Alaska Native populations are experiencing a nutrition transition and a resulting decrease in diet quality. The present study aimed to develop a quantitative food frequency questionnaire to assess ...the diet of the Yup'ik people of Western Alaska. A cross-sectional survey was conducted using 24-hour recalls and the information collected served as a basis for developing a quantitative food frequency questionnaire. A total of 177 males and females, aged 13-88, in six western Alaska communities, completed up to three 24-hour recalls as part of the Alaska Native Dietary and Subsistence Food Assessment Project. The frequency of the foods reported in the 24-hour recalls was tabulated and used to create a draft quantitative food frequency questionnaire, which was pilot tested and finalized with input from community members. Store-bought foods high in fat and sugar were reported more frequently than traditional foods. Seven of the top 26 foods most frequently reported were traditional foods. A 150-item quantitative food frequency questionnaire was developed that included 14 breads and crackers; 3 cereals; 11 dairy products; 69 meats, poultry and fish; 13 fruit; 22 vegetables; 9 desserts and snacks; and 9 beverages. The quantitative food frequency questionnaire contains 39 traditional food items. This quantitative food frequency questionnaire can be used to assess the unique diet of the Alaska Native people of Western Alaska. This tool will allow for monitoring of dietary changes over time as well as the identification of foods and nutrients that could be promoted in a nutrition intervention program intended to reduce chronic disease.
Objective: To study the prevalence of metabolic syndrome (MBS) in Indian women and to see how does it correlate to body mass index (BMI) and polycystic ovarian syndrome (PCOS) in this population. ...Study Design: Prospective cross-sectional observational study. Setting: Infertility clinic of a tertiary center. Materials and Methods: Two hundred women, 120 with PCOs and 80 age-matched controls were enrolled. The prevalence of MBS was studied in the women with and without and was co related to BMI by further subgrouping as team (BMI <23 kg/m3) and obese (BMI >23 kg/m2). The sample size was: team controls-40, obese controls-40, team PCOS-80. Each subject underwent a physical examination and laboratory evaluation for the diagnosis of MBS, which was defined according to the guidelines of National Cholesterol Education Program Adult Treatment Pamel (NCEP ATP III) 2005. INTERVENTION: None. Main Outcome Measures: Main Outcome Measures: Subjects with and without PCOs were compared with each other for the prevalence of MBS, and similarly team subjects were compared with obese subjects. Receiver operator characteristic (ROC) curves were obtained for both the PCOS and non PCOS population separately, co-relating the prevalence of MBS with BMI. These ROC curves were used to establish the cut off values of BMI, which could best predict the risk of MBS. Results: The prevalence of MBS was significantly higher in the women with PCOS, as compared to age-matched controls. Similarly, when BMI was considered, MBS was more prevalent in overweight subjects than in lean subjects with or without PCOS. In subgroup analysis, the presence of PCOS had a lesser impact on the prevalence of MBS as compared to non-PCOS controls with higher BMI. The relative risk of MBS increased as follows: lean controls-1, lean PCOS-2.66, obese controls-5.33, and obese PCOS-6.5. The most appropriate cut-off level of BMI for predicting the risk of MBS in Indian women without PCOS seems to be 23 kg/m 2 , whereas, with PCOS, it was 22.5 kg/m 2 . Conclusion: MBS is more prevalent in women with PCOS. However, obesity is an independent and stronger risk factor for developing MBS. To reduce the risk of MBS and its related long-term health consequences, lifestyle modification is advisable above BMI of 23 kg/m 2 in the normal population and 22.5 kg/m 2 in women with PCOS.
Aims To determine the feasibility of conducting a randomized controlled trial comparing a low-sodium to a moderate-sodium diet in heart failure (HF) patients. Methods and Results Patients with HF ...(New York Heart Association classes II-III) were randomized to low (1500 mg/d) or moderate-sodium (2300 mg/d) diet. Dietary intake was evaluated using 3-day food records. The end points were changes in quality of life as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores and B-type natriuretic peptide (BNP) levels from baseline to 6 months of follow-up presented as medians 25th, 75th percentiles. Thirty-eight patients were enrolled (19/group). After 6 months, median sodium intake declined from 2137 to 1398 mg/d in the low-sodium and from 2678 to 1461 mg/d in the moderate-sodium diet group. Median BNP levels in the low-sodium diet group declined (216-71 pg/mL, P = .006), whereas in the moderate-sodium diet group, there was no change in BNP (171-188 pg/mL, P = .7; P = .17 between groups). For 6 months, median KCCQ clinical score increased in both groups (63-75 P = .006 in the low-sodium diet group and 66-73 P = .07 in the moderate-sodium group; P = .4 between groups). At 6 months, a post hoc analysis based on the dietary sodium intake achieved (> or ≤1500 mg/d) in all patients showed an association between a sodium intake ≤1500 mg/d and improvement in BNP levels and KCCQ scores. Conclusions A dietary intervention restricting sodium intake was feasible, and achievement of this sodium goal was associated with lower BNP levels and improved quality of life in patients with HF.
Melioidosis is a life-threatening infectious disease that is caused by gram negative bacteria Burkholderia pseudomallei. This bacteria occurs as an environmental saprophyte typically in endemic ...regions of south-east Asia and northern Australia. Therefore, patients with melioidosis are at high risk of being misdiagnosed and/or under-diagnosed in South Asia.
Here, we report two cases of melioidosis from Nepal. Both of them were diabetic male who presented themselves with fever, multiple abscesses and developed sepsis. They were treated with multiple antimicrobial agents including antitubercular drugs before being correctly diagnosed as melioidosis. Consistent with this, both patients were farmer by occupation and also reported travelling to Malaysia in the past. The diagnosis was made consequent to the isolation of B. pseudomallei from pus samples. Accordingly, they were managed with intravenous meropenem followed by oral doxycycline and cotrimoxazole.
The case reports raise serious concern over the existing unawareness of melioidosis in Nepal. Both of the cases were left undiagnosed for a long time. Therefore, clinicians need to keep a high index of suspicion while encountering similar cases. Especially diabetic-farmers who present with fever and sepsis and do not respond to antibiotics easily may turn out to be yet another case of melioidosis. Ascertaining the travel history and occupational history is of utmost significance. In addition, the microbiologist should be trained to correctly identify B. pseudomallei as it is often confused for other Burkholderia species. The organism responds only to specific antibiotics; therefore, correct and timely diagnosis becomes crucial for better outcomes.
Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. ...Transgenerational trauma from past assimilation policies have affected the health of Indigenous populations.
The purpose of this paper is to comprehensively examine the social determinants of health (SDH), in order to identify priorities for health promotion policies and actions.
We undertook a series of systematic reviews focusing on four major SDH (i.e. income, education, employment, and housing) among Indigenous peoples in Alberta, following the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Equity.
We found that the four SDH disproportionately affect the health of Indigenous peoples. Our systematic review highlighted 1) limited information regarding relationships and interactions among income, personal and social circumstances, and health outcomes; 2) limited knowledge of factors contributing to current housing status and its impacts on health outcomes; and 3) the limited number of studies involving the barriers to, and opportunities for, education.
These findings may help to inform efforts to promote health equity and improve health outcomes of Indigenous Canadians. However, there is still a great need for in-depth subgroup studies to understand SDH (e.g. age, Indigenous ethnicity, dwelling area, etc.) and intersectoral collaborations (e.g. community and various government departments) to reduce health disparities faced by Indigenous Canadians.
Introduction: Pseudomonas aeruginosa isolates producing metallo-β-lactamase have caused nosocomial outbreaks, severe infections, and ineffective carbapenem therapy worldwide since 1991. Due to their ...prevalence, hospital infection control techniques are difficult. This study aimed to find out the prevalence of metallo-β-lactamase among P. aeruginosa isolates from two tertiary care hospitals in Kathmandu. Methods: A descriptive cross-sectional study was conducted at the Department of Microbiology and Department of Pathology of two tertiary care centres in Kathmandu from 7 December 2021 to 6 April 2023, after receiving ethical approval from the Ethical Review Board. Isolated strains were identified and tested for antibiotic susceptibility by modified Kirby-Bauer Methods. Metallo-β-lactamase presence was confirmed using an imipenem-imipenem/ ethylenediaminetetraacetic acid disc. A convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval. Results: Among 255, Pseudomanas aeruginosa isolates, the distribution of metallo-β-lactamase-producing Pseudomanas aeruginosa was 103 (40.39%) (34.32-46.69 at 95% Confidence Interval). Multidrug resistance categories included multidrug resistance 74 (71.80%), extensively drug resistance 32 (31.10%), P. aeruginosa difficult-to-treat 16 (15.53%) and carbapenem-resistant P. aeruginosa was determined to be 82 (79.60%). Conclusions: The study found a high prevalence of metallo-β-lactamase-producing Pseudomanas aeruginosa isolates, requiring early identification, infection control measures, and an all-inclusive antimicrobial therapy protocol to reduce their spread in medical settings.
To determine the portion sizes of traditional and non-traditional foods being consumed by Inuit adults in three remote communities in Nunavut, Canada.
A cross-sectional study was carried out between ...June and October, 2008. Trained field workers collected dietary data using a culturally appropriate, validated quantitative food frequency questionnaire (QFFQ) developed specifically for the study population.
Caribou, muktuk (whale blubber and skin) and Arctic char (salmon family), were the most commonly consumed traditional foods; mean portion sizes for traditional foods ranged from 10 g for fermented seal fat to 424 g for fried caribou. Fried bannock and white bread were consumed by >85% of participants; mean portion sizes for these foods were 189 g and 70 g, respectively. Sugar-sweetened beverages and energy-dense, nutrient-poor foods were also widely consumed. Mean portion sizes for regular pop and sweetened juices with added sugar were 663 g and 572 g, respectively. Mean portion sizes for potato chips, pilot biscuits, cakes, chocolate and cookies were 59 g, 59 g, 106 g, 59 g, and 46 g, respectively.
The present study provides further evidence of the nutrition transition that is occurring among Inuit in the Canadian Arctic. It also highlights a number of foods and beverages that could be targeted in future nutritional intervention programs aimed at obesity and diet-related chronic disease prevention in these and other Inuit communities.
Objective: To determine whether a single dose of gonadotropin-releasing hormone (GnRH) agonist administered subcutaneously in addition to the regular progesterone supplementation could provide a ...better luteal support in antagonist protocol fresh embryo transfer cycles. Methods: This prospective, multicentric, cohort study included total 140 women, 70 in each group. Controlled ovarian stimulation was carried out as per fixed GnRH antagonist protocol. The trigger was given with hCG. In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) was performed and day-3 embryos were transferred. Patients were divided into groups 1 and 2 based on computer generated randomization sheet. Six days following oocyte retrieval, group 1 received 0.2 mg decapeptyl subcutaneously in addition to regular progesterone support while group 2 received progesterone only. Luteal support was given for 14 days to both groups; if pregnancy was confirmed luteal support was continued till 12 weeks of gestation. The clinical pregnancy rate was the primary outcome. The implantation rate, miscarriage rate, live birth delivery rate, and multiple pregnancy rates were the secondary outcomes. Results: A total of 140 patients were analysed, 70 in each group. Clinical pregnancy rates (47.1% vs. 35.7%; P=0.17), implantation rates (23.4% vs. 18.1%, P=0.24), live birth delivery rates (41.4% vs. 27.1%, P=0.08), and multiple pregnancy rates (21.2% vs. 16.0%, P=0.74) were higher in group 1 than in group 2. Group 1 had a lower miscarriage rate than group 2 (5.7% vs. 8.6%; P=0.75). However, these differences were not statistically significant between the two groups. Conclusions: Administration of a single dose of GnRH agonist in addition to regular natural micronized vaginal progesterone as luteal support in GnRH antagonist protocol cycles marginally improves implantation rates, clinical pregnancy rates, and live birth delivery rates. However, more studies with higher sample sizes are needed before any conclusive statements about GnRH agonist as luteal phase support can be made.
Educational technology research has found that parents of young children widely share concerns about extended screen time, lack of physical activity, and lack of social interaction. Kid Space was ...developed to address these concerns by enabling multi-modal and immersive collaborative play-based learning. Kid Space utilizes multiple sensing technologies with an immersive physical space through a human-scale wall projection and incorporates a conversational AI agent to interact with children, understand individual progress, and personalize learning experiences in a blended physical and digital environment. To evaluate Kid Space in the wild, we conducted a multi-method user study involving a quasi-experimental design and exploratory case study with 14 students and three educators in an elementary school. Mixed methods for data collection and analysis were used to understand the students' and educators' perceptions of Kid Space and its impact on the students’ educational outcomes (learning engagement, experience, and performance). The findings showed (1) positive perceptions toward Kid Space, (2) high levels of engagement - with decreased screen time (41% of the time), increased physical activity (99.3% of the time), and increased social interactions with conversational AI agent and the other collaborating student (52% of the time), and (3) significant learning gains after experiencing Kid Space (24% gain, paired t-test: p < 0.01). These positive results are accompanied by critical user insights for improving future iterations of Kid Space to validate long-term educational outcomes.
Radical changes in diet have paralleled the increase in asthma with shifts toward a "Western" diet pattern, characterized by the high intake of processed meats and refined grains, high-fat dairy ...products, and sugary desserts and drinks. Because diet represents a modifiable risk factor in numerous chronic diseases, the authors examined the association between consumption of a Western diet pattern and asthma incidence, prevalence, and morbidity in adults.
PubMed, Cochrane, Web of Science, and Scopus were searched for peer-reviewed publications published from January 1980 to April 2014.
Studies retrieved for inclusion assessed dietary patterns representative of a Western diet and asthma incidence, prevalence, respiratory symptoms, and lung function.
Ten observational studies conducted in North American, European, and Asian countries, ranging from 153 to more than 70,000 individuals, did not provide evidence to support an association between a Western dietary pattern and asthma incidence and prevalence. Five of these studies also investigated asthma morbidity, with variable findings.
Current evidence does not support an association between a Western diet and incident or prevalent adult asthma but does suggest a possible link between a Western diet pattern and adult asthma morbidity.
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