Care Items Research Articles

Consumer Inclination to Purchase Personal Care Products in Salem City

The study's goal is to assess consumers' proclivity to buy personal care items in Salem. The data for the study was collected by using direct interview with the consumers who were purchasing personal care products via an interview schedule. The study collects data from 794 consumers in different parts of Salem City. The study was commenced with the motive to test demographic profile of consumers, factors influencing consumer inclination and satisfaction of consumers while purchasing personal care products. The data was appropriately collated and analyzed using basic frequencies and percentages, exploratory factors, weighted ranking, as well as multiple regression. The study confirmed that consumer inclination mainly relies on store ambience, product quality, product promotion, product price, interest to purchase, and external influences. Consumer satisfaction was mainly influenced by the package quality, variety of product, and quality offered by the personal care products. It is concluded that several factors determine consumer inclination to procure personal care products.

Phthalates removal from wastewater by different methods - a review.

Phthalate esters are commonly used as plasticizers to improve the durability and workability of polymeric materials, locating and identifying them in various contexts has become a major challenge. Because of their ubiquitous use in plastic packaging and personal care items, as well as their tendency to leach out of these materials, phthalates have been detected in a variety of aquatic situations, including surface water, groundwater, drinking water, and wastewater. Phthalate esters have been shown to affect reproductive health and physical growth by disrupting the endocrine system. As a result, developing energy-efficient and effective technologies to eliminate these harmful substances from the atmosphere has become more important and urgent. This paper examines the existing techniques for treating phthalates and degradation mechanisms, as well as knowledge gaps and future research directions. These technologies include adsorption, electrochemical, photocatalysis, membrane filtration and microbial degradation. Adsorption and photo catalysis are the most widely used techniques for phthalate removal, according to the literature survey papers.

Insecticidal Activity, Toxicity, Resistance and Metabolism of Pyrethroids: a Review

Pyrethroids are synthetic or man-made versions of natural pyrethrins discovered in the flowers of a plant species of the Compositae family called "Chrysanthemum cinerariaefolium". The plant was transported into Europe and America after it was discovered in the Near East. Commercial insecticides such as pyrethrin and synthetic pyrethroid are available. These are used to control agricultural pests as well as non-agricultural insects. They are also commercially used in personal care items such as shampoo and as a scent in insect repellent to boost efficacy and persistence in the environment, these insecticides are frequently combined with additional chemicals in diverse formulations, known as synergists. Nerve toxins, known as pyrethroids, although their chemical mechanism of action is unknown. Pyrethroids are neurotoxins, which interfere with the messages sent along nerves by maintaining sodium and chloride channels in an open position. This review presents perspectives, commercial uses and other useful characteristics features of pyrethroids based on human benefits and environmental friendly.

Assessment of Vietnamese nurse’s knowledge and practice regarding patient’s safety after coronary angiography or percutaneous coronary intervention

Many clinical and paraclinical studies related to coronary artery disease have been done in Vietnam in recent years. However, there have been no studies on nurses’ knowledge and practice regarding patient care after coronary angiography (CAG) or percutaneous coronary intervention (PCI). This study was conducted to assess nurses’ knowledge and practice on patient’s safety after CAG or PCI and its associated factors. A descriptive cross-sectional study was conducted from December 2019 to June 2020 at the Department of Internal Cardiology, Interventional Cardiology, Intravascular Intervention, and Intensive care unit/Coronary care unit in three general and specialist hospitals in Ho Chi Minh city, Vietnam. 167 nurses who have taken care of patients after CAG or PCI were included in the study through using convenient sampling technique. A translated self-administered questionnaire was utilised. This self-reported survey achieved 100% response rate. Statistical analysis was performed by the Chi-square test (X2). Statistical significance level was at p<0.05 to determine factors related to nurses’ knowledge and practice. Prevalence ratio (PR) with 95% confidence interval (95% CI) were also used to measure the association. The study findings revealed that only 36% of the study sample had a good knowledge while 78% of them had a good practice on patient’s safety after CAG or PCI. There were association between educational level, working place with the knowledge (PR=1.87-1.92, p<0.01) and practice (PR=1.18-1.35, p<0.05) on patient’s safety after CAG or PCI among Vietnamese nurses. Besides those factors, the number of years working in cardiac specialty were also found to have an association with the practice. A moderately positive correlation between the knowledge and the practice towards patient’s safety after CAG or PCI has been identified in this study (PR=1.27, 95% CI [1.09 – 1.47], p=0.005). More than a half of the study sample had poor knowledge but performed good practice in some items of care for patients after CAG or PCI. There was positive association between the knowledge and practice about patient’s safety after CAG or PCI among Vietnamese registered nurses. Educational training programs for staffs working in coronary angiography or percutaneous coronary intervention is recommended to develop.

Shopping smart: Look for the Seal

Shopping for oral health care products can be overwhelming. There are hundreds of products to help with your daily oral health care, like toothpaste, toothbrushes, and products to help you clean between your teeth. You also can choose from a number of mouthrinses, denture products, water filters, and many more. How can you select products that are safe and effective? Look for the American Dental Association (ADA) Seal of Acceptance (Seal) (Figure). The ADA Seal of Acceptance program is overseen by the ADA Council on Scientific Affairs and for 90 years has identified oral health care products that are safe and effective. Manufacturers that choose to participate in the program submit scientific evidence to the ADA Council on Scientific Affairs to prove that their products meet various ADA Seal requirements. A product submission must include data from clinical or laboratory studies that demonstrate safety and efficacy. In addition, manufacturers must provide scientific proof to support certain product benefits, such as fighting cavities. For example, if a toothpaste is advertised as helping prevent cavities, the manufacturer must present data supporting that claim. The ADA Seal is awarded for a 5-year period. If the manufacturer changes the composition of an accepted product during that time, the company must submit updated chemical and safety data before it can continue to carry the ADA Seal. There are more than 400 products with the ADA Seal in more than 20 categories, such as toothpastes, toothbrushes, and mouthrinses. No matter what you are shopping for, the ADA Seal can point you in the right direction. For a full list of ADA Seal products, visit MouthHealthy.org/Seal or look for the ADA Seal wherever dental health items are sold. You have a number of products to choose from when shopping for oral health care items. To help in making a decision, look for the ADA Seal. It is a sign that the product is safe and effective when used as directed and meets the performance claims made on the product’s label.

Developing assessments to elicit and characterize undergraduate mechanistic explanations about information flow in biology

ABSTRACT National calls to improve science education include focusing on scientific practices coupled with learning disciplinary core ideas. Among the practices is constructing explanations. In the field of cellular and molecular biology, explanations typically include a mechanism and can be used to make predictions about phenomena. In this work, we developed an assessment item about transcription, a key process in the biology core concept of genetic information flow. We used a mechanistic framework to develop a rubric that identifies undergraduate explanations that leverage molecular or sub-molecular mechanisms, descriptions, or use unlinked ideas. We applied this rubric to categorize 346 undergraduate written explanations and compare five-item versions. We found that one version elicited sub-molecular mechanistic explanations from 20% of students, compared to between 2% and 13% from other versions. This version included the element of time, by indicating that a new RNA was formed as part of transcription. We also developed and applied a conceptual rubric to capture the context students used in their explanations and found a median of two context ideas in student explanations of transcription. Our work demonstrates that with careful item wording, undergraduates can explain molecular processes like transcription by leveraging sub-molecular mechanisms.

Enhanced recovery after gynecologic surgery: review of the literature

Objective: Enhanced Recovery After Surgery (ERAS) includes practices aimed at providing rapid recovery by standardizing pre-and post-surgical care in patients undergoing colon surgery and reducing the metabolic stress response. The ERAS program is a systematic application that includes surgeons, anesthetists, nurses, and assistant healthcare professionals in the care process and has been successfully implemented in the international arena. Studies on ERAS protocols show that this system can be actively applied in different surgical areas. Mechanism: This review article discusses the main reviews and recommendations of the medical community on ERAS and valuable publications in the literature. Findings in brief: Guidelines of the ERAS Society for peri-operative care in gynecological procedures were first published in 2016 and updated in 2019. ERAS Society recommended 12 items for pre-and intra-operative care and 10 post-operative care items. The objectives of these applications are to provide patient education and consultancy services before surgery, to stop oral intake shortly before surgery and to start fast nutrition after surgery, to maintain a balanced body temperature and fluid level to maintain normal physiology, to increase mobilization, to provide pain control with painkillers, prophylaxis of nausea and vomiting and reduction of unnecessary or prolonged use of catheters. Conclusions: Studies suggest that increased compliance with ERAS agents in colon surgery has a positive effect on operation results, but more studies are needed to reach this affirmation in gynecological surgery.

Self-Reported Spiritual Care among Moslem ICU Nurses in the Rural Area of Indonesia

Spiritual care is very important particularly for patients who are experiencing critical conditions. Although the priority of critical care is to maintain the function of the organ systems and to improve the patient's health condition, the patient's spiritual care should not be ignored. This study aimed to identify spiritual care practice among ICU Nurses at public hospitals in rural areas. This survey study used the NSCTS (Nursing Spiritual Therapeutics Scale) questionnaires to identify spiritual care in the ICU wards. This study involved 39 ICU nurses who work in the three public hospitals of Pekalongan Regency, Central Java Indonesia (Kajen Hospital, Kraton Hospital, and Bendan Hospital). Data were analyzed by using Microsoft excel. The result of this study revealed that the average spiritual care among ICU nurses is 3.79. In the context of the spiritual care item question, the highest mean score was "Offered to pray with a patient," whereas the lowest was "Documented spiritual care you provided in a patient chart." Despite the study limitation, this study encourages the ICU nurses to record the spiritual nursing care into nursing care sheets.

Family experience of palliative sedation therapy: proportional vs. continuous deep sedation.

Some patients experience intense symptoms refractory to intensive palliative care, and palliative sedation is sometimes used. Palliative sedation may be classified into proportional and continuous deep sedation (CDS). The primary aim of this study was to compare family experience between families of patients who received proportional or CDS. A multicenter questionnaire survey was conducted involving bereaved families of cancer patients who received proportional or CDS based on a sedation protocol. Overall evaluation of sedation (satisfaction, family-perceived distress, appropriateness of timing, and patient distress) and 13-item family concerns, good death, satisfaction with care, depression, quality of care, unfinished business, and balance between symptom relief and maintaining communication were measured. Among the 2120 patients who died, 222 patients received a continuous infusion of midazolam. A sedation protocol was used in 147 patients, and questionnaires were sent to 124 families. A total of 78 responses were finally returned (proportional, 58 vs. CDS, 20). There were no significant differences in the overall evaluation, family concerns, total score of good death, satisfaction, depression, or balance between symptom relief and maintaining communication. On the other hand, some quality of care items, i.e., relationship with medical staff (P < 0.01), physical care by nurses (P = 0.04), and coordination and consistency (P = 0.04), were significantly better in the CDS group than in the proportional sedation group. Family-reported unfinished business was also better in the CDS group, with marginal significance. Family experience of CDS was not less favorable than proportional sedation, and actually rated more favorably for some elements of quality of care and unfinished business.

The association of comorbidities with the 25-question geriatric locomotive function scale and the diagnosis of locomotive syndrome

BackgroundNo studies have provided statistical evidence of the relationship between comorbidities and locomotive syndrome (LS). We therefore investigated the association of comorbidities with the 25-question Geriatric Locomotive Function Scale (GLFS-25) and the diagnosis of LS in community-dwelling residents. MethodsThis cross-sectional study was conducted on 2612 community-dwelling residents (≥40 years old) who attended a ‘basic health checkup’. There were 432 participants with comorbidities (45 with cerebrovascular diseases, 133 with cardiovascular diseases, 83 with pulmonary diseases, 108 with renal diseases, and 63 with multiple diseases) and 2180 participants without comorbidities. Subjects with a GLFS-25 total score of ≤6 points, 7–15 points, 16–23 points, and ≥24 points were diagnosed with non-LS, LS-1, LS-2, and LS-3, respectively. The domain scores covered body pain (items 1–4), movement-related difficulty (items 5–7), usual care (items 8–11 and 14), social activities (items 12, 13, and 15–23), and cognition (items 24 and 25). A multivariate regression analysis and multivariate logistic regression analysis were performed to assess the association between the GLFS-25 scores and comorbidities and between the diagnosis of LS and comorbidities after adjusting for age, sex, body mass index, and smoking status. ResultsA multivariate regression analysis showed that comorbidities were significantly related to the GLFS-25 total score and all domain scores. A multivariate logistic regression analysis revealed that comorbidities were significantly related to a diagnosis of LS-1 or more, LS-2 or more, and LS-3 or more. ConclusionsComorbidities were associated with increased GLFS-25 domain scores and total score and consequent diagnosis of LS. Therefore, attention should also be paid to the presence of comorbidities when diagnosing LS. Nevertheless, the causal relationship between comorbidities and the GLFS-25 remains unclear, and further studies are therefore required.

BASIC REQUIREMENTS OF BIOSAFETY IN UKRAINIAN POULTRY FARMS

The current level of effective poultry farming requires consideration of today's challenges, which, in our opinion, can be formed in two positions: the well-being of poultry farming and biosafety. Biosafety – it is the prevention, reduction and elimination of the impact of hazardous biological factors (agents) on humans, animals, plants and the environment. Given the pace of development of agricultural production, transport and foreign trade in the modern world, veterinary medicine is faced with many problems associated with the risks of occurrence and spread of infectious diseases. Biosafety issues are especially acute for poultry producers and farmers, as in the process of modern intensive production there are risks of pathogens and their rapid spread, especially in dense poultry, which requires strict conditions of biosafety and biosecurity. Biosafety is one of the most important components of Ukraine's food, environmental and national security. The implementation of policies in the field of biosafety and biological protection should be carried out by creating a system of identification, forecasting, prevention and counteraction to existing threats of biological origin. The purpose of biosecurity is to ensure that unauthorized persons, animals, vehicles, utensils, tools, other care items, inventory or equipment contaminated with infectious diseases of birds do not enter poultry farms and bird feed preparation areas. We analyzed the existing regulations on the welfare of poultry farms of various forms of ownership. The factors of biosecurity risk control, the basic rules of biosafety in the farm, the requirements for the territory of poultry farms, as well as the guarantees of poultry farm managers are highlighted.

Uncovering Pet Issues: A Survey of Professionals Working With Older Adults and Care Partners

Pets can play an important role in older adults’ health behaviors and decisions. However, the degree to which these issues are encountered or addressed by professionals working with this population remains unknown. An interdisciplinary (e.g., healthcare, social services) sample of professionals (N=72, 93.05% female, Mage=48.82, SDage=12.57) completed an online survey focused on the pet ownership issues they have encountered while working with older adults, persons with dementia, and care partners. The professionals (n=66) estimated 42.86% of their clients had been pet owners, and 45.58% regularly asked their clients about pets. Issues raised to the professionals varied by type of client. Older adults most often brought up exercising the pet, routine veterinary care, and the financial aspect of ownership (all 37.50%). Persons with dementia most often discussed accessing pet care items (12.50%), exercising the pet (9.72%), and basic pet care (8.33%). Care partners brought up basic pet care (33.33%), planning for the pet due to their care recipients’ housing transition (26.38%), and exercising the pet (25.00%). Professionals reported talking to clients about planning for the pet due to housing transition, concerns about falling, and concerns about the pet’s behavior (all 31.94%). The professionals (n=69) were very favorable toward pet ownership in general (M=4.43, SD=0.78) (1=extremely unfavorable, 5=extremely favorable), less favorable about older adult pet ownership (M=4.15, SD=0.72, p=.002), and even less favorable about persons with dementia owning pets (M=3.51, SD=0.93, p<.001). The results provide evidence that pet ownership issues are likely encountered in geriatric service settings and may shape healthy aging.

The concentration of phthalates in toys and children's care items in Kosovo

In this study, one hundred and twenty-eight toys and children's care items available in the Kosovo market were analyzed to determine the presence of phthalates and evaluate if the analyzed samples meet the national and EU standards. Toys and children's care items were imported from twelve countries, most of them from China. Phthalates were extracted and then analyzed using gas chromatography and mass spectrometry. Nine phthalates were analyzed in total, of them, benzyl butyl phthalate, di-isodecyl phthalate, diisobutyl phthalate and di-isononyl phthalate were the most frequently detected phthalates in the analyzed samples. Phthalates were not detected only in three toys and children's care items, others contained one or more phthalates, while none of them contained all (nine) analyzed phthalates. In total, 22 analyzed toys and children's care items did not fulfill at least one of the EU standards, of these 16 were toys and children's care items intended for children under age three and designed to be placed in the mouth. Overall, our work shows that toys and children's care items that exceed EU standards for phthalates are still present in the Kosovo market.

СТЕПЕНЬ ИНВАЗИРОВАННОСТИ ЛОШАДЕЙ PARASCARIS EQUORUM ПРИ РАЗНЫХ УСЛОВИЯХ СОДЕРЖАНИЯ

The significant dependence on the invasion of Parascaris equorum horses with different maintenance technologies was studied. Methods of helminthocoprooscopy revealed the spread of parascaridosis of horses kept in stable and herd conditions in the Pobeda farm in the Cheremshansky district of the Republic of Tatarstan. The high invasion of animals with herd and stable housing is apparently associated with a large contamination of horse stalls, stables, care items and the surrounding area with parascaride eggs. The maximum parasiticidal infection of horses was established with stable maintenance. As a result of the studies, it was found that the maximum extent of invasion (EI) of horses in the examined farm with stable technology of keeping was 42.8 % and herd content was 37.5 %. The intensity of invasion (II) by parascarides varied from 23.7±3.4 to 77.3±5.6 ind. eggs in 1 g of feces, depending on the technology of maintenance.

A cohort study investigating the occurrence of differences in care provided to men and women in an intensive care unit

It has been reported that there are differences in the care given within the intensive care unit (ICU) between men and women. The aim of this study is to investigate if any differences still exist between men and women regarding the level of intensive care provided, using prespecified intensive care items. This is a retrospective cohort study of 9017 ICU patients admitted to a university hospital between 2006 and 2016. Differences in use of mechanical ventilation, invasive monitoring, vasoactive treatment, inotropic treatment, echocardiography, renal replacement therapy and central venous catheters based on the sex of the patient were analysed using univariate and multivariable logistic regressions. Subgroup analyses were performed on patients diagnosed with sepsis, cardiac arrest and respiratory disease. Approximately one third of the patients were women. Overall, men received more mechanical ventilation, more dialysis and more vasoactive treatment. Among patients admitted with a respiratory disease, men were more likely to receive mechanical ventilation. Furthermore, men were more likely to receive levosimendan if admitted with cardiac arrest. We conclude that differences in the level of intensive care provided to men and women still exist.

Clinical case of associative course of panleukopenia and intestinal yersiniosis in cats

The study of the course and manifestation of mixed infections is an important modern problem of both humane and veterinary medicine because their diagnosis is quite complex and time-consuming. The clinical manifestation of double and sometimes triple infection has its characteristics, which depend on various biotic and abiotic factors. To date, it has been proven that the associative course of several infectious diseases is registered more and more often, which confirms the case of simultaneous manifestation of panleukopenia and intestinal yersiniosis in domestic outbred cats. Diagnosis of mixed infection was comprehensive through general clinical and laboratory studies, the use of rapid test systems to confirm the diagnosis of panleukopenia and RNGA with specific yersinia antigens to determine the status of intestinal yersiniosis in cats. The latter was caused by serovar Y. enterocolitica O: 9 with a diagnostic titer of 1: 400. Thanks to microbiological studies, the causative agent of intestinal yersiniosis Y. enterocolitica was isolated. Its biological properties were determined, and antimicrobial sensitivity to enrofloxacin and doxycycline was established against the background of polyresistance to ceftriaxone and tetracycline. During treatment, it was found that the clinical case of intestinal yersiniosis was also due to the simultaneous infection of Y. enterocolitica with two types of serotypes O: 3 and O: 9. Which also have their own specific features. But in most cases, we have different sensitivity to antibacterial drugs, in contrast to the case we described. Clinical signs of the associated course of panleukopenia and intestinal yersiniosis in domestic outbred cats were characterized by prolonged diarrhea, streaks of blood and mucus, apathy, refusal to feed, general weakness. Therapeutic measures containing antibacterial drugs, energy sources, crystalloids, buffer infusions which were aimed at reducing dehydration and maintaining water-salt balance in the complex, were effective, clinical signs of the disease disappeared on the eighth day of treatment, and complete isolation of the pathogen in the environment ceased on the thirteenth day, which indicated the complete recovery of the animal. However, to prevent re-infection, it was recommended to treat disinfectants with care items and utensils. And also to avoid direct contact with animals that have pronounced clinical signs of disease. To prevent the occurrence of panleukopenia, scheduled mass vaccinations with mandatory observance of time limits.

Implementation of oral hygiene practices in nursing homes – the view of supervisor nurses

Objectives The aim of our study was to analyse the implementation of oral health-related practices in private enhanced service housing units and nursing homes in Finland reported by supervisor nurses. Methods We sent an anonymous, voluntary Webropol-questionnaire to the supervisor nurses of private enhanced service housing units and nursing homes (N = 245). The questionnaire included items about the implementation of oral healthcare-related practices in the care units and items based on the Nursing Dental Coping Beliefs index (DCBS index). Five dimensions of the implementation of oral healthcare-related practices, Oral hygiene practices and Favourable diet for oral health, Oral hygiene equipment, Professional dental services, and Knowledge and opinions were used as outcomes. The factors in the nursing DCBS index and background variables were used as explanatory variables. Results Our main results showed that in care units, Oral hygiene practices, Favourable diet for oral health, Oral hygiene equipment, and Professional dental services were partly implemented. Furthermore, according to Knowledge and opinions supervisor nurses had challenges in oral health-related knowledge and difficulties in managing oral care. In the DCBS index, better self-efficacy in “Managing bleeding gums” was associated with better implementation of oral health practices. Furthermore, supervisor nurses’ better own oral health habits were associated with better implementation of oral health-related practices. Conclusions It can be concluded that based on the responses of the supervisor nurses, oral health-related practices were partly implemented in private enhanced service housing units and nursing homes in Finland.

Factors influencing the degree of physician-pharmacists collaboration within governmental hospitals of Jigjiga Town, Somali National Regional State, Ethiopia, 2020

BackgroundCollaboration is the way to deliver the desired health outcome for the patients or service users in the healthcare. Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between physicians and pharmacists within the public hospitals of Jigjiga town, Somali National Regional State, Ethiopia, 2020.MethodsA cross-sectional study qualitative was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians.ResultsThis study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals’ collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established.ConclusionsThe study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration.RecommendationPhysicians and pharmacists need to exert more efforts to enhance this collaboration. Further qualitative study might be needed to search for factors affecting, barriers and how to develop collaborative practice.

Preventing maternal phenylketonuria (PKU) syndrome: important factors to achieve good metabolic control throughout pregnancy

BackgroundInsufficient metabolic control during pregnancy of mothers with phenylketonuria (PKU) leads to maternal PKU syndrome, a severe embryo-/fetopathy. Since maintaining or reintroducing the strict phenylalanine (Phe) limited diet in adults with PKU is challenging, we evaluated the most important dietary and psychosocial factors to gain and sustain good metabolic control in phenylketonuric women throughout pregnancy by a questionnaire survey with 38 questions concerning therapy feasibility. Among them, the key questions covered 5 essential items of PKU care as follows: General information about maternal PKU, PKU training, diet implementation, individual metabolic care, personal support. In addition, all participating PKU mothers were asked to estimate the quality of their personal metabolic control of the concluded pregnancies. 54 PKU mothers with 81 pregnancies were approached at 12 metabolic centers in Germany and Austria were included. According to metabolic control, pregnancies of PKU women were divided in two groups: group “ideal” (not more than 5% of all blood Phe concentrations during pregnancy > 360 µmol/l; n = 23) and group “suboptimal” (all others; n = 51).ResultsThe demand for support was equally distributed among groups, concerning both amount and content. Personal support by the direct social environment (partner, family and friends) (“suboptimal” 71% vs “ideal” 78%) as well as individual metabolic care by the specialized metabolic center (both groups around 60%) were rated as most important factors. The groups differed significantly with respect to the estimation of the quality of their metabolic situation (p < 0.001). Group “ideal” presented a 100% realistic self-assessment. In contrast, group “suboptimal” overestimated their metabolic control in 53% of the pregnancies. Offspring of group “suboptimal” showed clinical signs of maternal PKU-syndrome in 27%.ConclusionThe development of training programs by specialized metabolic centers for females with PKU in child bearing age is crucial, especially since those mothers at risk of giving birth to a child with maternal PKU syndrome are not aware of their suboptimal metabolic control. Such programs should provide specific awareness training for the own metabolic situation and should include partners and families.

Advancing nutrition measurement: Developing quantitative measures of nutrition service quality for pregnant women and children in low- and middle-income country health systems.

The health sector plays an important role in the delivery of high‐quality nutrition interventions to women and children in low‐ and middle‐income countries (LMICs). However, there are no standardized approaches to defining and measuring nutrition service quality in these contexts. This study aims to systematically develop quality of care indices for direct health systems nutrition interventions using a five‐step process: (1) identify recommended interventions for inclusion in indices, (2) extract service readiness, provision of care, and experience of care items from intervention‐specific clinical guidelines, (3) map items to data available in global health facility surveys, (4) conduct an expert survey to prioritize interventions and items, and (5) use findings from previous steps to propose quality of care metrics. Thirty‐two recommended interventions were identified, for which the guidelines review yielded 763 unique items that were reviewed by experts. The proposed nutrition quality of care indices for pregnant women reflects eight interventions and the indices for children under 5 reflects six interventions. The indices provide a standardized measure for nutrition intervention quality and can be operationalized using existing health facility assessment data, facilitating their use by LMIC decision makers for planning and resource allocation.