Twin pregnancy a complicating journey for both mothers and babies: elaborate review

Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. A pregnancy may end in a live birth, abortion, or miscarriage, though access to safe abortion care varies globally. Research shows that 10 percent to 15 percent of all singleton births may have started off as twins; often one is lost early in pregnancy in a phenomenon known as "vanishing twin syndrome." Multiple pregnancy occurs when two or more ova are fertilized to form dizygotic (non-identical) twins or a single fertilised egg divides to form monozygotic (identical) twins. In the U.S, about three in every 100 pregnant women give birth to twins or triplets, according to the Mayo Clinic in Rochester, Minn. And by many accounts, twin pregnancies are on the rise. This review provides a blessful information to understand what happening when expecting twins and also help to cope with pregnancy related complications and give twins the best start in life.

Customers' Perceptions of Operational Status of and Needs for Sodium Reduction in the Industry Foodservice in Seoul / 대한지역사회영양학회지

OBJECTIVES: This study aimed to compare customers' perceptions of the need for a low-sodium diet and sodium-reduced operations in the industry foodservice by age. The relationships between health concerns and perceptions of the need for sodium-reduced operations and low-sodium diets in the industry foodservice were analyzed.METHODS: A survey was conducted among 340 industry foodservice customers aged 20–50 years and residing in Seoul, Korea. This study investigated the respondents' health concerns, their perception of the need for sodium-reduced foodservice operations, their perception of a sodium-reduced diet, and the general details of the foodservices they used. A cross-tabulation analysis and ANOVA were performed to identify differences in measurement items by age, and a simple regression analysis was performed to examine relationships between measurement items.RESULTS: For the customers' perception of the need for a sodium-reduced foodservice operation, the item “it is necessary to provide separate spices and sauces to reduce sodium intake” achieved the highest score (3.88 points out of a possible 5 points). For the perception of a sodium-reduced diet, the item “I think it is helpful for one's health” obtained the highest score (4.13 points). Respondents' health concerns had a positive effect on increasing the level of perception of the need for sodium-reduced foodservice operations and that of a sodium-reduced diet.CONCLUSIONS: Foodservice nutritionists could help enhance their customers' perceptions of the needs for sodium-reduced foodservice operations and sodium-reduced diets by frequently providing them with sodium-related health information.

Risk Assessment of Dietary Exposure to Acrylamide in the Norwegian Population

Request from the Norwegian Food Safety Authority The Norwegian Food Safety Authority (NFSA) requested the Norwegian Scientific Committee for Food Safety (VKM) to assess whether Norwegians in general or subgroups in the population could be expected to have different dietary exposure to acrylamide than reported for other European population groups, and if found to be different to calculate their exposure. Furthermore, VKM was asked to identify food categories with a high potential to increase acrylamide exposure; both for the whole population and for specific groups. Finally, VKM was asked to characterise the risk of acrylamide exposure to the Norwegian population compared to the rest of the European population. The Norwegian Food Safety Authority intends to use this risk assessment as a basis for the Norwegian contribution to the ongoing legislative work in the EU and to consider the necessity to adjust the existing national dietary advices or to issue new ones. How VKM has addressed the request VKM appointed a working group consisting of members of the Panel on Contaminants to answer the request. The Panel on Contaminants has reviewed and revised the draft prepared by the working group and finally approved the risk assessment on dietary acrylamide exposure in the Norwegian population. What acrylamide is and its toxicity to humans Acrylamide is a water-soluble organic chemical formed in carbohydrate-rich foods from naturally present carbohydrates and amino acids during cooking or other heat processing at temperatures above 120°C. Acrylamide is a widely used industrial chemical and is also formed in tobacco smoke. Acrylamide is known to be neurotoxic in humans and is classified as a probable human carcinogen. Concerns about exposure to acrylamide in the general population arose in 2002 when it was discovered in heat-treated foods. Dietary acrylamide exposure in Europe and Norway Dietary acrylamide exposure has been assessed by combining food consumption data and acrylamide concentration data and by biological markers of exposure both in Norway and different European countries. In the EFSA 2015 Scientific Opinion on acrylamide in food, chronic dietary exposure was calculated for 61,338 individuals from 28 surveys and 17 different European countries covering the following age groups: infants (<1 year old), toddlers (≥1 year to <3 years old), other children (≥3 years to <10 years old), adolescents (≥10 years to <18 years old), adults (≥18 years to <65 years old), elderly (≥65 years to <75 years old) and very elderly (≥75 years old). The estimation of human exposure to acrylamide revealed that infants, toddlers and other children were the most exposed groups, but EFSA concluded that dietary acrylamide represents a health concern for all age groups. In previous Norwegian studies reporting dietary acrylamide exposure, the mean and median exposure in adolescents and adults were in the range of 0.3-0.5 μg/kg bw per day. These estimates are in the same range as the mean daily exposures estimated by EFSA for adolescents (0.4-0.9 μg/kg bw) and adults (0.4-0.5 μg/kg bw). Taking into consideration the results from previous exposure estimates and knowledge about food consumption patterns in recent consumption surveys in Norway, VKM concludes that Norwegian adults, adolescents and children older than three years of age are not likely to have a different exposure to acrylamide than corresponding age groups in other European countries. VKM therefore decided not to perform a new exposure assessment in these age groups. No previous studies in Norway have assessed acrylamide exposure in infants and children less than three years of age. Information from national and European dietary surveys shows that Norwegian 1-year-olds, but not 2-year-olds, have higher consumption of infant porridge than other European toddlers. VKM therefore decided to conduct a full exposure estimate in 1-year-old toddlers. The comparison of data on acrylamide occurrence in food reported by EFSA (2015) and in foods sampled in Norway showed that acrylamide concentrations in the main food categories do not differ essentially, with the exception of three categories. The category “Potato crisps and snacks” has higher acrylamide concentrations in Norwegian samples than in those reported by EFSA, while the categories “Baby foods, other than cereal-based” and “Processed cereal-based baby food” (i.e. infant porridge) have lower concentrations in Norwegian samples than in those reported by EFSA. VKM considered that Norwegian analytical values were sufficient for exposure calculations if the concentrations were analysed in 16 samples or more. Infant porridge had 52 analysed samples and VKM considered that the brands sampled are representative for infant porridge on the Norwegian market. VKM calculated acrylamide exposure based on food consumption in Norwegian 1-year-olds by two approaches: one using EFSA concentration data only; and the other using Norwegian concentration data for food categories including 16 samples or more, and EFSA data for the remaining categories. Both approaches resulted in acrylamide exposures within the exposure range for toddlers reported by EFSA (2015). When using EFSA concentration data only the calculated daily exposure (mean: 1.6 μg/kg bw and P95: 3.2 μg/kg bw) is in the upper range calculated by EFSA for toddlers (mean range: 0.9-1.9 μg/kg bw, P95 range: 1.2-3.4 μg/kg bw). When using Norwegian concentration data for food categories including 16 Norwegian samples or more and EFSA data for the remaining categories, the calculated daily exposure (mean: 0.9 μg/kg bw, P95: 1.6 μg/kg bw) is in the lower range of what EFSA has calculated for toddlers. The dietary exposure for acrylamide in Norwegian 1-year-olds is within the same range as reported by EFSA for European toddlers. Although the acrylamide-concentration was lower in infant porridge (i.e. “Processed cereal-based baby food”) sampled in Norway than in those reported by EFSA, Norwegian 1-year-olds have higher consumption of infant porridge than European toddlers. In addition to infant porridge, soft bread is a major source of acrylamide in Norwegian 1-year-olds. Food categories with high potential to increase acrylamide exposure Baby food and soft bread contributed most to acrylamide exposure in the 1-year-olds, while food items contributing the most to acrylamide exposure in adults are fried potato products, coffee, biscuits, crackers and crisp breads, and soft bread. Previous Norwegian studies and EFSA (2015) showed that in all populations groups except toddlers, ‘fried potato products’ is a food group with high potential to increase acrylamide exposure. Acrylamide is also contributed by food items commonly consumed such as coffee and bread, and this is of concern in Norway as well as in the rest of Europe. The EFSA risk assessment included exposure scenarios addressing the potential impact of home-cooking habits, locations of consumption, and preferences for particular food products. These scenarios showed that food preparation, and particularly conditions of potato frying, resulted in large variations and a possible increase of acrylamide exposure by as much as 80%. VKM considers that these scenarios carried out by EFSA are equally relevant for the Norwegian population. The temperature and browning of fried potato products will have a considerable impact on the exposure to acrylamide. VKM calculated three simplified scenarios to illustrate the influence of consumption of particular food items on acrylamide exposure. These scenarios confirmed that potato crisps, French Fries and coffee are food items with high potential to increase acrylamide exposure. Risk characterisation of dietary acrylamide exposure in Norway VKM used the same reference points as EFSA (2015), and calculated Margin of Exposures (MOEs) for assessing health risk. MOE is the ratio between a reference value and the estimated dietary exposure. The MOE approach provides an indication of the level of safety but it does not quantify the risk as such. For non-neoplastic effects, EFSA used a BMDL10 value of 0.43 mg/kg bw/day as the reference point based on animal studies of neurotoxicity, and considered a substance-specific MOE of 125 or above as a sufficient safety margin for no health concern. For neoplastic effects, EFSA used a BMDL10 value of 0.17 mg/kg bw/day as the reference point based on animal studies, and taking into account overall uncertainties in the interpretation, EFSA concluded that a MOE of 10 000 or higher would be of low concern for public health. The EFSA risk assessment concluded that the MOEs for non-neoplastic effects were above 125 for all age groups indicating no health concern, whereas the MOEs for non-neoplastic effects were substantially lower than 10 000, indicating a health concern for all age groups. The dietary acrylamide exposure in Norwegian adolescent and adults reported in previous studies were within the range calculated by EFSA for these age groups. VKM therefore concludes that the resulting MOEs for non-neoplastic and neoplastic effects of acrylamide for adolescent and adults will be similar to those calculated by EFSA. VKM calculated acrylamide exposure based on food consumption in Norwegian 1-year-olds by two approaches: one using EFSA concentration data only; and the other using Norwegian concentration data for food categories including 16 samples or more, and EFSA data for the remaining categories. Both approaches resulted in comparable MOEs. For both non-neoplastic and neoplastic effects, MOEs for 1-year-olds were similar to those reported in EFSA 2015. For non-neoplastic effects of dietary acrylamide exposure, VKM reached the same conclusion as EFSA, which is that the MOEs across all age groups indicate no health concern. For neoplastic effects of dietary acrylamide exposure, VKM reached the same conclusion as EFSA, whi

Zika: a re-emerging infectious virus disease of public health concern

Zika is caused by a flavivirus transmitted by mosquitoes of the Aedes species, mainly Aedes aegypti. It causes a mild self-limiting illness in people that it infects, leaving most people asymptomatic. However, the recent rise in the spread of Zika virus predominantly in Latin America has been accompanied by unprecedented rise in a number of children being born with abnormally small heads-identified as microcephaly. In addition several countries, including Brazil, which has experienced the world largest Zika outbreaks, reported a steep increase in Guillain Barre Syndrome- a neurological autoimmune disorder that could lead to paralysis and death. Although it has not been definitively proven, evidence is growing that Zika virus causes both microcephaly and Guillain Barre Syndrome. Obviously, these reports made the World Health Organization to declare Zika as a significant global public health concern. Apart from using insecticides to control the spread of mosquitoes, several other approaches are being implemented to prevent Zika virus infection. These include vaccine development and impairing egg-laying female mosquito’s ability to transmit infection and also genetic modification and sterilization of male Aedes aegypti.

Factors Influencing Dietary Behavior in Nursing Students / 정신간호학회지

PURPOSE: The purpose of this study was to identify the level of dietary behavior in nursing students and also, to investigate factors that influence dietary behavior. METHODS: In this study, 250 nursing students who were enrolled in a university school in B city, Korea and who gave written consent completed the questionnaire. The data were collected between June 22 and 30, 2015 and analyzed using t test, one way ANOVA, Pearson correlation coefficients and multiple regression. RESULTS: The level of dietary behavior in nursing students was 3.06±0.52. Models including the variables, health concern and dietary self efficacy explained 12% of the variance for dietary behavior. Dietary self efficacy(β=.26, p<.001) was the most influential factor. CONCLUSION: Based on the outcomes of this study, steps should be taken to design intervention programs that emphasize the health dietary behavior of nursing students.

An overview of health concerns among elderly population.

Background: Urbanisation, nuclearisation of family, migration, and dual career families are making care of the elderly more and more of a personal and social problem in India. Objective: Assess the concerns about health issues among elderly people. Methodology: Community based cross-sectional study. Results: 64.4% of the elders were treated well and about 22.9% were treated very well during illness. 86.3% were consulted during illness. Son was the care taker in 55.6% of study subjects. 70.6% of elderly were consulted to allopathic practitioners / Govt Hospitals. Conclusion: It is the responsibility of family to look after elderly in respectful manner, especially during illness. The government should frame policies and provide social & economical security to elders.

Safety and Regulatory Aspects of Food Enzymes: An Industrial Perspective.

Linkages between diet habits and the quality of life continue to surface on numerous fronts. Safety concerns associated with food enzymes in general are possible allergenic, irritative and otherwise toxic properties .Oral toxicity is especially relevant to consumers of food enzymes. The regulation of enzymes internationally is quite varied between countries, with specific country either requiring a full approval process, a notification of enzyme or no requirement thereof. Pre-market approval may depend on whether an enzyme is classified as processing aid or a food additive, though the point of consideration regardless of classification is that the safety of the enzyme must be assured. Challenges to regulators and industry arise from unresolved issues and from lack of harmonization of both legislation and safety evaluation. The regulation of enzyme for Australia and New Zealand are contained within horizontal standards of processing aids. This standard regulates the use in food manufacture, stopping them from being used in food unless there is a specific permission in standard. In US enzymes classified as food additives or as GRAS, while certain enzymes are regulated as secondary direct food additives under the regulation. Finally the act permits an individual or company to decide on its own that based on the appropriate data whether an ingredient is GRAS for a particular intended use, and to market the ingredient for that use without any prior contact with the agency. In the EU, most food enzymes are not covered by food safety regulations neither on community nor on national level. On top of this availability of enzymes with new and unusual properties raises questions of safety. There seems to be a chance that these challenges will be tackled in the course of establishing a harmonized legislation on food enzymes.

Consumers' Purchasing Intentions of Organic Foods in relation to the Perceived Health Concerns, Healthy Eating Practices and Attitudes, and Food Choice Motives / 대한지역사회영양학회지

This study investigated the correlations of five constructs - health concerns, healthy eating practices and attitudes, food choice motives, attitudes toward organic foods - in the formation of behavioral to the purchasing intentions of organic foods. An instrument encompassing health perception, attitudes, habits and personal traits was developed through the comprehensive reviews of the literature and the assured validity and internal reliability of the contents. The questionnaire was administered to the students of three universities at Daegu, Kyungpook province. A total of 288 questionnaires were collected for a response rate of 96.0%. The correlations of five constructs and purchasing intention were tested simultaneously using structural equation modeling. Healthy eating practices and attitudes toward organic foods were found to be the determinants which directly influence the intention to purchase organic foods. Health concerns didn't show direct relation to the purchasing intention of organic foods. The hypothesized path from the health concerns to the purchasing intentions was not supported. The results indicated that food choice motives and healthy eating attitudes should be managed to achieve higher behavioral intention to purchase organic foods.

A Study on Health Concern, Self-rated Health, Health Status, and Health Promotion Behavior of Elderly Women in Urban Area / 간호학회지

PURPOSE: This study was conducted to examine the relationship among health concern, self-rated health, health status, and health promotion behavior of elderly women in urban areas. METHOD: The subjects of this study consisted of 271 Korean elderly women over 65years. The data was collected through personal interviews using questionnaires from March to May of 2003. The data was analyzed by the SPSS(ver.10.0) computer program, and it included descriptive statistics, t-test, one way ANOVA, and the pearson correlation coefficient. RESULT: There was a significant positive correlation between self-rated health and health status. Health promotion behavior related to all health concerns, self-rated health, and health status. CONCLUSION: This study showed that strategies of elderly care intervention to put in practice health promoting behavior is needed to improve quality of life in elderly women. In addition, health education appropriate for health maintenance and health promotion must be done fordaily living to maintain well-being for the rest of their lives.

A Study on Health Concern, Self-rated Health, Health Status, and Health Promotion Behavior of Elderly Women in Urban Area / 간호학회지

PURPOSE: This study was conducted to examine the relationship among health concern, self-rated health, health status, and health promotion behavior of elderly women in urban areas. METHOD: The subjects of this study consisted of 271 Korean elderly women over 65years. The data was collected through personal interviews using questionnaires from March to May of 2003. The data was analyzed by the SPSS(ver.10.0) computer program, and it included descriptive statistics, t-test, one way ANOVA, and the pearson correlation coefficient. RESULT: There was a significant positive correlation between self-rated health and health status. Health promotion behavior related to all health concerns, self-rated health, and health status. CONCLUSION: This study showed that strategies of elderly care intervention to put in practice health promoting behavior is needed to improve quality of life in elderly women. In addition, health education appropriate for health maintenance and health promotion must be done fordaily living to maintain well-being for the rest of their lives.

Structural Relationships among Health Concern, Health Practice and Health Status of the Disabled / 예방의학회지

OBJECTIVES: This study was performed to determine the relationships among Health concern, health practice and health status of the disabled. METHODS: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. RESULTS: Health concern had a significant and positive relationship with health practice(p2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect on health status(T>2.0). In men and women, health practice was significantly increased with increasing Health concern and the more health practice, the higher health status(T>2.0). CONCLUSIONS: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.

Structural Modeling of Health Concern, Health Practice and Health Status of Koreans / 예방의학회지

The purpose of this study was to determine the relationships among the health concern, health practice and health status of Koreans. This study utilized the data from Korean individuals(1,304 male and 1,495 females), whose ages were between 20 and 59. The data were analyzed using SAS version 6.04 and LISREL version 7.13. The analytic methods for the study were chi-square analysis and covariance structural analysis. The results of the study were as follows. (1) There were significant positive relationships between health concern level and health practice index, and between health practice index and self-perceived health status. (2)There were negative relationships between practice index and chronic illness, and between health practice index and acute illness only in female. (3) Based on the findings, the structural model of the health concern, health practice, health status and socioeconomic variables was established and then the covariance structural analysis was used. The higher educational level and economic status were, the higher the health concern was. And urban residents were much more concerned with their health than rural residents. The more persons were concerned with health, the more they did health practices. And the more the health practice was, the higher the health status was. The younger the persons were and the higher the health status of one's family was, the higher the health status was. In female, the higher the economic status was, the higher the health status was.