scholarly journals Reducing salt in bread: a quasi-experimental feasibility study in a bakery in Lima, Peru

2015 ◽  
Vol 19 (6) ◽  
pp. 976-982 ◽  
Author(s):  
Lorena Saavedra-Garcia ◽  
Vanessa Sosa-Zevallos ◽  
Francisco Diez-Canseco ◽  
J Jaime Miranda ◽  
Antonio Bernabe-Ortiz
Keyword(s):  
Cardiovascular Health ◽  
Phase 1 ◽  
Salt Content ◽  
Phase 2 ◽  
Post Intervention ◽  
Salt Reduction ◽  
Taste Test ◽  
Reduction Strategies ◽  
Quasi Experimental ◽  
Two Phases

AbstractObjectivesTo explore salt content in bread and to evaluate the feasibility of reducing salt contained in ‘pan francés’ bread.DesignThe study had two phases. Phase 1, an exploratory phase, involved the estimation of salt contained in bread as well as a triangle taste test to establish the amount of salt to be reduced in ‘pan francés’ bread without detection by consumers. In Phase 2, a quasi-experimental, pre–post intervention study assessed the effects of the introduction of low-salt bread on bakery sales.SettingA municipal bakery in Miraflores, Lima, Peru.SubjectsSixty-five clients of the bakery in Phase 1 of the study; sales to usual costumers in Phase 2.ResultsOn average, there was 1·25 g of salt per 100 g of bread. Sixty-five consumers were enrolled in the triangle taste test: fifty-four (83·1 %) females, mean age 58·9 (sd 13·7) years. Based on taste, bread samples prepared with salt reductions of 10 % (P=0·82) and 20 % (P=0·37) were not discernible from regular bread. The introduction of bread with 20 % of salt reduction, which contained 1 g of salt per 100 g of bread, did not change sales of ‘pan francés’ (P=0·70) or other types of bread (P=0·36). Results were consistent when using different statistical techniques.ConclusionsThe introduction of bread with a 20 % reduction in salt is feasible without affecting taste or bakery sales. Results suggest that these interventions are easily implementable, with the potential to contribute to larger sodium reduction strategies impacting the population’s cardiovascular health.

scholarly journals The effect of changes in visibility and price on fruit purchasing at a university cafeteria in Lima, Peru

2014 ◽  
Vol 18 (15) ◽  
pp. 2742-2749 ◽  
Author(s):  
María Kathia Cárdenas ◽  
Catherine P Benziger ◽  
Timesh D Pillay ◽  
J Jaime Miranda
Keyword(s):  
Phase 1 ◽  
Product Placement ◽  
Price Reduction ◽  
Phase 2 ◽  
Post Intervention ◽  
Phase 3 ◽  
Snack Foods ◽  
Additional Information ◽  
Point Of Purchase ◽  
Quasi Experimental

AbstractObjectiveTo determine the effect of increasing fruit visibility, adding information and lowering price on fruit purchasing at a university cafeteria in Lima, Peru.DesignQuasi-experimental pilot study of a three-phase stepped intervention. In Phase 1, fruit was displayed >3 m from the point of purchase with no additional information. Phase 2 consisted in displaying the fruit near the point of purchase with added health and price information. Phase 3 added a 33 % price reduction. The duration of each phase was 3 weeks and phases were separated by 2-week breaks. Primary outcomes were total pieces of fruit and number of meals sold daily.SettingA university cafeteria in Lima, Peru.SubjectsApproximately 150 people, students and non-student adults, who purchased food daily. Twelve students participated in post-intervention interviews.ResultsFruit purchasing doubled from Phase 1 to Phase 3 (P<0·01) and remained significant after adjusting for the number of meals sold daily (P<0·05). There was no evidence of a difference in fruit sold between the other phases. Females purchased 100 % of the fruit in Phase 1, 82 % in Phase 2 and 67 % in Phase 3 (P<0·01). Males increased their purchasing significantly between Phase 1 and 3 (P<0·01). Non-student adults purchased more fruit with each phase (P<0·05) whereas students did not. Qualitatively, the most common reason for not purchasing fruit was a marked preference to buy unhealthy snack foods.ConclusionsPromoting fruit consumption by product placement close to the point of purchase, adding health information and price reduction had a positive effect on fruit purchasing in a university cafeteria, especially in males and non-student adults.

Differential impact of on-site or telepharmacy in the intensive care unit: a controlled before–after study

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Joao Gabriel Rosa Ramos ◽  
Sandra Cristina Hernandes ◽  
Talita Teles Teixeira Pereira ◽  
Shana Oliveira ◽  
Denis de Melo Soares ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Phase 1 ◽  
Phase 2 ◽  
Differential Impact ◽  
Scarce Resources ◽  
Clinical Pharmacists ◽  
Versus Phase ◽  
Quasi Experimental ◽  
The Impact

Abstract Background Clinical pharmacists have an important role in the intensive care unit (ICU) team but are scarce resources. Our aim was to evaluate the impact of on-site pharmacists on medical prescriptions in the ICU. Methods This is a retrospective, quasi-experimental, controlled before-after study in two ICUs. Interventions by pharmacists were evaluated in phase 1 (February to November 2016) and phase 2 (February to May 2017) in ICU A (intervention) and ICU B (control). In phase 1, both ICUs had a telepharmacy service in which medical prescriptions were evaluated and interventions were made remotely. In phase 2, an on-site pharmacist was implemented in ICU A, but not in ICU B. We compared the number of interventions that were accepted in phase 1 versus phase 2. Results During the study period, 8797/9603 (91.6%) prescriptions were evaluated, and 935 (10.6%) needed intervention. In phase 2, there was an increase in the proportion of interventions that were accepted by the physician in comparison to phase 1 (93.9% versus 76.8%, P &lt; 0.001) in ICU A, but there was no change in ICU B (75.2% versus 73.9%, P = 0.845). Conclusion An on-site pharmacist in the ICU was associated with an increase in the proportion of interventions that were accepted by physicians.

Psychiatry Transcript Annotation: Process Study and Improvements

2021 ◽  
Vol 10 (1) ◽  
pp. 71-75
Author(s):  
Srinivasan Sridhar ◽  
Nazmul Kazi ◽  
Indika Kahanda ◽  
Bernadette McCrory
Keyword(s):  
Mental Health ◽  
Work Experience ◽  
Phase 1 ◽  
Kappa Statistics ◽  
Phase 2 ◽  
Rater Reliability ◽  
Standard Data ◽  
Annotation Process ◽  
Data Collection Process ◽  
Two Phases

Background: The demand for psychiatry is increasing each year. Limited research has been performed to improve psychiatrist work experience and reduce daily workload using computational methods. There is currently no validated tool or procedure for the mental health transcript annotation process for generating “gold-standard” data. The purpose of this paper was to determine the annotation process for mental health transcripts and how it can be improved to acquire more reliable results considering human factors elements. Method: Three expert clinicians were recruited in this study to evaluate the transcripts. The clinicians were asked to fully annotate two transcripts. An additional five subjects were recruited randomly (aged between 20-40) for this pilot study, which was divided into two phases, phase 1 (annotation without training) and phase 2 (annotation with training) of five transcripts. Kappa statistics were used to measure the inter-rater reliability and accuracy between subjects. Results: The inter-rater reliability between expert clinicians for two transcripts were 0.26 (CI 0.19 to 0.33) and 0.49 (CI 0.42 to 0.57), respectively. In the pilot testing phases, the mean inter-rater reliability between subjects was higher in phase 2 with training transcript (k= 0.35 (CI 0.052 to 0.625)) than in phase 1 without training transcript (k= 0.29 (CI 0.128 to 0.451)). After training, the accuracy percentage among subjects was significantly higher in transcript A (p=0.04) than transcript B (p=0.10). Conclusion: This study focused on understanding the annotation process for mental health transcripts, which will be applied in training machine learning models. Through this exploratory study, the research found appropriate categorical labels that should be included for transcripts annotation, and the importance of training the subjects. Contributions of this case study will help the psychiatric clinicians and researchers in implementing the recommended data collection process to develop a more accurate artificial intelligence model for fully- or semi-automated transcript annotation.

scholarly journals Evaluation of salt content in school meals

2015 ◽  
Vol 28 (2) ◽  
pp. 165-174 ◽  
Author(s):  
Cláudia Alexandra Colaço Lourenço Viegas ◽  
Jorge Torgal ◽  
Pedro Graça ◽  
Maria do Rosário Oliveira Martins
Keyword(s):  
High School Students ◽  
Salt Intake ◽  
Eating Habits ◽  
Salt Content ◽  
Food Samples ◽  
Mean Value ◽  
School Meals ◽  
School Students ◽  
Salt Reduction ◽  
Reduction Strategies

OBJECTIVE: High blood pressure is a major rick factor for cardiovascular disease, and it is closely associated with salt intake. Schools are considered ideal environments to promote health and proper eating habits. Therefore the objective of this study was to evaluate the amount of salt in meals served in school canteens and consumers' perceptions about salt. METHODS: Meals, including all the components (bread, soup, and main dish) were retrieved from school canteens. Salt was quantified by a portable salt meter. For food perception we constructed a questionnaire that was administered to high school students. RESULTS: A total of 798 food samples were analysed. Bread had the highest salt content with a mean of 1.35 g/100 g (SD=0.12). Salt in soups ranged from 0.72 g/100 g to 0.80 g/100 g (p=0.05) and, in main courses, from 0.71 g/100 to 0.97 g/100g (p=0.05). The salt content of school meals is high with a mean value of 2.83 to 3.82 g of salt per meal. Moreover, a high percentage of students consider meals neither salty nor bland, which shows they are used to the intensity/amount of salt consumed. CONCLUSION: The salt content of school meals is high, ranging from 2 to 5 times more than the Recommended Dietary Allowances for children, clearly exceeding the needs for this population, which may pose a health risk. Healthy choices are only possible in environments where such choices are possible. Therefore, salt reduction strategies aimed at the food industry and catering services should be implemented, with children and young people targeted as a major priority.

scholarly journals Removal of organic matter from pre-treated domestic sewage in anaerobic biological reactor by a combined system of electrolytic and biological aerobic treatment

2019 ◽  
Vol 14 (4) ◽  
pp. 1
Author(s):  
Ariela Araujo Fonseca ◽  
Yovanka Pérez Ginoris ◽  
Norma Mendes Pinheiro Gontijo ◽  
Marco Antonio Almeida de Souza
Keyword(s):  
Organic Matter ◽  
Electric Current ◽  
Phase 1 ◽  
Zooplankton Community ◽  
Batch Reactors ◽  
Phase 2 ◽  
Combined System ◽  
Organic Matter Removal ◽  
Electrolytic Process ◽  
Two Phases

Biological processes are the most widespread methods for wastewater treatment. However, they are limited in their ability to degrade toxic and refractory pollutants, contaminants that electrochemical processes can remove. Therefore, this research explored the possibility of treating sewage by an anaerobic biological process followed by an aerobic system integrated to an electrolytic process. Three sequential batch reactors were operated in an automated way. Each of three reactors represented a process: aerobic biological treatment (BR); electrolytic treatment (ER); and a combination of both, the bio electrolytic reactor (BER). Two phases were ran with different electrodes: (Phase 1) stainless steel and (Phase 2) graphite. The electric current was varied from 0.001 to 0.100 A. COD, TS, SS, turbidity, and the zooplankton community were monitored. The highest organic matter removal efficiencies were 86%, 79% and 87% for BR, ER and BER, respectively. The best weekly BER efficiencies for COD removal were 90% and 98%, with current densities of 0.27 A/m2 (Phase 1) and 0.05 A/m2 (Phase 2). The main conclusions about bio electrolytic process were: (1) it did not achieve organic matter removal high enough to justify its application; (2) inert electrodes are the more indicated; and (3) the zooplankton community was affected by the electric current.

scholarly journals Developing a realist theory of psychosocial rehabilitation: the Clubhouse model

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Jen Rouse ◽  
Kelly McShane ◽  
Criss Habal-Brosek
Keyword(s):  
Phase 1 ◽  
Psychosocial Rehabilitation ◽  
Theory Development ◽  
Realist Evaluation ◽  
Self Determination ◽  
Phase 2 ◽  
Two Phase ◽  
Realist Theory ◽  
Clubhouse Model ◽  
Two Phases

Background Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse. Method Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement. Results The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery. Conclusions The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.

scholarly journals Factors Influencing International Board Certified Lactation Consultants to Continue Advancing Practice Beyond Certification: A Multinational Study

2018 ◽  
Vol 7 (4) ◽  
pp. 227-237 ◽  
Author(s):  
Karolyn Vaughan ◽  
Anne McMurray ◽  
Mary Sidebotham ◽  
Jennifer Gamble
Keyword(s):  
Phase 1 ◽  
Demographic Data ◽  
Phase 2 ◽  
Online Questionnaire ◽  
Optimal Care ◽  
Lifelong Learners ◽  
Lactation Consultant ◽  
Qualitative Understanding ◽  
Lactation Consultants ◽  
Two Phases

Background:Certification as a lactation consultant is based on practitioners having achieved a standard of knowledge indicative of their competence to practice by passing a psychometric examination. The underpinning principle of recertification programs is to support clinicians to become lifelong learners by progressively enhancing and advancing their knowledge and skills in line with contemporary evidence. The aim of this study was to investigate the factors that influence International Board Certified Lactation Consultants (IBCLCs) to advance their practice.Method:A mixed-methods study was conducted in two phases. Phase 1 included focus groups, interviews, and participants’ demographic data. Phase 2 comprised of an online questionnaire to IBCLCs. This approach was designed to provide a comprehensive qualitative understanding of the IBCLCs’ experiences, which was then triangulated with quantitative data from a significantly larger population of IBCLCs in Phase 2.Results:The findings are described in themes and subthemes. Participants in phase 2 (n = 3,946) reported being intrinsically motivated (93.3%, n = 3,631) and committed to providing evidence-based guidance and optimal care to support breastfeeding mothers. They identified various sources of continuing education, although attendance at conferences, peer support, and reflective sessions were the most common approaches to enhancing knowledge. They recognized that it was through extension of knowledge that they were able to advance their practice.Conclusion:This article identifies strategies that the managers, educators, and certification bodies can adopt to support the IBCLCs in continuing to advance their practice, which will ultimately improve breastfeeding outcomes for mothers.

scholarly journals Improving eye health using a child-to-child approach in Bariadi, Tanzania

2017 ◽  
Vol 76 (1) ◽  
Author(s):  
Ving F. Chan ◽  
Hasan Minto ◽  
Eden Mashayo ◽  
Kovin S. Naidoo
Keyword(s):  
Refractive Error ◽  
Phase 1 ◽  
Health Messages ◽  
Eye Drops ◽  
Vision Screening ◽  
Phase 2 ◽  
Eye Health ◽  
Knowledge And Practice ◽  
Two Phases

Purpose: Vision Champions (VC) are children trained to perform simple eye health screening and share eye health messages among their community. Our objectives were to assess the ability of VC in identifying and referring children and the community with refractive error and obvious ocular disease and to assess the change in knowledge and practice of eye healthseeking behaviour of the community 3 months after the introduction of the Vision Champion Programme.Methods: We purposively sampled 600 households and interviewed 1051 participants in two phases with a close-ended questionnaire. The numbers of children screened, referred by the VC and those who attended the Vision Centre were recorded. The percentage of people who answered the questions correctly were compared between Phase 1 (P1) and Phase 2 (P2).Results: The VC shared their eye health messages with 6311 people, screened 7575 people’s vision and referred 2433 people for further care. The community were more aware that using eye ointment not prescribed by doctors (P1 = 58.96% vs. P2 = 72.75%) can lead to blindness. Participants were more aware that they should not administer eye drops in stock (P1 = 44.18% vs. P2 = 61.37%) or received from a friend or relative (P1 = 53.23% vs. P2 = 72.35%) if their eyes are red and painful.Conclusion: Children have the potential to effectively share eye health messages and conduct simple vision screening for their families and peers. Efforts are needed to sensitise the community to improve the referral or follow-up rate.

The new Myopic Traction Maculopathy Staging System

2020 ◽  
pp. 112067212093059 ◽  
Author(s):  
Barbara Parolini ◽  
Michele Palmieri ◽  
Alessandro Finzi ◽  
Gianluca Besozzi ◽  
Angela Lucente ◽  
...  
Keyword(s):  
Macular Hole ◽  
Phase 1 ◽  
Staging System ◽  
Wide Field ◽  
Phase 2 ◽  
Macular Detachment ◽  
Myopic Traction Maculopathy ◽  
Fundus Photographs ◽  
Two Phases ◽  
Stage 1

Purpose: To describe a comprehensive OCT-based classification of myopic traction maculopathy (MTM). Methods: Two hundred eighty-one eyes with MTM (visited from 2006 to 2018), were retrospectively reviewed for age, best-corrected-visual-acuity (BCVA), axial length (AL), optical coherence tomography (OCT), and wide-field color fundus-photographs. The study was divided in two Phases. Phase 1: MTM types were categorized with OCT and correlated with age and BCVA. The type of staphyloma was described. Phase 2: the evolution of MTM was studied evaluating at least three OCT exams of each eye taken at different timings (interval between each exam: 1–10 years). Results: Phase 1: We identified, four MTM retinal stages (1. Inner/Outer Maculoschisis; 2. Predominantly outer Maculoschisis; 3. Maculoschisis-Macular Detachment; 4. Macular Detachment) and three foveal stages (a. Normal fovea; b. Inner Lamellar-Macular-Hole; c. Full-Thickness-Macular-Hole). Outer-Lamellar-Macular-Holes and epiretinal abnormalities were associated findings. Stages 1 to 2 were younger than stages 3 to 4 ( p < 0.05). BCVA in stages 1, 2 was similar, and higher than stages 3, 4 ( p < 0.02). About 14% of eyes had no staphyloma, 73% of eyes had staphyloma type 1 or 2. MTM stages were not correlated with AL. Phase 2: The retina could change in time from stage 1 to 4, or the fovea could change from stage a to c. Mean evolution time from stage 1 to 2, stage 2 to 3, and 3 to 4 were 20, 12, 3 months, respectively. BCVA decreased over time as stages increased ( p = 0.47). Conclusion: The MSS Table displays a new classification, the natural evolution, and practical insights for the management of MTM.

Oxygen delivery rate and sufficiency of oxygenation during ECMO in newborn baboons

1989 ◽  
Vol 66 (1) ◽  
pp. 210-216
Author(s):  
J. D. Cornish ◽  
D. R. Gerstmann ◽  
D. M. Null ◽  
M. D. Smith ◽  
T. J. Kuehl
Keyword(s):  
Phase 1 ◽  
Ductus Arteriosus ◽  
Serum Lactate ◽  
Papio Cynocephalus ◽  
Phase 2 ◽  
Primate Model ◽  
O2 Extraction ◽  
Two Phases ◽  
The Right ◽  
O2 Delivery

Minimum acceptable O2 delivery (DO2) during extracorporeal membrane oxygenation (ECMO) remains to be defined in a newborn primate model. The right atrium, carotid artery, and femoral artery were cannulated, and the ductus arteriosus, aorta, and pulmonary artery ligated in neonatal baboons (Papio cynocephalus) under a combination of ketamine, diazepam, and pancuronium. The internal jugular vein was also cannulated retrograde to the level of the occipital ridge. We measured hemoglobin, pH, arterial and venous PO2 (both from the pump circuit and from the cerebral venous site), serum lactate and bicarbonate concentrations, and pump flow, and we calculated hemoglobin saturations, (DO2), O2 consumption (VO2), systemic O2 extraction, and cerebral O2 extraction. Six baboons were studied during each of two phases of the experiment. In the first, flow rates were varied sequentially from 200 to 50 ml.kg-1.min-1 with saturation maximized. In the second, flow was maintained at 200 ml.kg-1.min-1 and saturation was reduced sequentially from 100 to 38%. VO2 fell significantly below baseline at a flow rate of 50 ml.kg-1.min-1 and a DO2 of 8 +/- 2 (SE) ml.kg-1.min-1 in phase 1 and at DO2 of 12 +/- 5 in phase 2. Both systemic and cerebral O2 extraction rose significantly at a flow of 100 ml.kg-1.min-1 and DO2 of 17 +/- 4 ml.kg-1.min-1 in phase 1, whereas neither rose with decreasing DO2 in phase 2. In fact, cerebral extraction fell significantly DO2 of 16 +/- 6 ml.kg-1.min-1.(ABSTRACT TRUNCATED AT 250 WORDS)

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