Establishing the sex-of-origin for beef products is an important consideration for distinguishing between endogenous and exogenous hormone sources. A quantitative polymerase chain reaction (qPCR) assay was developed to determine the sex of store-bought beef products, which detected as little as 0.003% male in a female sample. Of the 213 store-bought beef steak and organ samples, 56% originated from males and 44% from females. Among ground beef samples (n = 108), 78.7% were mixed male/female, 16.7% were male, 3.7% were female contaminated with a low-level of male, and 0.9% were female. Liquid chromatography tandem-mass spectrometry was used to quantify 12 endogenous or synthetic hormones/hormone growth promotants (HGP) in 517 beef samples. Meat, organs and adipose from steers implanted with HGP served as positive controls for sex genotype and hormone-treatments. Among all samples tested, two HGP (trenbolone, n = 2; and melengestrol acetate, MGA, n = 78) were detected. Two endogenous hormones that potentially originated from HGP, namely progesterone (P4; n = 140) and testosterone (n = 23), were also detected. MGA and P4 were highest in female samples (P < 0.0001), testosterone was highest in male samples (P < 0.05), while testosterone levels correlated with epitestosterone in male samples (R2 = 0.33). Based on the sexing of samples, all P4 and testosterone detections were almost certainly from endogenous sources. MGA was detected in seven male samples, two organic samples and six samples marketed as "Hormone Free", which was inconsistent with product usage guidelines or label claims. These results demonstrate the efficacy of qPCR for determining the sex of store-bought beef for identifying the origin of residual hormones.
The genetic identity of coffee cultivars is fundamental to the specialty coffee sector, where premium prices are paid under the assumption that the purchased planting material corresponds to the declared variety. However, many producing countries lack the certification infrastructure necessary to guarantee this identity in their informal seed systems, exposing producers to undetected varietal non-conformity. In this study, we examine a case from a specialty coffee (Coffea arabica L.) farm in southern Ecuador where seeds labeled as Sidra (USD 100/kg) and Gesha (USD 500/kg) were purchased without genetic or phytosanitary certification. Using a combination of SSR-based DNA fingerprinting and quantitative morphological characterization, including plant architecture, leaf functional traits, and fruit characteristics, we documented varietal identity and assessed the discriminant capacity of morphological traits across the four resulting morphotypes. Using eleven microsatellite markers for SSR fingerprinting, we found that two of the four morphotypes did not match their declared commercial identity. One plant sold as Sidra was identified as compatible with Batian, a composite variety of Kenyan origin that is genetically unrelated to Ethiopian landraces. The plants acquired as Gesha corresponded to a pure Ethiopian landrace that is genetically similar to, but not identical to, the Panamanian Geisha reference accession T.02722. Only two morphotypes were confirmed as Sidra. Furthermore, the placement of Sidra within the Core Ethiopia genetic group is consistent with prior population-level analyses and with its likely status as a selected Ethiopian landrace rather than a variety of hybrid origin. Morphological linear discriminant analysis achieved 82.4% overall classification accuracy under leave-one-out cross-validation (LOOCV), with internode length dominating the first discriminant function (LD1 = 66.6%). These results demonstrate that varietal nonconformity in the specialty coffee seed sector can extend to the inadvertent introduction of genetically unrelated material and underscore the urgent need for accessible seed certification.
Over six million students study abroad each year, and many experience culture shock. Engaging with a new food culture often changes eating habits, and dietary acculturation can be challenging for young people. However, little is known about this process among international students in the Nordic context and how it affects their health and well-being. This study aimed to explore the main challenges international students face concerning food choices and eating habits after encountering Norwegian food culture. Ten international students at a university in Southern Norway were interviewed using semi-structured face-to-face interviews. Data were analysed using inductive codebook thematic analysis within an applied orientation. Five main themes were identified: food cost, missing the taste from home, food literacy, language barriers, and the social aspects of eating. Food cost was identified as the most significant challenge, possibly influencing food choices and eating habits, particularly among non-European students. International students in Norway face several food-related challenges similar to those reported elsewhere, which may negatively affect both their diet quality and their social and emotional well-being. These insights provide perspectives on practical, social, and emotional aspects of cultural adaptation, informing potential support measures for international students in the Nordic context.
Incorporation of peanut oral immunotherapy (OIT) into clinical practice is increasing, but the approaches used and reported outcomes vary. Our aim was to describe a volume-based dosing approach for OIT using store-bought peanut powder in a pediatric population and report initial outcomes. A standardized, volume-based OIT protocol using non-pharmaceutical-grade peanut powder was developed at a single academic center. Retrospective chart review was completed for patients (aged 8 months-18 years) who underwent single-food peanut OIT using this approach. OIT effectiveness was evaluated by determining the proportion of patients who (1) reached maintenance therapy and (2) tolerated a cumulative desensitization challenge using 6 g of peanut protein after 1 year of high-dose maintenance therapy. Tolerance to alternative peanut products with estimated equivalent peanut protein was also evaluated. Safety was assessed through clinical reporting of adverse reactions, retrospective assessment of severity of reaction symptoms, epinephrine use, and diagnosis of eosinophilic esophagitis. Of the 76 patients, 82% reached maintenance therapy. The 31 patients who achieved a high daily maintenance dose for at least 1 year completed a desensitization challenge; 94% demonstrated clinical tolerance. All patients challenged with equivalent doses of alternative peanut products were tolerant. The most common adverse symptoms were gastrointestinal symptoms (43%); 5 patients (6.6%) received treatment with epinephrine, and 1 patient (1.3%) was diagnosed with eosinophilic esophagitis. A volume-based approach using store-bought peanut powder can be implemented in clinical practice for oral desensitization in pediatric patients with peanut allergy. Although mild adverse symptoms are common, patients can tolerate transitions between peanut products, and some tolerate desensitization challenge, allowing for limited dietary consumption.
Beekeepers in the continental United States cannot obtain USDA organic certification because interim recommendations require more organic-certified land for foraging than is available surrounding most apiaries. To test whether organic farms in the Northeast USA provide sufficient forage for organic honey production, we established 72 colonies using organic management practices on six large organic farms (mean: 1 km2, 249 ac.) in 2023, where natural and seminatural habitats comprised 56-93% of land within a 3 km radius. In 2024, we screened the resulting honey for 96 pesticide residues, compared contamination to 20 brands of store-bought organic and conventional honey, and tested whether landscape composition predicted contamination. Pesticide contamination in honey from Northeast USA organically managed colonies was low, comparable to store-bought certified organic honeys, and lower than conventional honey. Landscape composition did not predict contamination, but may reflect a limited number of sites and narrow range of landscape conditions. Only one sample from Northeast USA organically managed colonies exceeded maximum residue limits (MRLs) for organic honey. These results suggest that organic colony management on farms where natural and seminatural habitats dominate the surrounding landscape (>56%) can produce honey with pesticide contamination comparable to certified organic products. Despite being certified organic, 30% of Hawaiian honeys contained amitraz metabolite residues above MRLs, potentially via in-hive contamination. While the required 6.4 km forage and surveillance zone surrounding apiaries has excluded continental USA beekeepers from organic certification, preventing in-hive chemical contamination may be as important as maintaining organic foraging zones to produce certified organic honey.
Poor diet is a leading risk factor of non-communicable diseases. Product placement strategies in retail outlets can influence customers' food preferences. The United Kingdom government introduced legislation in October 2022 restricting chain retailers from using location promotions on unhealthy food and drinks. High-quality scientific evidence is needed to inform the inclusion of healthier product placement approaches into these regulations. In the context of Brexit, COVID-19 and the cost-of-living crisis, this study assessed whether positioning an expanded fresh fruit and vegetable section near store entrances in discount supermarkets, which do not routinely market produce this way, improved store sales, household purchasing and diet. This natural experiment had a prospective matched controlled cluster design, involving 36 stores (18 intervention and 18 control) across England. The intervention was implemented continuously for 6 months. Control stores were matched on store sales, customer profiles and neighbourhood deprivation. Participants were women, aged 18-60 years, with loyalty cards and were assigned to their primary store (n = 280 intervention and n = 300 control). Weekly store sales and household data from loyalty cards were provided by the collaborating supermarket chain. Dietary quality, household food waste and demographic characteristics were collected through questionnaires. A process evaluation and economic evaluation were completed. Store-level sales of fruit and vegetables were greater in intervention stores than predicted at intervention implementation and 3 and 6 months' follow-up, equivalent to ≈ 2525, ≈ 1940 and ≈ 1450 extra portions per store per week, respectively. Effect sizes were somewhat stronger in stores where the produce section moved forwards more than 14 m. The proportion of households purchasing fruit and vegetables were somewhat protected among intervention compared to control participants after 3 and 6 months. Changes in dietary quality were small but generally in the expected direction for health benefit. Changes in frequency of household fruit and vegetable waste were negligible at 3 months' follow-up but increased at 6 months. The intervention was implemented according to the study protocol, with marked differences in the positioning of fresh fruit and vegetables between intervention and control stores post-intervention implementation. Fresh fruit and vegetable availability increased post intervention in intervention compared with control stores. Interviews with store staff demonstrated that changes in staff attitudes had a positive reinforcing effect on intervention implementation. Assessment of the policy context showed that stakeholders across the food system largely support the United Kingdom government's unhealthy placement ban; some felt it does not go far enough. This study shows that positioning produce sections near supermarket entrances can improve the nutrition profile of store sales and may improve household purchasing and diet. The United Kingdom Food (Promotion and Placement) Regulations could be refined to require a produce section near supermarket entrances to increase its health impact. Future research should continue to build the evidence for which healthy eating interventions are effective in retail outlets. Further evaluations of real-world supermarket intervention studies using robust scientific study designs are required, alongside process and economic evaluations, to provide evidence for policy intervention to improve retail food environments in the United Kingdom and internationally. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number 17/44/46. Supermarkets are a major source of food for families. Discount supermarkets have less-healthy environments than other supermarkets and are used more by families living on lower incomes. We worked with a United Kingdom discount supermarket chain to assess if moving a bigger fresh fruit and vegetable section near store entrances improves what people buy. A total of 580 women aged 18–60 years who regularly shopped at one of 36 stores (18 with changes and 18 with no changes) across England took part. Women did a survey over the phone four times (once before the change in layout and 1, 3 and 6 months after). The survey asked about the foods they and their young children (aged 2–6 years) usually ate, where they shopped for food and how much they spent each week, as well as their age, number of children and highest educational qualification. Information about the food each woman bought from loyalty card data and the total sales of fruit and vegetables for each store in the study was given by the supermarket. We found that the sales of fruit and vegetables were higher in stores where they had been moved to the front when compared to stores where they remained at the back of the store, though the size of the impact decreased over time. We found that during the time of Brexit, COVID-19 and the cost-of-living crisis, all families bought fewer fruit and vegetables over time. Families who shopped mostly at study stores with fruit and vegetables near the front entrance had a smaller decline in fruit and vegetable purchases than families who shopped at stores with fruit and vegetables towards the back. Our study provides new information that governments could use to make all supermarkets place fruit and vegetables near the front of their stores so people buy and eat more fresh produce.
What makes persuasive messages effective: expressing attitudes, describing behaviors, or combining both? Across two preregistered experiments (total N = 1,506) and an internal meta-analysis, we compared attitudinal statements (e.g., “The car was good” or “I liked the car”), behavioral statements (e.g., “I bought the car” or “I intended to buy the car”), and combined attitudinal–behavioral statements (e.g., “The car was good, and I bought it,” or “I recommended buying the car”). Participants read positive or negative social media messages about various products and reported their attitudes, perceived norms, and behavioral intentions. Mixed-effects models revealed that combined attitudinal–behavioral statements had the strongest persuasive impact, attitudinal statements had a moderate impact, and behavioral statements had the weakest impact. These effects were mediated by mental simulation of behavior, generalized across higher- and lower-value products, and were confirmed in a network meta-analysis. These findings advance theory and application in communication by showing how integrating attitudinal and behavioral content enhances persuasion.
The hyacinth bean (Lablab purpureus L.), is a major winter legume in Bangladesh. However, there is very little information on how different cultivars and developmental stages of this legume affect its nutritional profile concerning pod composition. Consequently, the purpose of this study was to determine how both genotype and developmental stage (maturity) affect the morphological characteristics, proximate composition, phytochemical characteristics, and mineral composition of hyacinth bean pods grown in Bangladesh. We examined six commercially grown genotypes, which included four improved BARI cultivars collected at three stages (immature, premature, and mature) from four different BARI research stations throughout Bangladesh, as well as two local varieties bought from Chattogram markets. The morphological characteristics were measured using precision measuring devices and included total stem and leaf area, total pod and seed weight, and pod length; proximate analysis included moisture content, crude protein, crude fat, crude fiber, and ash content; physicochemical analysis was accomplished using approved AOAC methods; for phytochemical analysis, we determined total phenolic content (TPC), total flavonoid content (TFC), and total Vitamin C content (TVC); finally, for mineral analysis we determined the amounts of calcium (Ca), potassium (K), phosphorus (P), and iron (Fe) in each genotype using atomic absorption spectrophotometry. In all cases, statistical analysis was conducted using two-way analysis of variance (ANOVA) at α = 0.05. Significant genotype- and stage-dependent differences were observed. Pod weight and dry matter increased with maturity, while moisture decreased. Potassium was the predominant mineral (780.3-2346.0 mg/kg DW). Immature pods exhibited relatively higher antioxidant-associated phytochemicals. The study highlights the large amount of compositional diversity available among hyacinth bean cultivars and developmental periods, which indicates that this may have the potential to be a useful tool for crop selection and diet diversification in Bangladesh.
Irish farmers are recognized as a high-risk group for premature cardiovascular disease (CVD) mortality compared to other occupation groups. To better characterize CVD risk within farming subpopulations, there is a need for real-world data examining socio-demographic, economic, and occupational determinants of cardiovascular risk. This study reports baseline data from health checks and face-to-face questionnaire capturing socio-demographic and farm characteristics from the Farmers Have Hearts - Cardiovascular Health Program. Farmers were recruited at livestock marts, where live cattle are sold and bought through bidding and predominantly visited by beef farmers, and agri-branches, local retail outlets linked to agribusinesses, commonly visited by dairy farmers. Descriptive statistics characterized the sample, and regression analysis was performed with and without recruitment venue to examine its influence on associations between socio-demographic and cardiovascular risk factors. Most farmers had a higher cardiovascular risk, with 74.0% having ≥4 CVD risk factors. Mart-recruited farmers had a significantly higher prevalence of multiple risk factors compared to agri-branch-recruited farmers (79.3% vs 68.8%). This disparity aligned with distinct socio-demographic profiles, as mart-recruited farmers were more likely to be older, single, have lower educational attainment, and operate smaller farms. Including recruitment venue in regression models changed associations between education and low HDL-C and between age and smoking, reflecting contextual influences beyond individual factors. This study demonstrates that cardiovascular risk is unequally distributed among Irish farmers, with mart-recruited farmers carrying a higher burden. Socio-demographic and occupational differences captured by recruitment venue influence cardiovascular risk, emphasizing the need for targeted health interventions, and agricultural health policy.
Traditional markets are places where edible plants and animals are bought and sold for commercial purposes and/or for human animal consumption. Studies on food biodiversity in markets in the Yucatán Peninsula (YP) are limited or non-existent. Therefore, the principle objectives of this study has been to compile a taxonomically verified inventory of edible plant taxa traded in traditional markets of the Yucatán Peninsula, Mexico, and classify them by culinary category and origin (native vs. exotic); and quantify how product richness and availability are structured across market stalls and states of YP. Semi-structured surveys were conducted among vendors in 10 YP markets to identify, based on culinary classification, the fruits, vegetables, roots, or tubers sold there. A total of 117 taxa (76 species, two subspecies, five varieties, and three hybrids) belonging to 61 genera and 33 botanical families were reported. The botanical origin of these taxa, 14 native and 103 exotic. The culinary classification identified 51 fruits, 44 vegetables, 10 legumes, seven roots or tubers, and five aromatic plants. Fruits and vegetables were the most important part of the commercial offering in the YP, due to the population's dietary preferences. However, a low demand for roots, tubers, legumes, and aromatic plants were observed, most possibly due to the changes in eating habits, the industrialization of consumption, and/or limited access to these products; demonstrating a supply focused on everyday products needs and a high local demand.
Iron and Folic Acid (IFA) supplementation is one of the highly recommended strategies to tackle anemia. Under the backdrop of high anemia prevalence among pregnant women, this study examines the level of non-adherence with IFA supplementation, separately for 100 + days and 180 + days, among pregnant women in India. The analysis is conducted on a sample of 174,947 women, who bought or received IFA tablets/syrup during their last pregnancy, and was surveyed during the National Family Health Survey-5 (2019-21). The NFHS is a cross-sectional survey that claims to represent 95% of the Indian population. The survey adopted stratified random sampling specific to rural and urban population. Descriptive statistics and conditional probabilities are calculated to examine the initiation and attainment of different levels of IFA consumption across selected background variables. Binary logistic regressions are employed to understand the influence of socio-economic factors on non-adherence of IFA supplementation for minimum 100 days and 180 days, and the results are presented as adjusted odds ratios at 95% confidence intervals. While the probability of initiation of IFA tablets is fairly high among pregnant women in India, the probability of consuming at least 100 tablets declines drastically for pregnant women irrespective of their socio-economic profile. The chances of not taking IFA for at least 100 days and 180 days are lesser by 21% and 15% respectively for urban with respect to rural women. When compared to the richest, the poorest face 1.6 times higher odds for not consuming IFA for at least 100 days, and 1.96 times higher in case of non-adherence for minimum 180 days. Women with no education shows 1.73 and 1.46 times higher likelihood to be non-adherent with both criteria as compared to those with higher education. Minimum four antenatal care (ANC) visits and husband's presence during any of these visits demonstrated significant associations. Risk of non-compliance is lesser among women with lower birth order as compared to pregnancies of third and higher birth order. It is mandatory to involve community health workers in awareness generation and close monitoring of IFA consumption behaviour first ensuring access to IFA supplements, and then adherence for 100 + days, which in turn will improve the possibility of meeting 180 days' recommendation.
Cannabis supply methods vary depending on the country, legislation, availability, and population characteristics. In many countries, cannabis consumption remains illegal and poses a major public health concern. Therefore, it is essential to study the factors associated with cannabis supply. Data were obtained from the 2017 French ESCAPAD and Health Barometer surveys (HBS). ESCAPAD is a national cross-sectional survey representative of 17-year-olds, while the HBS is a national cross-sectional telephone survey representative of French individuals aged 18-64. To ensure representativeness, data were weighted, and missing data were imputed. Three cannabis supply methods used in the past year were available in both databases and were analyzed using multivariate multinomial logistic regressions: (a) obtained for free; (b) bought from friends, relatives, or dealers; (c) home cultivation. The study included 2,943 17-years-old and 1,221 adults who reported using at least one of the analyzed methods to obtain cannabis. The majority had purchased cannabis (60% in ESCAPAD and 68% in HBS), while 33% and 24%, respectively, obtained it free, and only 5% and 8% had cultivated it. Among both 17-year-olds and adults, compared with obtaining cannabis for free, being male and experiencing problematic cannabis use were associated with buying or cultivating cannabis. Among 17-year-olds, being an apprentice was associated with a higher likelihood of cultivation, while earning money in the past 30 days and experiencing depression were associated with buying cannabis. Early experimentation with cannabis was associated with both supply methods among adolescents. Among adults, the 26-34 age group was associated with both buying and cultivating, while having less than a high school diploma was associated only with purchasing. Cannabis supply methods are similar between minors and adults, with buying from friends, relatives, or dealers being the most common source. This study identifies vulnerable people who use cannabis and their acquisition practices, providing valuable insights for public policies.
Dentin hypersensitivity (DH) has been known to adversely affect a person's daily activities, including a person's ability to eat, drink, and engage in the appropriate oral hygiene practices. Literature about DH in Africa as a continent and in Ghana is limited. A cross-sectional study approach was used, and 500 participants were sampled using consecutive sampling. Respondents completed the questionnaire and oral examination. DH was clinically measured by cold air stimulation, and pain was rated using the Schiff cold air score. Almost half (212 out of 500) participants experienced DH, with an equal male-to-female ratio (1:1). Respondents had DH significantly impact drinking (47.3%) (P < 0.0004), rather than eating and brushing (26.5 and 26.1%). Thus, a significant number of sufferers (67.7%) did something about their pain (P < 0.001), with the majority (38.3%) visiting their dentist, while 27.8% bought over-the-counter desensitizing agents and 23.9% opting for a warm saltwater rinse. Patients who responded to cold air stimulation were 71.8% and were found to have either a form of tooth wear or gingival recession. More than half of the respondents (71.8%) responded to cold air simulation, with the majority (46.2%) experiencing a Schiff pain score of 1. The prevalence of DH out of 500 participants was 42.4%, with most patients in the age group of 30-50 (44%) years, followed by >50 (34%) years and the rest below 30 years. There should be renewed public education on DH to help in the prevention and treatment of this condition.
Oils containing cannabidiol (CBD) produced from Cannabis sativa L. became popular due to their health benefits. They contain not only known but also unknown active compounds. Hence, for the first time, an effect-directed non-target screening of 13 CBD oils for hazardous compounds was performed using high-performance thin-layer chromatography coupled with highly efficient duplex and multiplex planar bioassays, providing 13 different biological or toxicological endpoints. Antimicrobial (against Gram-positive/-negative bacteria), anti-/estrogenic, anti-/androgenic, cytotoxic (against Saccharomyces and three different Salmonella strains), neurotoxic/-modulating, genotoxic, and mutagenic compounds were found in the CBD oils. Selected hazardous substance zones were automatically eluted from the chromatogram and analyzed by high-resolution mass spectrometry. The tentatively assigned hazardous substances were bought as reference standards, co-analyzed, and confirmed to be various cannabinoids, assumedly oxidized acylglycerides, the estrogenic contaminants dibutyl phthalate and diisobutyl phthalate, and the estrogenic and mutagenic mycotoxin zearalenone, including metabolites. For more sustainability, the CBD oil analysis was successfully performed with the miniaturized open-source 2LabsToGo-Eco, which makes effect-directed non-target screening affordable for everyone.
Knowledge of the true social benefits of pro-environmental activities is limited due to the difficulty of evaluating and quantifying the non-market benefits of such actions. Valuing non-marketed compost benefits and impacts is difficult because they do not have market prices, as they are not bought and sold (i.e. traded) in markets. This article fills this gap by quantifying the non-market benefits of compost use in agriculture. As an initial contribution, this study applied revealed preference methods to quantify the economic values of important non-marketed compost benefits to plant and soil systems in tree and shrub nursery production. The estimated benefits were compared for compost produced using two windrow composting methods, namely: aerobic or thermophilic composting and fermentative or static pile inoculated composting. Specific compost benefits considered included: (i) medium in potting soil mix; (ii) Nitrogen Phosphorus and Potassim (NPK) nutrient supply; (iii) improved nursery plant yield/performance; (iv) disease, pest and weed control and (v) reduced branch pruning. Total economic value, aggregated for the compost benefit types considered, was lower for thermophilic compost applied (CAD$192 per tonne per year) than for fermentative compost (CAD$385 per tonne per year), due to lower fermentative compost production cost. Among the compost benefit types considered, improved nursery plant yield and performance accounted for the highest proportion of quantified benefits; 75% of total economic value for thermophilic compost and 93% for fermentative compost. Further studies considering all important compost benefits beyond those considered in this study, and compost use in other agricultural production systems will be useful.
This analysis examined associations between factors in the food environment and fruit and vegetable (F&V) intake among women living in rural Northern Tanzania. We used cross-sectional data from 2597 women and 1275 food sources. Women's self-reported factors included buying frequency, sources, availability, and convenience. We also measured women's access to F&V sources using geospatial measures of distance and time from home to the reported typical sources. Data from a 30-day F&V food frequency questionnaire were used to calculate two scores that captured intake frequency and variety. We conducted a descriptive analysis of indicators of women's experience and tested their associations with the scores using multivariable and Poisson regression models, controlling for covariates. On average, 5% and 35% of women reported buying F&V daily, respectively. Fruit was mostly bought from markets: F: 80%, V: 40%. Two-thirds of respondents perceived F&V as available (F: 65%, V: 60%). Median (IQR) distance and time to fruit sources were 9 km (2,19), 39 min (19,78), and to vegetable sources were 3 km (1,10), 32 min (8-69). Compared to women who reported making daily purchases of F&V, those who purchased weekly or monthly reported lower frequency and variety of F&V intake. Women's perceptions that F&V were less available and at a longer distance were associated with lower frequency and variety of vegetable intake.Buying frequency, perceived availability, and distance to markets were associated with women's frequency and variety of F&V intake, underscoring the need to consider these and other factors in food environments to increase F&V intake.
Sickle cell disease (SCD) affects about 7.7 million people worldwide, and this has been increasing annually due to an increasing population in sub-Saharan Africa and the Caribbean. Pulmonary complications contribute significantly to mortality due to sickle cell disease. We have frequently heard wheezing in children with sickle cell disease that has responded to beta agonists such as salbutamol leading us to wonder whether this was asthma or a presentation of acute chest syndrome. We present this case to highlight the co-occurrence of sickle cell disease and asthma, and to re-ignite the debate on the whether this is coincidental or causal. We present a 9-year-old male from Ugandan, with no known history of any chronic illness who presented with a one-day history of abdominal, limb, and chest pain. He had associated yellowing of eyes, palpitations, and difficulty in breathing. The patient had had a long-standing history of difficulty in breathing, worse during the night and cold seasons, relieved by taking prednisolone tablets that were bought over the counter. On examination, he was sick looking, in mild respiratory distress, with moderate pallor and severe jaundice. Investigation showed a low hemoglobin (6.6g/dl) and immunoglobulin E (IgE) levels were 2300 IU/mL (normal range 0.1 to 200 IU/mL). Hemoglobin electrophoresis showed predominantly sickled hemoglobin (HbSS) (71%), and low fetal hemoglobin (HbF) (8.3%). Spirometry showed an increase of forced expiratory volume after bronchodilator therapy of 22.8%. We made a diagnosis of sickle cell disease and asthma and managed the patient using oxygen, fluid therapy, analgesia, salbutamol by nebulization, hydroxyurea, folate, ceftriaxone and a blood transfusion. For the long-term management, we initiated him on hydroxyurea 20.8mg/kg/day, folate, and fansidar. We also prescribed budesonide and formeterol and are in the process of linking him to a regional referral hospital for chronic care. We present a case of a 9-year-old newly diagnosed with sickle cell disease and asthma highlighting that both conditions can occur in the same individual. We diagnosed both during the same visit and cannot comment on what manifested first. Our findings reinforce the importance of objective pulmonary function testing and allergic evaluation when assessing wheezing in children with SCD.
BACKGROUND: In low-socioeconomic contexts like South-eastern Türkiye, where child labor rates exceed national averages due to economic pressures, working youth face amplified risks of gambling as a maladaptive coping mechanism. The present study was conducted to identify gambling addiction, predictors and psychological consequences among working youth in the South-eastern Anatolia Region of Türkiye. METHODS: This cross-sectional and descriptive study, which was planned in accordance with STROBE guidelines, was conducted between 01.04.2024 and 31.12.2024 with youth working on the streets of Şanlıurfa and Diyarbakır for more than two years. Ethical approval was obtained from the university and institutional permission was obtained from the governor's office in the province where the study was conducted. After explaining the study to each adolescent and parent, informed consent was obtained from all adolescents and parents. The study was conducted with 671 working youth who met the specified inclusion criteria. Regression analysis and mediation models were used in the analyses. RESULTS: It was found that 18% (122) of the adolescents working on the street played rummikub, 25% (171) played billiards or bowling for money once a week, 32% (217) played iddaa (official football betting game), 17% (112) betted on horse racing, 11% (72) bought numerical lotto tickets, 33% (223) played scratch card games and 23% (152) played online games every week in the last 12 months. Strengths and Difficulties Questionnaire score had a negative statistical effect on multidimensional perceived social support scale (β1 = -0.973), and a positive statistical effect on depressive symptoms (β1 = 0.690) and anxiety symptoms (β1 = 0.726). The change of 60.2% of the scores in the gambling screening test was explained by depressive symptoms, anxiety symptoms and multidimensional perceived social support scores (R2 = 0.602). More than half of the gambling screening test was explained by these three variables. CONCLUSIONS: Current evidence indicates that culturally sensitive, enhanced social support could alleviate symptoms of depression and anxiety associated with gambling behaviour. However, randomised controlled trials (RCTs) are needed to establish causality and the clinical efficacy of this relationship definitively. Therefore, future policy frameworks must balance methodological rigour and robust evidence generation with advocacy for the potential role of such interventions.
It is critical to understand the characteristics of people who use cannabis during pregnancy. We examined the prevalence and sociodemographic and clinical correlates of current, recent, former, and never cannabis use among pregnant individuals in the U.S. We analyzed pooled data from 1,992 pregnant participants in the National Survey on Drug Use and Health (NSDUH) from 2021 to 2023. We used multinomial regression to identify correlates of cannabis use status (i.e., never use vs. current [past 30-day], recent [past 2-12-month], and former [nonuse in the past year], respectively). Overall, nearly 7% of pregnant participants reported current cannabis use. Among current users, 31% reported any doctor-recommended cannabis use in the past year and 52% bought their cannabis from a dispensary. Compared to never users, current cannabis use was more likely among those aged 18-25 (vs. 26+; Relative Risk Ratio [RRR] = 2.08, 95% CI: 1.04-4.18), unmarried (vs. married; RRR = 2.54, 95% CI: 1.05-6.14), with greater education (vs. < high school; RRR = 2.97, 95% CI: 1.42-6.23), past 30-day cigarette use (RRR = 2.57, 95% CI: 1.11-5.94), alcohol use (RRR = 7.24, 95% CI: 1.52-34.49), e-cigarette use (RRR = 4.92, 95% CI: 1.71-14.10), or serious psychological distress (RRR = 6.25, 95% CI: 2.46-15.85); current use was less likely among those perceiving some risk of weekly cannabis use (vs. no risk; RRR = 0.07, 95% CI: 0.03-0.14). Recent use (vs. never use) was less likely in states where cannabis was illegal (RRR = 0.45, 95% CI: 0.22-0.95). Cannabis use during pregnancy remains high among certain subgroups. Future research should develop tailored interventions targeting motivations of cannabis use during pregnancy, such as risk perceptions and polysubstance use, which negatively impact maternal and fetal health.