Food Insecurity and Nutritional Inadequacy in Children and Adolescents of Basic Education Schools of Cantagalo District in São Tomé and Príncipe, Central Africa.

Food insecurity (FI) is a critical socioeconomic and public health problem globally, particularly affecting children's nutritional status and development. This cross-sectional study aimed to assess the prevalence of nutritional inadequacy among children and adolescents in the Cantagalo district of São Tomé and Príncipe (STP), in Central Africa. It also assessed their households' FI situation and examined sociodemographic, anthropometric, and nutritional characteristics associated with severe FI. Data included 546 children/adolescents (51.8% males, aged 9-15 years) from the eight public basic education schools. A structured questionnaire provided sociodemographic data, while anthropometric measurements assessed nutritional status. Dietary intake data were gathered using a single 24 h dietary recall, and the adjusted prevalences of nutritional inadequacy were obtained using version 2.0 of the PC-Software for Intake Distribution Estimation (PC-SIDE®). The Household Food Insecurity Access Scale was used to assess FI, and households were classified as severely or non-severely food insecure. Multivariable binary logistic regression models adjusted for potential confounders identified factors related to FI. Children's/adolescents' thinness was exhibited in 34.1% of participants, and over 95% had inadequate intake of essential micronutrients, including iron. Notably, 73.7% were severely food insecure. A higher severity of FI was positively associated with a lower intake of iron and certain household head characteristics, such as being female or older, and negatively associated with having a home garden.

Prevalence of micronutrient inadequacy differs by severity of food insecurity among adults living in Canada in 2015.

Household food insecurity is generally associated with poorer quality diets in Canada, but whether household food insecurity heightens the probability of inadequate micronutrient intakes is unknown. The objective of this research was to investigate how prevalence of micronutrient inadequacy differed by severity of household food insecurity among adults in Canada. Using the 2015 Canadian Community Health Survey Nutrition, this study included participants aged 19-64 years who completed up to two 24 h dietary recalls and provided details about household food insecurity (n = 9486). Children and older adults were not included due to sample size limitations. Usual micronutrient intake distributions were estimated by a four-level measure of food insecurity status using the National Cancer Institute method. Welch's t tests assessed differences in prevalence of inadequacy for selected micronutrients. Prevalence differed for some micronutrients among those living in marginally and moderately food insecure compared to food-secure households. The greatest differences in prevalence of inadequacy were observed between severely food-insecure and food-secure households: vitamin A (60.0%, SE = 11.9 vs. 40.6%, SE = 2.7, p < 0.0001), vitamin B6 (42.7%, SE = 9.1 vs. 12.8%, SE = 2.5, p < 0.0001), folate (39.4%, SE = 10.0 vs. 15.9%, SE = 2.2, p < 0.0001), vitamin C (63.3%, SE = 5.2 vs. 29.1%, SE = 2.8, p < 0.0001), calcium (78.6%, SE = 6.4 vs. 58.7%, SE = 1.3, p < 0.0001), magnesium (75.6%, SE = 9.5 vs. 48.7%, SE = 1.2, p < 0.0001), and zinc (34.9%, SE = 10.0 vs. 23.2%, SE = 2.4, p = 0.0009). Apparent underreporting also differed by severity of food insecurity, with increased underreporting observed with worsening food insecurity. The probability of inadequate micronutrient intakes among adults rises sharply with more severe household food insecurity in Canada.

Micronutrient inadequacy among lactating mothers in rural areas of North Mecha District, Amhara Region, Ethiopia.

Background: Lactating mothers are frequently at risk for nutritional deficiencies due to the physiological requirements of lactation. Throughout the world, a significant number of lactating mothers have micronutrient intake inadequacy. Evidence on micronutrient intake during lactation is limited in rural Ethiopia. Therefore, this study aimed to determine micronutrient intake inadequacy and associated factors among lactating mothers. Methods and materials: A community-based cross-sectional study was conducted from February 1 to 18, 2023, among lactating mothers in rural areas of the North Mecha District of Amhara Region, Northwest Ethiopia. A multistage sampling technique was used to select 449 study participants. An interviewer-administered questionnaire was employed to collect dietary intake data by using a single multiphasic interactive 24-h dietary recall. The NutriSurvey 2007 software and Ethiopia, Tanzania and Kenya food composition tables were used to calculate nutrient values for the selected 12 micronutrients. For the remainder of the analysis, SPSS version 25 was employed. The Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) were calculated by dividing all NAR values by the number of micronutrients computed to evaluate the nutrient intakes. A logistic regression analysis was conducted to determine the factors contributing to the overall micronutrient intake inadequacy, and statistical significance was determined at a p value <0.05. Result: A total of 430 lactating mothers participated in the study, with a 96% response rate and a mean age of 29.46 ± 5.55 years. The overall prevalence of micronutrient intake inadequacy was 72.3% (95% CI: 67.9, 76.5). The odds of micronutrient intake inadequacy were 2.5 times higher among lactating mothers aged 18-25 years old as compared to mothers in the age group ≥36 years old (AOR = 2.52, 95% CI: 1.09, 5.83). Mothers with the educational status of unable to read and write and primary school incomplete were 3.5 (AOR = 3.49, 95% CI: 1.24, 9.83) and 3.6 (AOR = 3.56, 95% CI: 1.06, 11.99) times more likely to have micronutrient intake inadequacy than mothers with secondary school completed or above educational status, respectively. Mothers whose partner's occupation was other than farming were 3.3 times more likely to have micronutrient intake inadequacy as compared to mothers whose partners were engaged in farming (AOR = 3.32, 95% CI: 1.08, 10.27). Lactating mothers who were from food-insecure households were 83% more likely to have high micronutrient intake inadequacy as compared to lactating mothers from food-secure households (AOR = 1.83, 95% CI: 1.04, 3.23). Lactating mothers with nutrition-related unfavorable attitudes were 77% more likely to have inadequate intake of micronutrients compared to lactating mothers with favorable attitudes (AOR = 1.77, 95% CI: 1.07, 2.93). Conclusion: The prevalence of micronutrient intake inadequacy among lactating mothers was high. Age of the mothers, educational status of the mothers, occupation of the partner, household food security, and nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Community driven nutrition education and interventions are needed to address the high micronutrient intake inadequacy among lactating mothers in rural Ethiopia.

Adequate calorie and protein administration via enteral nutrition may contribute to improved 30-day survival in patients with solid tumors at nutritional risk.

BACKGROUND: Patients with cancer receiving adequate enteral nutrition (EN) have improved clinical outcomes. Unfortunately, discrepancies may exist between the amounts prescribed and received. This study aimed to investigate: (1) the receiving exclusive EN, (2) the relationship between inadequacy and unfavorable outcomes, and (3) the impact of inadequate EN administration on the survival of patients with cancer. METHODS: This study included hospitalized patients with solid tumors who exclusively received EN and were evaluated using data extracted from electronic medical records. Nutritional risk was evaluated using Nutritional Risk Screening (NRS - 2002). EN adequacy was assessed from days 3-7 of hospitalization. Calorie and protein delivery by EN was classified as adequate (≥80 % of EN administration) or inadequate (<80 % of EN administration). Data were analyzed using dispersion and Bland-Altman plots, Pearson's chi-square and Fisher's exact tests, and Kaplan-Meier survival curves. RESULTS: A total of 114 patients were evaluated (63.9 ± 13.1 years of age, 67.5 % male, 32.5 % with head and neck cancer, and 86.8 % at nutritional risk). During the 5-day evaluation period, only 14 % of the patients received the mean volume, proteins, and calories according to the EN prescription. A relationship was observed between inadequate EN (<80 %) and 30-day in-hospital mortality. This result was confirmed by Kaplan-Meier survival analysis (p = 0.020), which showed a survival benefit in patients at nutritional risk who received adequate calories and protein. CONCLUSION: This study demonstrated significant caloric and protein deficits related with EN. Furthermore, adequate calorie and protein administration could contribute to improved survival in patients with cancer who are at a risk of malnutrition, however, randomized controlled trials are required to confirm whether adequate calorie administration could contribute to improved survival.

Vitamin D Status among Patients Admitted to a Geriatric Ward-Are Recommendations for Preventing Its Deficiency Effective Enough?

Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old. The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7-33.0) ng/mL. Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL). It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007). The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices.

Iron Deficiency and Vitamin D Deficiency Are Associated with Sleep in Females of Reproductive Age: An Analysis of NHANES 2005-2018 Data.

BACKGROUND: Iron and vitamin D deficiencies have been implicated in sleep disturbance. Although females are more susceptible to these deficiencies and frequently report sleep-related issues, few studies have examined these associations in females. OBJECTIVE: This study investigates the association of iron and vitamin D deficiencies on sleep in a nationally representative sample of females of reproductive age. METHODS: We used 2 samples of 20-49-y-old non-pregnant females from National Health and Nutrition Examination Survey (NHANES) 2005-2008 (N = 2497) and NHANES 2005-2010 and 2015-2018 (N = 6731) to examine the associations of iron deficiency (ID), iron deficiency anemia (IDA), vitamin D deficiency (VDD), vitamin D inadequacy (VDI), and the joint association of both deficiencies with sleep duration, latency, and quality. Sleep outcomes were measured using a self-reported questionnaire. We used the body iron model based on serum ferritin and serum soluble transferrin receptor to identify ID, along with hemoglobin to identify IDA cases. In addition, 25-hydroxyvitamin D levels were used to determine VDD and VDI cases. Logistic regression was used to evaluate these associations, adjusting for potential confounders. In addition, we assessed the multiplicative and additive interactions of both deficiencies. RESULTS: ID and IDA were associated with poor sleep quality, with 1.42 [95% confidence interval (CI): 1.02, 2.00)] and 2.08 (95% CI: 1.29, 3.38) higher odds, respectively, whereas VDD and VDI were significantly associated with short sleep duration, with 1.26 (95% CI: 1.02, 1.54) and 1.22 (95% CI: 1.04, 1.44) higher odds, respectively. Subjects with both nutritional deficiencies had significantly higher odds of poorer sleep quality compared with subjects with neither condition. For sleep quality, a significant multiplicative interaction was observed between ID and VDD (P value = 0.0005). No associations were observed between study exposures and sleep latency. CONCLUSIONS: Among females of reproductive age, iron and vitamin D deficiencies are associated with sleep health outcomes. The potential synergistic effect of both deficiencies warrants further assessment.

OPTIMIZATION OF POWER-ASSISTED ADENOIDECTOMY IN CHILDREN USING SHAVER TIPS OF VARIOUS MODIFICATION.

OBJECTIVE: The aim: To study the efficacy of surgical treatment of patients with adenoid vegetations by implementing a differential method for choosing a tip for endo-scopic power-assisted adenoidectomy in children depending on dentition. PATIENTS AND METHODS: Materials and methods: We investigated the presence of nasal air emissions in 127 children (2-12 years old) before and after the operation. We excluded 12 patients due to the presence of nasal air emission before the operation. All patients were divided in 2 groups: I - children with aging primary dentition (55 children), II- children with mixed dentition (60 children). Depending on tips, that were used for the operation, we divided patients into two subgroups: A - 40˚ and B- 60 ˚. RESULTS: Results: In 9,4% of patients have the presence of nasal air emissions before the operation. The use of 40˚ tips does not allow removal of lymphoid tissue in "hard-to-reach" areas of the nasopharynx (perichoanal and peritubular sections) in 30% of children with aging primary dentition and 42.9% with mixed dentition. CONCLUSION: Conclusions: The use 40˚ tips for the adenoidectomy is accompanied by a higher risk of velopharyngeal insufficiency in children with mixed dentition compared to children who underwent the intervention with a tip with a larger bending angle and a longer working part (60°). In patients with temporary dentition, it is recommended to use a standard tip for adenoidectomy, except when correction of tubal lymphoid tissue is planned (it is necessary to use a tip with a rotating window). In patients with mixed dentition, it is recommended to use a 60° tip.

Assessment of calcium intake and recognition of calcium-rich food sources among the Saudi population.

Calcium is an essential skeletal mineral, and calcium deficiency has a negative impact on bone health. We conducted an online questionnaire to assess the intake and knowledge among the Saudi population. The survey included 950 participants, with 51.1% demonstrating poor knowledge of calcium sources and a mean intake lower than the recommended level. INTRODUCTION: Calcium is an essential mineral and one of the most prevalent in the body. Chronic insufficient calcium intake increases the risk of osteopenia, osteoporosis, and bone fracture. PURPOSE: This study aimed to assess the Saudi population's calcium intake and knowledge of calcium sources as well as to identify factors associated with inadequate calcium intake. METHODS: This cross-sectional study was conducted across Saudi Arabia using an online questionnaire distributed randomly through social media channels. The questionnaire was a validated tool that was previously developed and used by the original author to assess knowledge of calcium food sources and estimate calcium intake in the Saudi population. If an individual answered more than 11 questions correctly, calcium knowledge was considered adequate. Calcium intake was considered sufficient or insufficient based on the recommended dietary allowance (RDA) of 1000 mg/day. RESULTS: The survey included male and female Saudi citizens and residents aged 14 years or older. A total of 950 respondents aged 9-70 completed the questionnaire. A total of 62.9% of the respondents were 26-50 years old. Of the participants, 64.2% were female, 71.7% were married, and 61.9% had a diploma or a bachelor's degree. Of these, 63.8% were from the central region, and 97.6% were from Saudi Arabia. For those aged 9-18, the average calcium consumption was 577 mg/day, whereas it was 479 mg/day for those aged 19-50. The average intake was 479 mg/day for males aged 51-70 (EAR = 1000 mg/day) and 438 mg/day for females (EAR = 1200 mg/day). These calcium consumption values were significantly lower than the estimated average requirement (EAR) and RDA (p < 0.01). Correct response rates for the 19 calcium intake knowledge items ranged from 23.4 to 94.7%. Among the participants, 48.9% had significant calcium intake knowledge, as indicated by a score of > 11 out of 19 correct responses. Age, sex, marital status, educational attainment, and residence were significantly correlated with adequate knowledge of calcium. Demographic characteristics such as age, marital status, and residence were associated with sufficient calcium intake in the study. CONCLUSION: The study findings revealed that a significant proportion (51.1%) of participants demonstrated inadequate knowledge regarding calcium food sources. Additionally, the mean calcium intake was found to be lower than the RDA of 1300 mg/day for males and females 14-18 years old and 1000 mg/day for males and females 19-50 years old and males 51-70 years old; however, the RDA for females 51-70 years old is 1200 mg/day, suggesting an urgent need for interventions aimed at enhancing both calcium knowledge and intake.

Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project.

Suboptimal micronutrient intake in children remains a public health concern around the world. This study examined the relationship between a previously defined dietary carbohydrate quality index (CQI) and the risk of micronutrient intake inadequacy in a pediatric cohort of Spanish preschoolers. Children aged 4-5 years old were recruited at their medical center or at school, and information on sociodemographic, dietary, and lifestyle variables were collected through a self-administered online questionnaire. Dietary information was obtained from a validated 147-item semi-quantitative food frequency questionnaire. We calculated the CQI and categorized participants into quartiles according to their scores. We assessed the intakes of 20 micronutrients and evaluated the probability of intake inadequacy by using the estimated average requirement cut-off point. Generalized estimating equations were used to adjust for potential confounders and account for the intra-cluster correlations between siblings. The adjusted proportions of children with an inadequate intake of ≥three micronutrients were 23%, 12%, 11%, and 9% in the first, second, third, and fourth quartiles of the CQI, respectively. Children in the highest quartile of the CQI had 0.22-fold lower odds (95% CI 0.10-0.48) of having ≥three inadequate micronutrient intakes than their peers in the lowest quartile. These findings reinforce the relevance of carbohydrate quality in children's diets.

The influence of sport motivation on college students' subjective exercise experience: a mediation model with moderation.

Background: The degree to which an individual experiences a positive emotional state after exercise is a measurement of how much enjoyment sports bring to the individual. This can also be seen as the individual's essential motivation for engaging in sports, and an indirect means of improving the individual's physical health. Therefore, it is necessary to explore the factors that affect college students' subjective exercise experience and their effecting mechanism, thereby providing a basis for promoting college students' positive emotional experience after exercise. Methods: A questionnaire survey on 600 college students was conducted to examine the mediating effect of sport-confidence on the relationship between college students' sport motivation and their subjective exercise experience, and to investigate whether this process is moderated by the feelings of inadequacy. Results: The indirect effect of sport-confidence was significant (95% CI [0.133, 0.276]), and the index of moderated mediation Bootstrap 95% CI [0.003, 0.017] did not contain 0. Conclusion: The results indicated that: (1) sport-confidence had a partial mediating effect between college students' sport motivation and their subjective exercise experience; (2) the mediating effect of sport-confidence was moderated by the feelings of inadequacy, and the feelings of inadequacy moderated the latter half path of the mediating process of sport motivation - sport-confidence - subjective exercise experience. Therefore, the influence of college students' sport motivation on their subjective exercise experience is a moderated mediating model.

Corrigendum: Micronutrient intake inadequacies in different types of milk consumers in Indonesian children 1-5 years: dietary modeling with young child milk improved nutrient intakes.

[This corrects the article DOI: 10.3389/fnut.2023.1169904.].

Micronutrient intake inadequacies in different types of milk consumers in Indonesian children 1­5 years: dietary modeling with young child milk improved nutrient intakes

Background: Indonesian children under-five have a high prevalence of micronutrient deficiencies. Improving young child feeding practices may be the solution. Increasing the consumption of appropriate milk products could help to reduce nutrient inadequacy. Methods: The objective of this study was to assess nutrient inadequacy in Indonesian children to evaluate the potential improvement using dietary modeling analysis. Data from children aged 1-5 years from the Indonesian Individual Dietary Consumption Survey in 2014 were used in this analysis (n = 11,020). Diet modeling was conducted in two scenarios, substitution volume to volume and calories to calories. Results: The proportion of children consuming young child milk (YCM) was the highest compared to other milk types across all age groups, followed by condensed milk and cow's milk. YCM, also called "Growing-Up Milk" (GUM), are marketed as a product specifically formulated for the nutritional needs of young children. YCM consumers had lower prevalence of inadequate intakes in iron, zinc, vitamins A, C and D across age groups when compared to condensed milk consumers. The prevalence of inadequate intakes of nutrients in condensed milk consumers was Vitamin A (67, 64%), folate (92, 91%), Vitamin D (87, 84%), iron (84, 76%), and zinc (76, 76%) in 1-2y and 3-4y, respectively. The substitution of condensed milk with a YCM reduced the prevalence of inadequate intakes of micronutrients, such as Vitamin A, vitamin D, folate, iron and zinc, which are important for immune function. YCM reduced the prevalence of inadequate intakes of micronutrients by 20-40% (Vit A and folate) and 40-50% (Vit D and zinc). The reduction of prevalence of inadequate iron intake was 31% in 1-2y and 63% in 3-4y. Conclusion: The prevalence of inadequate micronutrient intakes was high among children aged 1-5 years old in Indonesia. YCM consumers had better nutrient intake. The substitution of condensed milk with a YCM reduced the prevalence of inadequate of micronutrient intake. Thus, nutrient intakes could be improved by YCM consumption in 1-5 years old children in Indonesia, along with nutrition education on feeding practices.

Two sides of the same coin? Absolute income and perceived income inadequacy as social determinants of health.

BACKGROUND: Absolute income is commonly used in studies of health inequalities, however it does not reflect spending patterns, debts, or expectations. These aspects are reflected in measures concerning perceived income inadequacy. While health inequities by absolute income or perceived income inadequacy are well established, few studies have explored the interplay of absolute income and perceived income inadequacy in relation to health. METHODS: Multiple data sources were linked into a nationally representative dataset (n = 445,748) of Dutch adults (18 +). The association between absolute income, perceived income inadequacy and health (self-reported health, chronic disease and psychological distress) was tested using logistic and Poisson regressions, controlling for various potential confounders (demographics, education) and mastery. Interactions were tested to check the association between perceived income inadequacy and health for different absolute income groups. RESULTS: Perceived income inadequacy was reported at every absolute income group (with 42% of individuals in the lowest income group and 5% of individuals in the highest income group). Both absolute income and perceived income inadequacy were independently associated with health. The adjusted relative risk (RR) for lowest absolute income group is 1.11 (1.08-1.1.14) and 1.28 (1.24-1.32) for chronic disease and self-reported health respectively, and the Odds Ratio (OR) for psychological distress is 1.28 (1.16-1.42). For perceived income inadequacy the RR's were 1.41 (1.37-1.46) and 1.49 (1.44-1.54) and the OR for psychological distress is 3.14 (2.81-3.51). Mastery appeared to be an important mediator for the relationship between perceived income inadequacy, poor self-rated health and psychological distress. CONCLUSIONS: Absolute income and perceived income inadequacy reflect conceptually different aspects of income and are independently associated with health outcomes. Perceived income inadequacy may be accounted for in health inequality studies, alongside measures of absolute income. In policy-making, targeting perceived income inadequacy might have potential to reduce health inequalities.

Estimating habitual iodine intake and prevalence of inadequacy from spot urine in cross-sectional studies: a modeling analysis to determine the required sample size.

BACKGROUND: The habitual/usual iodine intake and the prevalence of iodine inadequacy may be estimated from spot urinary iodine concentrations in cross-sectional studies by collecting a repeat spot urine in a subgroup of the study population and accounting for within-person variability in iodine intake. However, guidance on the required overall sample size (N) and the replicate rate (n) is lacking. OBJECTIVES: To determine the sample size (N) and replicate rate (n) needed to estimate the prevalence of iodine inadequacy in cross-sectional studies. METHODS: We used data from local observational studies conducted in women 17-49 y old in Switzerland (N = 308), South Africa (N = 154), and Tanzania (N = 190). All participants collected 2 spot urine samples. We calculated the iodine intake using urinary iodine concentrations and accounted for urine volume using urinary creatinine concentration. For each study population, we estimated the habitual iodine intake distribution and determined the prevalence of iodine intake below the average requirement using the Statistical Program to Assess habitual Dietary Exposure (SPADE). We used the obtained model parameters in power analyzes and estimated the prevalence of iodine inadequacy for different sample sizes (N = 400, 600, and 900) and replicate rates (n = 50, 100, 200, 400, 600, and 900). RESULTS: The estimated prevalence (95% CI) of inadequate iodine intake was 21% (15, 28%), 5.1% (1.3, 8.7%), and 8.2% (3.4, 13%) for Swiss, South African, and Tanzanian women, respectively. An N of 400 women, with a repeated measure (n) in 100 women, achieved a satisfactory precision of the prevalence estimate in all study populations. Increasing the replicate rate (n) improved the precision more effectively than increasing the N of the study. CONCLUSIONS: The sample size for cross-sectional studies aiming to assess the prevalence of inadequate iodine intake depend on the expected prevalence, the overall variance in intake, and the study design. However, an N of 400 participants with a repeated measure of 25% may be used as guidance when planning observational studies applying simple random sampling. This trial was registered at clinicaltrials.gov as NCT03731312.

Demographical, clinical, and complication differences between vaccinated and unvaccinated hospitalized children with measles in mogadishu somalia: a hospital-based retrospective cohort study.

Measles is endemic in Somalia; recurrent outbreaks are reported annually. Under-five children are the most affected due to low immunization coverage, vitamin A deficiency, and malnutrition. The study aims to evaluate the demographical, clinical, and complication variations between vaccinated and unvaccinated hospitalized children with measles in the study hospital. Method: A hospital-based retrospective cohort study was implemented between 10 October and 10 November 2022 by reviewing case record files following a well-structured checklist of admitted clinical features, demographic characteristics, history of measles immunization, and measles complication status. Descriptive statistics were used by presenting frequency and percentage for categorical and the mean score for continuous variables. χ2 and Fisher's exact test at P =0.05 were used to identify the proportions differences between vaccinated and unvaccinated cases. Result: A total of 93 hospitalized measles children participated in the study. Over half were boys, the mean age in months was 20.9 (SD±7.28), and over two-thirds of the mothers/caregivers did not have formal education. Almost 9.7% of hospitalized measles children had one dose of the measles-containing vaccine, while none had two doses. The vaccinated cases had fewer ill with fewer complications than the unvaccinated cases. Fever, cough, rash, and Koplik's spots were clinical features associated with measles immunization status. Conclusion: Around one in ten hospitalized children had one dose of the measles vaccine. Vaccinated cases had fewer illnesses with few complications than unvaccinated cases. The paper highly emphasizes providing booster doses, improving vaccine logistics and storage, and following immunization schedules. In addition, conducting further multicentral high sample-size studies is highly required to identify whether vaccine inadequacy was due to host-related or vaccine-related factors.

Impact of a Switch to Plant-Based Foods That Visually and Functionally Mimic Animal-Source Meat and Dairy Milk for the Australian Population-A Dietary Modelling Study.

Sales of plant-based 'meat' and 'milk'-products that mimic the visual and functional characteristics of animal-source foods-have increased rapidly during the past decade and are predicted to continue to increase. As plant-based 'meat' and 'milk' are nutritionally dissimilar to the animal-source originals, this study aimed to estimate the nutritional implications for the Australian population of substituting 'Easily Swappable' animal-source meat and dairy milk with plant-based imitation products. Computer simulation modelling was undertaken using dietary intake data collected in 2011-12 from a nationally representative survey sample. Conservative and Accelerated dietary transition scenarios were modelled in which various amounts of dairy milk and animal-source meat were replaced with plant-based 'milk' and plant-based 'meat', for the entire population and for various sub-populations. The scenarios were based on sales reports and economic projections. Modelling revealed that the intake of nutrients already at risk of inadequate intake, such as iodine and vitamin B12 (particularly for females), zinc (particularly for males) and n-3 long-chain fatty acids (for adults), would likely be adversely impacted in an Accelerated scenario. In conclusion, widespread replacement of dairy milk and animal-source meat with plant-based 'milk' and 'meat' may increase the risk of nutritional inadequacies in the Australian population. Messages and policy actions promoting the transition to more environmentally sustainable diets should be designed to avoid such adverse nutritional impacts.

Independent and joint contributions of inadequate antenatal care timing, contacts and content to adverse pregnancy outcomes.

BACKGROUND: Poor quality and inadequate of antenatal care (ANC) visits during pregnancy may increase the risk of preventable adverse pregnancy outcomes. We tested the hypothesis that the adequacy of ANC utilization combined with quality of ANC services will reduce the risk of low birth weight (LBW) and preterm delivery (P T D) in the Tamale metropolis of Ghana. MATERIALS AND METHODS: A facility-based analytical cross-sectional study was conducted on a sample of 553 postpartum women who had delivered within the last 12 months prior to the study. The overall utilization of ANC services was measured in terms of ANC timing, contacts, and content (TCC) of essential ANC services. The sample was drawn using systematic random sampling procedure. Primary data was collected from mothers by administering a structuredquestionnaire while the secondary data was extracted from individual records. RESULTS: After controlling for confounders, women who had adhered to all WHO recommendations in terms of ANC timing, frequency and content were 71 % protected from PTD, AOR = 0.29 (95 % CI: 0.15, 0.59) and 56 % protection from LBW AOR = 0.44 (95 % CI: 0.23, 0.83). CONCLUSION: Individually and jointly, inadequate ANC contacts and content associatedsignificantly with preterm delivery than LBW.Key messagesLimited evidence exists on the joint effect of ANC services timing, contacts and content on adverse pregnancy outcomes.Total adherence to recommended ANC initiation, attendance and receipt of essential services had greater protection against PTD and LBW, compared to any single element/component of ANCWomen who had adequate overall ANC services utilization in terms of timing, contacts and content were 71 % protected from PTD, AOR = 0.29 (95 % CI: 0.15, 0.59) and 56 % protection from LBW AOR = 0.44 (95 % CI: 0.23, 0.83).

Pregnancy post-bariatric surgery: Improved outcomes with telephonic nutritional management program.

BACKGROUND: Pregnancies post-bariatric surgery are increasingly common. It is important to understand how to manage prenatal care in this high-risk population to optimize perinatal outcomes. OBJECTIVE: To determine among pregnancies post-bariatric surgery whether participation in a telephonic nutritional management program was associated with improved perinatal outcomes and nutritional adequacy. STUDY DESIGN: Retrospective cohort study of pregnancies post-bariatric surgery from 2012 to 2018. Participation in a telephonic management program with nutritional counseling, monitoring and nutritional supplement adjustment. Modified Poisson Regression estimated the relative risk using propensity score methods to account for baseline differences between the patients who participated in the program and patients who did not. RESULTS: 1575 pregnancies occurred post-bariatric surgery, of which 1142 (72.5 % of pregnancies) participated in the telephonic nutritional management program. Participants in the program were less likely than non-participants to have a preterm birth (aRR 0.48, 95 % CI 0.35-0.67), preeclampsia (aRR 0.43, 95 % CI (0.27-0.69)), gestational hypertension (aRR 0.62, 95 % CI 0.41-0.93), and to have neonates admitted to a Level 2 or 3 (aRR 0.61, 95 % CI0.39-0.94; aRR 0.66, 95 % CI 0.45-0.97, respectively), after adjusting for the propensity score to account for baseline differences. Risk of cesarean delivery, gestational weight gain, glucose intolerance and birthweight did not differ by participation. Among 593 pregnancies with nutritional labs available, participants in the telephonic program were less likely to have nutritional inadequacy in late pregnancy (aRR 0.91, 95 % CI 0.88-0.94). CONCLUSION: Participation in a telephonic nutritional management program post-bariatric surgery was associated with improved perinatal outcomes and nutritional adequacy.

Ultrasound features affecting the sample adequacy after fine-needle aspiration of thyroid nodules with different risk stratification.

BACKGROUND: The inadequacy samples caused by the internal characteristic structure of thyroid nodules are difficult to be solved. OBJECTIVE: To evaluate the ultrasound features affecting the sample adequacy after fine-needle aspiration (FNA) of thyroid nodules with different risk stratification. METHODS: 592 thyroid nodules that underwent ultrasound-guided FNA were included in this retrospective study. The sample obtained by FNA were classified as inadequacy and adequacy according to the cytopathological results. Ultrasound features (ie., size, position, cystic predominance, composition, echo, shape, margin, and superficial annular calcification status) of the nodules were recorded and compared between the inadequacy sample group and adequacy sample group. RESULTS: Multiple logistic regression shows that preponderant cystic proportion (OR, 0.384; P = 0.041), extremely hypoechogenicity and hypoechogenicity (OR, 6.349; P = 0.006) were the independent influencing factors of inadequate samples after FNA in benign expected nodules. In addition, nodule size ≤10 mm (OR, 1.960; P = 0.010) and superficially annular calcification (OR, 4.600; P < 0.001) were independent influencing factors for inadequate samples after FNA in malignant expected nodules. CONCLUSION: The ultrasound features of hypoechogenicity or high cystic proportion in benign expected nodules and that of small size or annular calcification in malignant expected nodules were the risk factors for inadequacy samples by US-guided FNA.

Prevalence of nutritional inadequacy in children aged 12-36 months: EPACI Portugal 2012.

Adequate nutritional intake in the first years of life is crucial for future health. The purpose of this study is to assess the adequacy of nutritional intake in Portuguese toddlers. The EPACI Portugal 2012 is a cross-sectional study of a representative sample of toddlers (n = 2230), aged between 12 and 36 months. Data on diets were collected by trained interviewers. The current analysis included 853 children with full data from 3-day food diaries completed by parents/caregivers. Intakes of energy, macro- and micronutrients were estimated through Statistical Program to Assess Dietary Exposure (SPADE). Nutritional adequacy was evaluated using Dietary Reference Values established by the European Food Safety Authority. A large proportion of children exceeded the recommended energy intake. The median daily protein intake was 4.7 g/kg/day, five times more than that recommended. About 9% and 90% of the children consumed a lower proportion of energy than the lower limit of the Reference Intake range for carbohydrates and fat, respectively. Around a third consumed less fibre and magnesium and 100% less vitamin D than the recommended Adequate Intake (AI). Almost a third consumed less vitamin A than the recommended Average Requirement (AR) and 86% of the children showed excessive sodium consumption. Portuguese toddlers consumed a low proportion of energy from fat, had energy and protein intakes above the recommendations and excessive intakes of sodium, and inadequate intakes of vitamin A. Every child consumed less than the recommended AI for vitamin D.