The Impact of Nasal Intubation on Feeding Outcomes in Neonates Requiring Cardiac Surgery: A Randomized Control Trial

Neonates who require surgery for congenital heart disease (CHD) frequently have difficulty with oral feeds post-operatively and may require a feeding tube at hospital discharge. The purpose of this study was to determine the effect of oral or nasal intubation route on feeding method at hospital discharge. This was a non-blinded randomized control trial of 62 neonates who underwent surgery for CHD between 2018 and 2021. Infants in the nasal (25 patients) and oral (37 patients) groups were similar in terms of pre-operative risk factors for feeding difficulties including completed weeks of gestational age at birth (39 vs 38 weeks), birthweight (3530 vs 3100 g), pre-operative PO intake (92% vs 81%), and rate of pre-operative intubation (22% vs 28%). Surgical risk factors were also similar including Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery category (3.9 vs 4.1), shunt placement (32% vs 41%), cardiopulmonary bypass time (181 vs 177 min), and cross-clamp time (111 vs 105 min). 96% of nasally intubated patients took full oral feeds by discharge as compared with 78% of orally intubated infants (p = 0.05). Nasally intubated infants reach full oral feeds an average of 3 days earlier than their orally intubated peers. In this cohort of patients, nasally intubated infants reach oral feeds more quickly and are less likely to require supplemental tube feeding in comparison to orally intubated peers. Intubation route is a potential modifiable risk factor for oral aversion and appears safe in neonates. The study was approved by the University of Virginia Institutional Review Board for Health Sciences Research and was retrospectively registered on clinicaltrials.gov (NCT05378685) on May 18, 2022.

Infectious keratoconjunctivitis in semi-domesticated reindeer (Rangifer tarandus tarandus): a questionnaire-based study among reindeer herders in Norway and Sweden

BACKGROUND

The effects of climate change, loss of pastureland to other land usage and presence of large carnivores are the main reasons for the increase in supplementary feeding of semi-domesticated reindeer (Rangifer tarandus tarandus) in Fennoscandia over the last decades. Feeding might expose reindeer to stress and increased animal-to-animal contact, leading to an increased risk of infectious disease transmission, such as infectious keratoconjunctivitis (IKC). As it can develop rapidly and be very painful, IKC is described as an important animal welfare concern and a potential source of economic loss. The aim of this study was to investigate the current presence of IKC and potential associations between IKC and supplementary feeding through an online questionnaire survey, distributed among reindeer herders in Norway and Sweden in 2021.

RESULTS

Seventy-six reindeer herders (33 from Norway and 43 from Sweden) responded to the questionnaire, representing 6% and 4% of the registered reindeer herding groups in Norway and Sweden, respectively. Infectious keratoconjunctivitis was common, with 54 (71%) of the 76 herders that responded having observed clinical signs during the past 10 years. These signs were mainly observed as increased lacrimation, causing "wet cheeks", but also as keratitis and conjunctivitis. Autumn and winter were the seasons in which IKC was observed most. The herders reported several measures, such as slaughter and isolation of affected reindeer, to counteract the spread of disease. The herding year 2019/2020 was associated with reports of outbreaks of IKC in herds as well as being the herding year where most herders (80%) had performed supplementary feeding. A significant association was found between IKC and feeding performed in an enclosure (odds ratio = 15.20), while feeding on free-range areas had a non-significant, negative, relationship with the appearance of IKC outbreaks (odds ratio = 0.29). Finally, there was a trend in the data suggesting that IKC affected calves especially.

CONCLUSIONS

Infectious keratoconjunctivitis is a common disease, mainly observed in winter and autumn. It usually has mild to moderately severe clinical signs. Our results imply that IKC is associated with stress and feeding situations and that calves might be more susceptible than adults, however, this needs to be confirmed with further studies, preferably at an individual animal level.

Low impact of tuberculosis severity on wild boar body condition

Body condition (BC), is a measure to assess the health status of domestic and wild animals. When food resources are abundant, a decrease in BC may indicate an increase in the energetic expenditure due to the effects of growth, reproduction, or disease. BC impoverishment is one of the most common clinical effects of diseases progressing chronically, such as animal tuberculosis (TB) caused by bacteria belonging to the Mycobacterium tuberculosis complex. The Eurasian wild boar (Sus scrofa) is the main wild TB reservoir in the Mediterranean basin. The specific aims of this work were to assess the relationship between sex, age and TB severity altogether on the BC of wild boar. For this purpose, we used the kidney fat index (KFI), to assess the impact of TB progression on the BC of 1372 hunter-harvested free-ranging wild boar in seven populations in southern Spain. Surprisingly, TB had only slight effects on wild boar BC and individuals exhibiting severe TB showed greater BC than TB-free individuals. The age (adults had greater BC than juveniles) and sex (females had greater BC than males) were the main BC determinants in wild boar. Sampling population and season explained more BC variability than individual factors, suggesting that other external factors might play an important role in the BC, and probably on the impact of the disease on this wild reservoir. The low impact of TB on wild boar BC suggests that individuals with severe TB and good BC represent potential long-term super-shedders of this pathogen.

Determinants of the exposure of Eurasian griffon vultures (Gyps fulvus) to fluoroquinolones used in livestock: The role of supplementary feeding stations

Veterinary pharmaceuticals, including antibiotics, are emerging contaminants of concern worldwide. Avian scavengers are exposed to pharmaceuticals through consumption of livestock carcasses used for feeding wildlife for conservation purposes at supplementary feeding stations. Here we tested the hypothesis that griffon vultures (Gyps fulvus) would be more exposed to antibiotics (i.e., quinolones) when feeding on livestock carcasses from intensive farming than when they rely on carcasses from extensive farming or wild animals. We sampled 657 adult griffon vultures captured between 2008 and 2012. In addition, we sampled tissues from domestic livestock supplied at feeding stations in the study area between 2009 and 2019; pig (n = 114), sheep (n = 28), cow (n = 1) and goat (n = 2). Samples were analysed by liquid chromatography with electrospray ionization mass spectrometry (LC-ESI-MS). Quinolones were detected in plasma from 12.9% of the griffon vultures analysed. Quinolone prevalence in griffon vultures varied significantly among feeding stations but was also affected by the total amount of carcasses supplemented, especially the mass of pig carcasses. These results aligned with a 21.1% quinolone prevalence in pig carcasses sampled at feeding stations, wherein enrofloxacin and ciprofloxacin levels of up to 3359 ng/g and 1550 ng/g, respectively, were found. Given enrofloxacin pharmacokinetics in pig tissues, 5.3% of the analysed pigs may have died no more than one day after treatment. Quinolone presence in vultures was negatively associated with blood lead levels, which mostly originates from lead ammunition and indicates a higher consumption of game animal carcasses. Carcass disposal for feeding avian scavengers must always assess and manage the risks posed by veterinary pharmaceuticals, especially when livestock provided may have died soon after treatment.

Effect of early oral nutrition supplement using Encover in patients undergoing hepato-biliary-pancreatic surgery

Backgrounds/Aims

Early recovery after surgery has become a popular trend. The aim of this study was to evaluate effect of nutritional intervention using Encover, an oral nutritional supplement, in patients undergoing hepato-biliary-pancreatic surgery.

Methods

This single center, prospective case-control study was conducted in Gangnam Severance Hospital from September 2018 to April 2019. Through randomization, patients were divided into an experimental group (30 patients) and a control group (30 patients). At postoperative seven days, the experimental group was instructed to take two packs of Encover (JW Pharmaceutical, Seoul, Korea) daily for seven days. Body cell mass index was measured at seven days after surgery and 14 days after discharge and Patient-Generated Subjective Global Assessment (PG-SGA) was performed at 14 days after discharge.

Results

Body cell mass index during outpatient follow-up was significantly decreased compared to that at discharge in both groups. However, the amount of body cell mass index showed no significant difference between postoperative seven days and outpatient follow- up in either group. During outpatient follow-up, the experimental group had a higher mean value of PG-SGA score than the control group (11.32 ± 3.46 vs. 9.48 ± 3.97; p = 0.037).

Conclusions

Short-term Encover doses after surgery may not produce significant results in weight gain or other body cell mass index. Encover did not significantly affect other dietary conditions based on PG-SGA.

Review: An overview of beef production from pasture and feedlot globally, as demand for beef and the need for sustainable practices increase

Beef is a high-quality source of protein that also can provide highly desirable eating experiences, and demand is increasing globally. Sustainability of beef industries requires high on-farm efficiency and productivity, and efficient value-chains that reward achievement of target-market specifications. These factors also contribute to reduced environmental and animal welfare impacts necessary for provenance and social licence to operate. This review provides an overview of beef industries, beef production, and beef production systems globally, including more productive and efficient industries, systems and practices. Extensive beef production systems typically include pasture-based cow-calf and stocker-backgrounding or grow-out systems, and pasture or feedlot finishing. Cattle in pasture-based systems are subject to high levels of environmental variation to which specific genotypes are better suited. Strategic nutritional supplementation can be provided within these systems to overcome deficiencies in the amount and quality of pasture- or forage-based feed for the breeding herd and for younger offspring prior to a finishing period. More intensive systems can maintain more control over nutrition and the environment and are more typically used for beef and veal from dairy breeds, crosses between beef and dairy breeds, and during finishing of beef cattle to assure product quality and specifications. Cull cows and heifers from beef seedstock and cow-calf operations and dairy enterprises that are mostly sent directly to abattoirs are also important in beef production. Beef production systems that use beef breeds should target appropriate genotypes and high productivity relative to maintenance for the breeding herd and for growing and finishing cattle. This maximizes income and limits input costs particularly feed costs which may be 60% or more of production costs. Digital and other technologies that enable rapid capture and use of environmental and cattle performance data, even within extensive systems, should enhance beef industry productivity, efficiency, animal welfare and sustainability.

Supplementary feeding of cattle-yak in the cold season alters rumen microbes, volatile fatty acids, and expression of SGLT1 in the rumen epithelium

Cattle-yak, a hybrid offspring of yak (Bos grunniens) and cattle (Bos taurus), inhabit the Qinghai-Tibet Plateau at an altitude of more than 3,000 m and obtain nutrients predominantly through grazing on natural pastures. Severe shortages of pasture in the cold season leads to reductions in the weight and disease resistance of grazing cattle-yak, which then affects their production performance. This study aimed to investigate the effect of supplementary feeding during the cold season on the rumen microbial community of cattle-yak. Six cattle-yak (bulls) were randomly divided into two groups-"grazing + supplementary feeding" (G+S) (n = 3) and grazing (G) (n = 3)-and rumen microbial community structure (based on 16S rRNA sequencing), volatile fatty acids (VFAs), and ruminal epithelial sodium ion-dependent glucose transporter 1 (SGLT1) expression were assessed. There were significant differences in the flora of the two groups at various taxonomic classification levels. For example, Bacteroidetes, Rikenellaceae, and Rikenellaceae_RC9_gut_group were significantly higher in the G+S group than in the G group (P < 0.05), while Firmicutes and Christensenellaceae_R-7_group were significantly lower in the G+S group than in the G group (P < 0.05). Kyoto Encyclopedia of Genes and Genomes (KEGG) and Clusters of Orthologous Groups (COG) analyses revealed that functions related to carbohydrate metabolism and energy production were significantly enriched in the G+S group (P < 0.05). In addition, the concentration of total VFAs, along with concentrations of acetate, propionate, and butyrate, were significantly higher in the G+S group than in the G group (P < 0.05). Furthermore, SGLT1 expression in ruminal epithelial tissue was significantly lower in the G+S group (P < 0.01). Supplementary feeding of cattle-yak after grazing in the cold season altered the microbial community structure and VFA contents in the rumen of the animals, and decreased ruminal epithelial SGLT1 expression. This indicated that supplementary feeding after grazing aids rumen function, improves adaptability of cattle-yak to the harsh environment of the Qinghai-Tibet Plateau, and enhances ability of the animals to overwinter.

Metabolism response of grazing yak to dietary concentrate supplementation in warm season

Supplementary feeding has a significant effect on the growth performance of grazing yaks. However, as far as is known, little information is available concerning how energy or protein feed supplementation affects the serum metabolome of grazing yaks during the warm season. We investigated the effects of supplementation with two different concentrates on the serum metabolome in grazing yaks using nuclear magnetic resonance spectroscopy in conjunction with multivariate data analysis. Twenty-four 2-year-old female yaks (133.04 ± 6.52 kg BW) were randomly divided into three groups and fed three different regimes (n = 8 per group): (1) grazing plus hull-less barley (HLB) supplementation, (2) grazing plus rapeseed meal (RSM) supplementation, and (3) grazing without supplementation. Both HLB and RSM supplementation significantly increased the average daily gain (ADG), and ADG under HLB supplementation was 11.9% higher (P < 0.05) than that of the RSM group. Supplementation markedly altered glucose, lipid, and protein metabolism, with the difference manifested as increased levels of some amino acids, acetyl-glycoproteins, low-density lipoproteins, and very low-density lipoproteins . Furthermore, the levels of 3-hydroxybutyrate, acetoacetate, and lactate metabolism were decreased. Serum metabolite changes in yaks in the HLB supplementation treatment differed from those in the RSM supplementation treatment; the difference was primarily manifested in lipid- and protein-related metabolites. We conclude that both the energy supplementation (HLB) and the protein supplementation (RSM) could remarkably promote the growth of yak heifers during the warm season, and the effect of energy supplementation was superior. Supplementary feeding changed the serum metabolite levels of yak heifers, indicating that such feeding could improve glucose's energy-supply efficiency and increase the metabolic intensity of lipids and proteins. Supplementation of yaks with HLB was more efficient in the promotion of yak glucose and protein anabolism compared to supplementation with RSM, while having a lesser effect on lipid metabolism.

Use of lucerne hay in ruminant feeds to improve animal productivity, meat nutritional value and meat preservation under a more variable climate

This study investigated the effect of low energy (LE) and high energy (HE) diets fed to Crossbred and Merino sheep on carcass weight, meat nutritional value (essential fatty acids) and preservative (shelf life) aspects. Animals were slaughtered after seven weeks of feeding and the longissimus lumborum (LL) and rectus femoris (RF) muscles collected for measurement of fatty acid concentration and retail colour. Liveweight and carcass weight at slaughter were not affected by dietary treatments. Adding lucerne hay as an ingredient to LE diet increased (P < .001) omega-3 fatty acids concentrations and lowered (P < .001) the omega-6: omega-3 ratio in meat. The redness of meat for LL and RF muscles at simulated retail display was higher (P < .05) for lambs fed LE than lambs fed HE diet. Results indicate that adding lucerne hay as an ingredient in ruminant diets has potential for maintaining liveweight (wellbeing) of animals as well as nutritional value and preservative aspects of meat.

Effects of supplementary feeding on the rumen morphology and bacterial diversity in lambs

Early supplementary feeding of lambs before weaning is important to meet their nutritional needs, promote the development of rumen and improve performance. To study the effect of early supplementary feeding on rumen development and the microbiota of lambs, 22 Hu lambs were randomly divided into two groups: one group was fed with milk replacer (group C), and the other group was fed with milk replacer and starter (group S). At 28 days, six lambs in each group were slaughtered, and the rumen content and tissue samples were collected for detection and analysis. The starter significantly promoted the length of rumen papilla (P = 0.03), the concentration of acetate, propionate, butyrate and total volatile fatty acids (TVFA) (P < 0.01), which were higher in group S compared with group C. Group C had a higher rumen microbial diversity than group S. The dominant bacteria in the two groups were the same (Bacteroidetes, Firmicutes and Proteobacteria); however, they differed notably at the genus level. The microbial abundance of the two groups was significantly different for 22 species. In group C, the first three dominant bacteria were Bacteroides, Porphyromonas, and Campylobacter, while in group S they were Succinivibrio, unidentified_Prevotellaceae, and unidentified_Lachnospiraceae. Spearman correlation analysis showed that some ruminal bacteria were closely related to internal environmental factors, e.g., the relative abundances of unidentified_Bacteria, Euryarchaeota, Fusobacteria, and Gracilibacteria correlated negatively with acetate, propionate, butyrate, and TVFA (P < 0.05), while the relative abundances of Firmicutes correlated positively with acetate, propionate, butyrate and TVFA (P < 0.05). Bacteroidetes correlated negatively with propionate, butyrate, and TVFA (P < 0.05); Synergistetes correlated negatively with acetate, propionate, and butyrate (P < 0.05); Deinococcus-Thermus correlated negatively with propionate, butyrate, and TVFA (P < 0.05); Spirochaetes correlated negatively with propionate and TVFA (P < 0.05); and Elusimicrobia correlated negatively with propionate and butyrate (P < 0.05). Actinobacteria and Verrucomicrobia correlated positively correlated with NH₃-N. In conclusion, supplementary feeding of lambs before weaning promoted the development of rumen tissue morphology and rumen microorganisms.

Whey protein ingestion in elderly diet and the association with physical, performance and clinical outcomes

Nutrition is critical to the health of the elderly, since most of them have a deficiency in key nutrient. The use of whey protein may be a food strategy to increase protein intake. The objective of this work was to evaluate the ingestion of whey protein for the elderly and the association with physical performance and clinical outcomes. A systematic review was conducted in order to find papers that shed some light in the correlation between whey protein and the elderly.

INCLUSION CRITERIA

population: elderly; intervention: use of whey protein when compared to control group; outcome: related to health, nutrition, or quality of life.

DATABASE

PubMed, with papers published in the last 5 years.

SEARCH STRATEGY

(elder OR senior OR elderly OR aging OR aged OR old OR older) AND (whey OR "whey protein"). 35 papers were selected of which 22 had a physical performance outcome and 13 had clinical outcomes. Studies indicate that whey protein supplements promote protein synthesis in the elderly, improving muscle performance and aerobic capacity, protecting against sarcopenia and reducing the risk for falls. In the papers studied, the age group considered to be elderly was ≥65 years in 27 papers and ≥60 years in the other 8 papers. Whey protein also appears to contribute to improved health, recovery from disease, prevention of cardiovascular and metabolic risks, and hepatic steatosis complications. Data suggest that whey protein supplements may be promising for the health improvement of the elderly.

Impact of stakeholder perspectives on cost-effectiveness estimates of four specialized nutritious foods for preventing stunting and wasting in children 6-23 months in Burkina Faso

Background

Multiple specialized nutritious food options are programmed for supplementation in humanitarian and development settings. However, comparative cost-effectiveness evidence is lacking, let alone incorporation of perspectives from uncompensated stakeholders. A Burkina Faso trial evaluated the cost-effectiveness of Corn Soy Blend Plus w/ oil (CSB+ w/oil, reference arm), Corn Soy Whey Blend w/oil (CSWB w/oil), Super Cereal Plus (SC+), and Ready-to-Use Supplementary Food (RUSF) in reducing stunting and wasting among children 6–23 months old. This paper presents cost-effectiveness findings from multiple stakeholders’ perspectives, including caregivers and program volunteers.

Methods

An activity-based costing with ingredients approach was used to summarize cost of the 18-month-long blanket supplementary feeding for each enrolled child (in 2018 USD). Time data were collected using self-reported and observational instruments. Cost-effectiveness relative to CSB+ w/oil assessed incremental cost per enrolled child against incremental outcomes: prevalence of stunting at 23 months of age and number of months of wasting. Two combined perspectives were compared: program (donor, implementer, and volunteer) versus program and caregiver (adding caregiver).

Results

A total of 6112 children were enrolled. While similar effectiveness was found in three arms (CSWB w/oil was less effective), costs differed. Product cost and caregiver time to prepare study foods were major drivers of cross-arm cost differences from the respective combined perspective. The two major drivers were used to construct uncertainty ranges of cost per enrolled child from program and caregiver perspective: $317 ($279- $355) in CSB+ w/oil, $350 ($327- $373) in CSWB w/oil, $387 ($371- $403) in RUSF, and $434 ($365- $503) in SC+. Cost from program and caregiver perspective was a substantial increase from program perspective. CSB+ w/oil was most cost-effective in reducing stunting and wasting, and this main finding was robust to changing perspectives and all corresponding sensitivity analyses when uncompensated time was valued at minimum wage ($0.36/h). The break-even point for uncompensated time valuation is >$0.84/h, where RUSF became the most cost-effective from the program and caregiver perspective. Relative cost-effectiveness rankings among the other three arms depended on choice of perspectives, and were sensitive to values assigned to product cost, international freight cost, opportunity cost of time, and outcomes of a hypothetical control. Volunteer opportunity cost did not affect arm comparisons, but lack of compensation resulted in negative financial consequences for caregivers.

Conclusions

Evaluating cost-effectiveness by incorporating uncompensated stakeholders provided crucial implementation insights around nutrition products and programming.

Trial registration

Trial registration number: NCT02071563.

Name of registry: ClinicalTrials.gov

URL of registry: https://clinicaltrials.gov/ct2/show/NCT02071563?type=Intr&cond=Malnutrition&cntry=BF&draw=2&rank=9

Date of registration: February 26, 2014.

Date of enrollment of first participant: July 2014.

Additional food supplements as a tool for biological conservation of predator-prey systems involving type III functional response: A qualitative and quantitative investigation

Provision of additional food supplements for the purpose of biological conservation in ecosystems has of late been intensely researched by agriculturalists, biologists and mathematicians. The study of these ecosystems is usually done using the predator-prey systems. In these ecological studies it has been observed that the quality and quantity of additional food supplements provided play a crucial role in the growth of the predators and thereby influence the eventual state of the ecosystem. Also, in some of the ecological experiments it has been observed that predators exhibit non-optimal foraging behaviour in the presence of additional food. Findings also show that the predators exhibit a Holling type II response towards a target prey with predation highest at low prey densities. The results suggest that predation by predators is unlikely to stabilize low density prey populations. This can be attributed to the prey detectability independent nature of the type II response. In nature, sigmoidal functional responses such as the Holling type III response, have been documented in organisms from various taxa. In this kind of type III response the predators exhibit low detectability nature at low prey densities. Due to this the ecosystem tends to get stabilized at low prey densities avoiding the oscillations encountered in type II response. Motivated by these studies, in this paper, we consider a predator-prey system provided with additional food where the predator is assumed to exhibit Holling type III functional response towards the available food and the additional food supplements provided are assumed to be of constant density. We also assume that the predators are not optimal foragers. The model is analyzed in the control parameter space using the control parameters, quality and quantity of additional food. It is observed that the system exhibits apparent competition only when the predators are provided with high quality additional food supplements. Further, it has been shown that the ecosystem tends to get stabilized at low prey densities and the system can be steered to a desired state by a suitable choice of additional food supplements. Provision of low quality additional food supplements can result in completely opposite results to the expected ones.

Effective delivery of social and behavior change communication through a Care Group model in a supplementary feeding program

BACKGROUND

In 2014, an intervention aimed at increasing the oil in corn soy blend (CSB) porridge prepared by caregivers of children with moderate acute malnutrition was implemented in Southern Malawi. This analysis describes the flow of key messages delivered through the Care Group model during this intervention.

METHODS

The intervention provided a supplementary food ration of CSB and oil and used a Care Group model in which healthcare workers were trained to deliver social and behavior change communication (SBCC) to care group volunteers who then delivered messages to caregivers of beneficiary children. Healthcare workers also delivered messages to caregivers directly. Interviews and focus groups were conducted with all three groups in order to determine the exchange of key messages about ingredient use, storage, and purpose, which were analyzed descriptively.

RESULTS

Analysis of SBCC flow and information exchange showed that 100% of caregivers reported learning about the amounts of oil and CSB to use while preparing porridge and over 90% of caregivers, healthcare workers, and care group volunteers reported talking about it. Focus groups confirmed an effective flow of communication among these three groups.

CONCLUSION

This analysis evaluated the flow of key SBCC messages through multiple, overlapping lines of communication among healthcare workers, care group volunteers, and caregivers; the effective transmission of these SBCC messages through this model may contribute to the success of a supplementary feeding intervention program.

TRIAL REGISTRATION

The study was registered at ClinicalTrials.gov ( NCT01873196 ).

Age at introduction of ultra-processed food among preschool children attending day-care centers

OBJECTIVE

To identify the age of introduction of ultra-processed food and its associated factors among preschool children.

METHODS

Cross-sectional study carried out from March to June 2014 with 359 preschool children aged 17 to 63 months attending day-care centers. Time until ultra-processed food introduction (outcome variable) was described by the Kaplan-Meier analysis, and the log-rank test was used to compare the survival functions of independent variables. Factors associated with ultra-processed food introduction were investigated using the multivariate Cox proportional hazards model. The results were shown as hazard ratios with their respective 95% confidence intervals.

RESULTS

The median time until ultra-processed food introduction was six months. Between the 3rd and 6th months, there is a significant increase in the probability of introducing ultra-processed food in the children's diet; and while the probability in the 3rd month varies from 0.15 to 0.25, at six months the variation ranges from 0.6 to 1.0. The final Cox proportional hazards model showed that unplanned pregnancy (1.32 [1.05-1.65]), absence of prenatal care (2.50 [1.02-6.16]), and income >2 minimum wages (1, 50 [1.09-2.06]) were independent risk factors for the introduction of ultra-processed food.

CONCLUSION

Up to the 6th month of life, approximately 75% of preschool children had received one or more ultra-processed food in their diet. In addition, it was observed that the poorest families, as well as unfavorable prenatal factors, were associated with early introduction of ultra-processed food.

Occurrence of veterinary pharmaceuticals in golden eagle nestlings: Unnoticed scavenging on livestock carcasses and other potential exposure routes

Wildlife exposure to pharmaceuticals can occur through contaminated water, and through the excreta and carcasses of medicated livestock, with potential for bioaccumulation and transfer through food webs. We evaluated whether nestling exposure to pharmaceuticals can occur from food delivered to nests in the golden eagle (Aquila chrysaetos), a top predator and facultative scavenger. Despite the fact that diet analysis suggests an apparently low dependence on livestock carcasses reduced to two piglets remains (1.5% of food remains, n=134), a high proportion of nestlings (71%, n=7) showed fluoroquinolone residues in plasma, mostly enrofloxacin, which is exclusively used in veterinary treatments. The occurrence and concentration (54.5±6.6μg·L^-1) of fluoroquinolones in plasma was similar to those found in the nestlings of three vulture species largely dependent on livestock carcasses obtained at supplementary feeding stations, which are managed for the conservation of their populations. Although the number of analysed eaglets is comparatively small, the fact that enrofloxacin was found in all nests sampled in three breeding seasons suggest an exposure to the drugs similar to that of vultures. An underestimation of the role of carrion, especially from small piglets whose consumption may have gone unnoticed, and the predation of semi-domestic prey and generalist prey exploiting carcasses of medicated livestock, can contribute to explaining the unexpectedly high occurrence of these drugs in eaglets.

Supplementary feeding and endoparasites in threatened avian scavengers: Coprologic evidence from red kites in their wintering stronghold

Many obligate and facultative avian scavengers are increasingly dependent on food provided in supplementary feeding stations (SFS), which are managed for the conservation of these species. Deliberate feeding can influence disease-related host demography and population dynamics through physiological changes and density-dependent parasite acquisition and transmission, but information on this threat to avian scavengers is scarce. Due to their effects on host aggregation and density, we hypothesised that the predictability and concentration of food in SFS can exacerbate parasite infection. This hypothesis was tested by comparing the prevalence, richness, abundance and mixed infection of endoparasites (coccidia and helminths) in red kites Milvus milvus foraging on livestock carcasses (mostly of pigs and poultry) in overcrowded and confined conditions at SFS, relative to those foraging alone or in small groups on wild prey unevenly randomly distributed within large areas during winter, mostly wild rabbits (Oryctolagus cuniculus). No clear differences were found between areas with and without SFS in the prevalence and abundance of oocyst of Eimeria. This coccidian genus appears to include parasites of the prey rather than the raptors, thus representing parasite transport or pseudo-parasitism rather than actual parasitism in the kites. A higher prevalence and richness of helminths, as well as mixed infections with several phyla, was found in kites exploiting SFS than in those feeding on wild prey in the area without SFS. The unsanitary conditions derived from the stack of livestock carcasses and the contamination of carrion with the faeces of multiple scavenger hosts can increase the accumulation and persistence of helminths eggs and intermediate hosts. The regular use and frequent confinement of large numbers of red kites at SFS can promote the spread of parasites to a large proportion of the European breeding population distributed across Spain during the winter. We encourage that carcasses of free roaming livestock can be left in the countryside, as well as the conservation management of wildlife exploited as food by red kites (especially wild rabbits), to attempt avoiding overcrowded and confined conditions at SFS. Further research is required to assess the impact of deliberate feeding on the spread of parasites and other disease agents in the threatened species SFS are intended to favour.

Patterns And Determinants Of Breast Feeding Among Mother Infant Pairs In Dera Ghazi Khan, Pakistan

BACKGROUND

Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. The objective of the present study was to determine the patterns and explore the determinants associated with breast feeding practices among the nursing women in Dera Ghazi Khan.

METHODS

A cross sectional study was conducted on randomly selected lactating mother infant pairs in Dera Ghazi Khan. Structured questionnaire was used for data collection. Analysis was done by using SPSS, chi square test was applied to see the association between breast feeding practices and its determinants such as knowledge of breast feeding practices.

RESULTS

Majority 372 (93%) of mothers mentioned that they had ever breastfed the youngest child. About 292 (73%) mothers gave colostrum to the child, and 48 (12%) exclusively breastfed. Weaning babies before four month of age was practiced by 84 (21%) of the mothers, 120 (55%) mothers started weaning at 4-6 months of child age, while 72 (18%) started to give additional food after baby turned six months old. Out of total 276 (69%) mothers reported that they had knowledge regarding breast feeding. Significant association was found between knowledge of breastfeeding and initiation and Exclusive Breast Feeding (EBF) practices (p-values <0.05). Income, family type, mode of delivery and assistance for child were significantly associated with initiation of breastfeeding within one hour after birth (p-value <0.001).

CONCLUSIONS

Breast feeding practices in the studied area were not up to the mark. There is a strong need to improve the breastfeeding practices by Behavior Change Communication.

Influence of management and biological factors on the parasitic invasions in the wild-spread of blood-sucking nematode Ashworthius sidemi in European bison (Bison bonasus)

The full course of new parasite introductions in wild animals is difficult to accurately trace. We documented and analysed the invasive blood-sucking nematode Ashworthius sidemi (Trichostrongylidae) introduction and spread in European bison (Bison bonasus) from the initial phase of its progression. In the Polish part of the Białowieża Primeval Forest (BPF) the parasite was first found in 2000. From 2002 to 2015, 165 culled bison were investigated. The prevalence and intensity of A. sidemi Schulz, 1933 infection increased over the following years, reaching 100% of investigated bison four years after introduction and a maximal median intensity of 8200 nematodes per animal in the winter of 2008/2009. Afterwards, a significant decline of median infection intensity was observed to the minimum value of 410 nematodes per animal. Between 2011 and 2014 prevalence varied from 89 to 100%. Among the factors analysed, the number of years since introduction, herd size, age and sex proved to significantly influence infection intensity. A higher infection intensity was recorded in sub-adults compared to juveniles and adults. Males had significantly lower infection intensity than females, but this was the case for adults only. The highest infection intensities were recorded in the biggest bison herds, where the winter supplementary feeding of bison is intense. Moreover, the longer the parasite was present in the host population, the more important herd size became as a factor. Our study indicates that it is not solely biological factors that determine the spread of a newly detected parasite in wildlife, but that management practices can also have a strong influence. This is especially important in endangered species under intensive human care as the management practices may pose a threat to the species.

Determination of fluoroquinolone antibiotic residues in the plasma of Eurasian griffon vultures (Gyps fulvus) in Spain

Due to the possible toxicological impact, the accumulation of pharmaceuticals in wildlife as a consequence of human practices is of growing concern. The consumption of carrion at feeding stations - the so-called 'vulture restaurants' - with no management of the veterinary drugs it contains may expose scavengers to pharmaceuticals. To demonstrate this, we analyzed plasma from Eurasian griffon vultures (Gyps fulvus) originating from two different areas of Spain for antibiotics such as enrofloxacin and ciprofloxacin, its primary metabolite. Quinolone residues were detected in about 65% (n=106) of birds, of which 15.1% (16/106) had quantifiable amounts of enrofloxacin (0.049±0.102μg/mL) and 5.7% (6/106) of ciprofloxacin (0.009±0.007μg/mL). The differences in exposure between the two sampled areas are attributable to different types of carrion management: the vultures that fed in areas with a high density of dead livestock (supplied directly to feeding stations) were more prone to exposure than those that sought food in areas where carcass availability is more unpredictable. Our findings are evidence that vultures have access to medicated livestock and that there are quantifiable levels of livestock antibiotics in vulture plasma. However, the vultures analyzed in this study had maximum antibiotic concentrations of only 0.4μg/mL, much less than the concentrations used in the clinical treatment of scavengers and a level that is probably too small to cause intoxication.

Wildlife contamination with fluoroquinolones from livestock: Widespread occurrence of enrofloxacin and marbofloxacin in vultures

There is much recent interest in the presence and impact of veterinary pharmaceuticals in wildlife. Livestock carcasses are often disposed of in supplementary feeding stations for avian scavengers, as a management and conservation tool for these species worldwide. In feeding stations, vultures and other scavengers can consume carcasses almost immediately after disposal, which implies the potential ingestion of veterinary pharmaceuticals as a non-target consequence of supplementary feeding. Using UPLC-MS/MS and HPLC-TOF, we evaluated the presence and concentration of fluoroquinolone residues in plasma of nestling vultures feeding on domestic livestock carrion. Three different fluoroquinolones (marbofloxacin, enrofloxacin and its metabolite ciprofloxacin) and a non-targeted β-lactam (nafcillin) were detected in vulture plasma. The high proportion of individuals (92%) with fluoroquinolone residues at variable concentrations (up to ∼20 μg L(-1) of enrofloxacin and ∼150 μg L(-1) of marbofloxacin) sampled in several geographically distant colonies and on different dates suggests that these and other drugs were potentially ingested throughout nestling development. Contamination with veterinary fluoroquinolones and other pharmaceuticals should be considered as an unintended but alarming consequence of food management in threatened wildlife.

Effect of maternal vitamin A supplementation on retinol concentration in colostrum

OBJECTIVE

To investigate the effect of vitamin A supplementation on the retinol concentration in colostrum under fasting and postprandial conditions.

METHODS

This was a quasi-experimental study, with before and after assessments, conducted with 33 patients treated at a public maternity hospital. Blood and colostrum samples were collected under fasting conditions in the immediate postpartum period. A second colostrum collection occurred two hours after the first meal of the day, at which time a mega dose of 200,000 IU of retinyl palmitate was administered. On the following day, the colostrum was collected again under fasting and postprandial conditions. Serum and colostrum retinol concentrations were determined by high performance liquid chromatography.

RESULTS

The serum retinol concentration was 37.3 (16.8-62.2) μg/dL, indicating adequate nutritional status. The colostrum retinol concentration before supplementation was 46.8 (29.7-158.9) μg/dL in fasting and 67.3 (31.1-148.7) μg/dL in postprandial condition (p < 0.05), showing an increase of 43.8%. After supplementation, the values were 89.5 (32.9-264.2) μg/dL and 102.7 (37.3-378.3) μg/dL in fasting and postprandial conditions, respectively (p < 0.05), representing an increase of 14.7%.

CONCLUSIONS

This study demonstrated that maternal supplementation with high doses of vitamin A in postpartum resulted in a significant increase of the retinol concentration in colostrum under fasting conditions, with an even greater increase after a meal.

[A structural model for primiparas' breastfeeding behavior]

PURPOSE

The study was done to construct and test a structural model to explain primipara breastfeeding behavior.

METHODS

The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs.

RESULTS

Fitness statistics for the hypothetical model were appropriate (χ² =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, χ²/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior.

CONCLUSION

The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.

Contrasting effects of supplementary feeding of insects or mineral nutrients on the growth and nitrogen and phosphorous economy of pygmy species of Drosera

Growth responses and accumulation of N and P were studied in two pygmy south-west Australian species of Drosera following supplementary feeding of arthropods (collembolans, Hypogastrura vernalis and fruit flies, Drosophila melanogaster) and/or a balanced mineral nutrient supplement (N as nitrate) via the roots. One feeding experiment used glasshouse-raised germlings from vegetative propagules (gemmae) of the perennial Drosera closterostigma, the other three (two on D. closterostigma and one on the annual D. glanduligera) involved natural populations engaging in natural captures of indigenous prey. All experiments recorded highly significant increases in plant dry matter, N and P (all plant age groups) and in reproductive performance (adult plants only) from artificial feeding of arthropods, but no apparent benefits from minerals alone or additive effects of minerals above that due to insects. Unresponsiveness to mineral nutrients was suggested to relate to inability of the species to use nitrate, while up to three-fold growth and nutrient uptake response to insects indicated that growth of natural populations might be severely limited by inadequate catches of prey. It is concluded that the highly nutrient-poor conditions typical of the habitat of pygmy species of Drosera may have promoted marked specialization towards carnivory and an attendant decline in ability to utilize soil-derived sources of nutrients.