficiencies at all steps, most notably at the medical treatment step.
Key messages
Pre-hospital healthcare workers’ pre-graduate education and professional experiences have an positive impact on their knowledge, attitudes and skills regarding the pandemic.
In order to increase the pandemic preparedness in pre-hospital healthcare workers intensive training should be given in the first year of their professional life and its continuity should be provided.
Background
In the struggle with COVID-19 pandemic, Pre-Hospital Emergency Healthcare Workers(PHE-HCW) are faced with a lot of problems. It is known that people with good psychological resilience(PR) ...levels could successfully cope with the problems. The study was aimed to evaluate the effectiveness of the psychological resilience training program in PHE-HCW.
Objectives
This intervention study conducted on PHE-HCW. In the study, when type 1 error(α) was taken as 5% and type 2 error(1-β) was taken as 95% and the effect size was accepted as 0.5, it was calculated that there should be at least 47 HCW in the groups.To minimizing the differences between groups, two groups were selected as intervention(n = 51) and control(n = 49) by applying propensity score matching analysis, taking into age, gender, occupation and working time. The questionnaire included questions of sociodemographic characteristics and the PR Scale(PRS).The questionnaire was applied to the both groups before the program and after four weeks of follow-up. The PRS consists of six subdimensions(structural style, future perception, family cohesion, personal strenghts, social competence, social resources), and it was accepted that psychological resilience increased as the score increased. The intervention group received video training on PR(self-awareness, hopefulness, optimism, etc.) whereas online classical training was applied to the control group.
Results
There was no difference in PR score between the intervention and control groups before the intervention(p > 0.05).The mean PR score±SD increased in both groups, for the intervention group from (67.2±18.2) to (80.3±12.4) and for the control group from (64.2±19.3) to (77.7±9.5).After the follow-up, positive changes were found in all subdimensions in the intervention group and in subdimensions except structural style and social competence in the control group(p < 0.05).
Conclusions
Psychological resilience training is effective in PHE-HCW during the pandemic period.
Key messages
Pre-hospital emergency healthcare workers need psychological resilience training during the pandemic process and this training program provides a positive change in healthcare workers.
Psychological resilience training programs should be developed according to the needs of healthcare workers and added to in-service training.
Since Cree, Inc.'s 2 nd generation 4H-SiC MOSFETs were commercially released with a specific on-resistance (R ON, SP ) of 5 mΩ·cm 2 for a 1200 V-rating in early 2013, we have further optimized the ...device design and fabrication processes as well as greatly expanded the voltage ratings from 900 V up to 15 kV for a much wider range of high-power, high-frequency, and high-voltage energy-conversion and transmission applications. Using these next-generation SiC MOSFETs, we have now achieved new breakthrough performance for voltage ratings from 900 V up to 15 kV with a R ON, SP as low as 2.3 mΩ·cm 2 for a breakdown voltage (BV) of 1230 V and 900 V-rating, 2.7 mΩ·cm 2 for a BV of 1620 V and 1200 V-rating, 3.38 mΩ·cm 2 for a BV of 1830 V and 1700 V-rating, 10.6 mΩ·cm 2 for a BV of 4160 V and 3300 V-rating, 123 mΩ·cm 2 for a BV of 12 kV and 10 kV-rating, and 208 mΩ·cm 2 for a BV of 15.5 kV and 15 kV-rating. In addition, due to the lack of current tailing during the bipolar device switching turn-off, the SiC MOSFETs reported in this work exhibit incredibly high frequency switching performance over their silicon counter parts.
Abstract Background & aims A Mediterranean-like dietary pattern has been shown to be inversely associated with many diseases, but its role in early obesity prevention is not clear. We aimed to ...determine if this pattern is common among European children and whether it is associated with overweight and obesity. Methods and results The IDEFICS study recruited 16,220 children aged 2–9 years from study centers in eight European countries. Weight, height, waist circumference, and skinfolds were measured at baseline and in 9114 children of the original cohort after two years. Diet was evaluated by a parental questionnaire reporting children's usual consumption of 43 food items. Adherence to a Mediterranean-like diet was calculated by a food frequency-based Mediterranean Diet Score (fMDS). The highest fMDS levels were observed in Sweden, the lowest in Cyprus. High scores were inversely associated with overweight including obesity (OR = 0.85, 95% CI: 0.77; 0.94) and percent fat mass ( β = −0.22, 95% CI: −0.43; −0.01) independently of age, sex, socioeconomic status, study center and physical activity. High fMDS at baseline protected against increases in BMI (OR = 0.87, 95% CI: 0.78; 0.98), waist circumference (OR = 0.87, 95% CI: 0.77; 0.98) and waist-to-height ratio (OR = 0.88, 95% CI: 0.78; 0.99) with a similar trend observed for percent fat mass ( p = 0.06). Conclusions Although a Mediterranean dietary pattern is inversely associated with childhood obesity, it is not common in children living in the Mediterranean region and should therefore be advocated as part of EU obesity prevention strategies.
Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse.
We examined the ...association between adherence to Mediterranean dietary pattern and overall cancer risk using data from the European Prospective Investigation Into Cancer and nutrition, a multi-centre prospective cohort study including 142,605 men and 335,873. Adherence to Mediterranean diet was examined using a score (range: 0-9) considering the combined intake of fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. Association with cancer incidence was assessed through Cox regression modelling, controlling for potential confounders.
In all, 9669 incident cancers in men and 21,062 in women were identified. A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet (hazard ratio=0.96, 95% CI 0.95-0.98) for a two-point increment of the Mediterranean diet score. The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco (P (heterogeneity)=0.008). In all, 4.7% of cancers among men and 2.4% in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern.
Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk.
Studies in children and adolescents suggest that higher dairy consumption may exert a protective effect on adiposity. However, only few studies examined the association between dietary calcium intake ...and body mass measures with conflicting results. We evaluated the association between total dietary calcium, calcium from dairy and non-dairy sources and anthropometric indices in a large European cohort of children and adolescents.
As many as 6,696 children belonging to the IDEFICS study were eligible for the cross-sectional analysis (Boys = 51%; age 6.0 ± 1.8 years; mean ± SD). Of these, 2,744 were re-examined six years later (Boys = 49.6%; age = 11.7 ± 1.8 years) in the framework of the I.Family study. The exposures were the baseline energy-adjusted total, dairy and non-dairy calcium intakes measured by a validated 24-h dietary recall. Multivariable linear regression was used to determine the association between calcium intake and z-scores of anthropometric indices (body mass index, BMI; waist circumference, WC; sum of skinfolds, SS; fat mass index, FMI) at baseline, and their variation over the 6 years follow-up. The association of dietary calcium with the incidence of overweight/obesity was also assessed.
At baseline, an inverse association between total calcium intake and all the adiposity indices was consistently observed in boys, while only SS and FMI were significant in girls. The prevalence of overweight/obesity decreased significantly (P < 0.0001) across tertiles of calcium intake, in both sexes. Over the follow-up, boys with higher baseline calcium intake value showed significantly lower increase in BMI, WC and FMI z-scores, while in girls only a lower increase in WC z-score was observed. Only in boys, the risk to become overweight/obese decreased significantly across tertiles of calcium intake. Similar results were observed by analyzing only dietary calcium from dairy, while no association was observed between non-dairy calcium and adiposity indices.
We showed in a large cohort of European children and adolescents that dietary calcium intake may play a role in the modulation of body fat in developmental age. The association between dietary calcium and adiposity indices was driven by dairy calcium, while no effect was observed for non-dairy calcium intake. The existence of a sex-related difference in the association deserves further investigations.
•Few studies evaluated the association between dietary calcium intake and body mass measures in children and adolescents.•We assessed the association between calcium intake and anthropometric indices in a large European youth cohort.•We showed that dietary calcium intake may play a role in the modulation of body fat in developmental age.•The association between dietary calcium and adiposity indices was driven exclusively by dairy calcium.
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