| 1. |
- Glasbey, JC, et al.
(author)
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- 2021
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swepub:Mat__t
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| 4. |
- Lee, Catherine J., et al.
(author)
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Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia
- 2020
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In: Blood Advances. - : American Society of Hematology. - 2473-9529 .- 2473-9537. ; 4:6, s. 983-992
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Journal article (peer-reviewed)abstract
- There is marked paucity of data regarding late effects in adolescents and young adults (AYAs) who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML). We evaluated late effects and survival in 826 1-year disease-free survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBI was independently associated with a higher risk of cataracts only (hazard ratio [HR], 4.98; P < .0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P = .0006), avascular necrosis (HR, 2.49; P = .006), and diabetes mellitus (HR, 3.36; P = .03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.
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| 5. |
- Nyokabi, Ndungu S., et al.
(author)
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Exploring the adoption of food safety measures in smallholder dairy systems in Ethiopia : implications for food safety and public health
- 2024
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In: Food Security. - : Springer. - 1876-4517 .- 1876-4525. ; 16:2, s. 423-435
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Journal article (peer-reviewed)abstract
- Milk is highly perishable and can be a conduit for the transmission of zoonotic foodborne pathogens. This cross-sectional survey involving 159 farming households and 18 participant observations in participating farms was undertaken in Addis Ababa and surrounding areas in Oromia, Ethiopia to assess the adoption of food safety measures in smallholder farms. Adoption of food safety measures at the farm level influences milk quality and safety across the entire milk value chain, from "grass to glass". This study considered the adoption of 36 different food safety measures (FSM) including animal health, milking hygiene, hygienic milk storage, and hygienic milking premises. A weighted food safety index (FSI, ranging from 0 to 100) was calculated for each household based on FSM adopted. Ordinary Least Squares linear regression was used to quantify the factors of FSM adoption by smallholder farmers. The overall food safety index ranged between 59.97-60.75. A majority of farmers may be classified as moderate adopters of FSM (index ranging between 30-70%). Farm and farmers' characteristics such as herd size, farmer's education level, farmer's expertise in dairying, and participation of the farm in the formal milk value- chain, were shown to positively influence the level of adoption of FSM. Low farm-level adoption of FSM has food safety and public health implications as it can lead to milk contamination and, therefore, expose consumers to foodborne diseases. There is an imperative for policymakers to design and implement policies and intervention strategies that lead to increased farmer training related to livestock production and awareness of the important role that FSM adoption can play in improving food safety and public health.
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| 6. |
- Nyokabi, Ndungu S., et al.
(author)
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Exploring the composition and structure of milk and meat value chains, food safety risks and governance in the Addis Ababa and Oromia regions of Ethiopia
- 2023
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In: Frontiers in Sustainable Food Systems. - : Frontiers Media S.A.. - 2571-581X. ; 7
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Journal article (peer-reviewed)abstract
- Demand for animal-source foods (ASF) is increasing globally, driven by population growth and changing dietary preferences. In global south countries, low compliance with good agricultural practices (GAPs) and food safety standards in the production of ASF is a major public health concern due to the high prevalence of foodborne diseases. This study examines the composition and structure of milk and meat value chains and explores food safety risks and governance in the Addis Ababa and Oromia regions of Ethiopia. Stakeholder discussions, key informant interviews and participant observation were undertaken to collect data on milk and meat value chain actors' perceptions of opportunities and constraints to improving access to safe, high-quality milk and meat products. The results reveal low compliance with rules and standards by milk and meat value chain actors which could compromise food safety and quality and expose consumers to public health risks. There was stricter enforcement of GAPs and food safety standards in the case of milk and meat products destined for export compared to products sold in the local market. The main barriers to compliance with food safety regulations were actors' low knowledge, small profit margins, absence of critical food safety infrastructure such as electricity and road and low access to capital to invest in the recommended equipment such as aluminum containers, coolers and fridges. This paper concludes there is a need for targeted efforts to support the adoption of low-cost technologies that could mitigate food safety risks. Additionally, there is a need for improved communication and tailored training for value chain actors that reflect local social, cultural and economic context to incentivise compliance with rules governing food safety and quality.
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| 7. |
- Nyokabi, Ndungu S., et al.
(author)
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From farm to table : exploring food handling and hygiene practices of meat and milk value chain actors in Ethiopia
- 2023
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In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Journal article (peer-reviewed)abstract
- Livestock value chains constitute a source of livelihood for meat and milk value chain actors in Ethiopia, from dairy farmers to other associated value chain actors such as milk traders, abattoir workers, public health officials, veterinarians, butcheries selling meats, milk cooperatives, artisanal milk processors, and transporters. The development of these livestock value chains, however, is constrained by poor food safety and quality, while consumers are also exposed to public health risks due to milk and meat value chain actors' food handling and hygiene practices.This study used Photovoice and participant observation to explore meat and milk value chain actors' food handling and hygiene practices in suburban areas of Addis Ababa and neighbouring Oromia in Ethiopia. The results of this study reveal that milk and meat value chain actors' food handling practices are not aligned with the recommended Ethiopian food safety and quality standards. Low compliance with food safety and quality standards reflected a combination of factors such as lack of incentives, poor road infrastructure and low enforcement of food safety standards.Participatory and visual research methods enable a researcher to collect context-aware data that can lead to the development of policies and intervention strategies that reflect local needs and priorities. The results of this study affirm the need to identify socially acceptable and economically viable policies and intervention strategies that are acceptable to all chain actors; and suggest there is an imperative to train milk and meat value chain actors on good hygiene handling practices, improve road infrastructure, and facilitate access equipment such as fridges and freezers that can contribute to maintaining food safety and quality.
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| 8. |
- Phelan, Suzanne, et al.
(author)
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One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials
- 2020
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In: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 44, s. 57-68
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Journal article (peer-reviewed)abstract
- Background/objectives: Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores. Subjects/methods: In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants. Results: Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of −1.6 kg (95% CI −2.5, −0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months. Conclusions: Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.
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| 9. |
- Nyokabi, Ndungu S., et al.
(author)
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Implementing a one health approach to strengthen the management of zoonoses in Ethiopia
- 2023
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In: One Health. - : Elsevier BV. - 2352-7714. ; 16
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Journal article (peer-reviewed)abstract
- In East Africa, a region with many endemic and emerging zoonoses, and in countries such as Ethiopia in particular, One Health (OH) approaches are increasingly seen as effective ways, to mitigate the risk of zoonoses at the interface between human, animal and the environment. The OH approach promotes interdisciplinary cooperation and collaboration between researchers and practitioners from the disciplines of human, animal and environmental health. Moreover, it advocates for the establishment of a public health sector model which recognises the imperative to holistically address diseases that occur in the human, animal and environmental health arena.Key informant interviews were conducted with human and animal health practitioners and academic researchers in Ethiopia to collect data on the implementation of the OH approach to manage zoonotic diseases at the human and animal health interface. Participants' observations were undertaken within animal and human health clinics and government laboratories to gather additional data. Environmental health was not considered in this study as it is not yet fully integrated into the OH approach in Ethiopia.The results reveal a lack of interdisciplinary cooperation, collaboration, and coordination between animal and human health practitioners in operationalising the OH framework in Ethiopia. Professionals in academic and non-academic institutions and organisations are interested in implementing the OH approach, however, an organisational "silo" culture constrains collaboration between institutions dealing with animal and human health. Understaffing and underfunding of institutions were also cited as major challenges to the implementation of a OH approach. Lack of interdisciplinary training for animal and human health practitioners hinders collaboration in the management of zoonoses.Policymakers need to go beyond the rhetoric to a genuine focus on reform of health management and implement policies that bridge human, animal and environmental health. There is a need for multidisciplinary and transdisciplinary training in human, animal and environmental health and collaborative research for the management of zoonoses.
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| 10. |
- Redman, Leanne M., et al.
(author)
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Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium
- 2021
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In: Diabetes Research and Clinical Practice. - : Elsevier BV. - 0168-8227. ; 171
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Journal article (peer-reviewed)abstract
- Aims: To examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. Methods: LIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. Results: Lifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. Conclusion: Moderate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.gov: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.
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