Eighty-two children underwent polysomnography (PSG) for symptoms suggestive of obstructive sleep apnea (OSA). Symptoms reported included snoring, witnessed apneic episodes, daytime somnolence, mouth breathing, and enuresis. Tonsillar size, nasal airway patency, and percentile weight were recorded. OSA was diagnosed on PSG when obstructive events were noted and apnea + hypopnea index was five or more per hour. The overall predictive accuracy of clinical suspicion of OSA was 25 (30%) of 82. Predictive accuracies (as a percentage of those with symptoms/signs who have OSA) and prevalences (as a percentage of those with OSA who have the symptom/sign), respectively, were for moderate snoring 29% (12 of 41), 48%; loud snoring 31% (11 of 35), 44%; witnessed apneas 32% (22 of 69), 88%; enuresis 46% (11 of 24), 44%; 2+ tonsillar size 37% (21 of 57), 84%; 3+ tonsillar size 33% (3 of 9), 12%; 90th percentile weight or greater 26% (7 of 27), 28%; 10th percentile weight or less 33% (5 of 15), 20%. Multiple regression analysis did not reveal a significant association between clinical parameters and the presence of OSA as defined by PSG.
Abstract:Local food has recently gained popularity under the assumption that it is more sustainable than food from distant locations. However, evidence is still lacking to fully support this assumption. The goal of this study is to compare local and global food chains in five dimensions of sustainability (environmental, economic, social, ethical and health), covering all stages of the chain. In particular, four cheese supply chains are compared in detail: a local (L'Etivaz) and global (Le Gruyère) case in Switzerland and a local (Single Gloucester) and global (Cheddar) case in the UK. A multi-dimensional perspective is adopted to compare their sustainability performance. Eight attributes of performance (affordability, creation and distribution of added value, information and communication, consumer behaviour, resource use, biodiversity, nutrition and animal welfare) are used to frame the comparative analysis. The results suggest that local cheese performs better in the field of added value creation and distribution, animal welfare and biodiversity. Global chains, by contrast, perform better in terms of affordability and efficiency and some environmental indicators. This analysis needed to be expressed in qualitative terms rather than quantified indicators and it has been especially useful to identify the critical issues and trade-offs that hinder sustainability at different scales. Cheese supply chains in Switzerland and the UK also often present hybrid arrangements in term of local and global scales. Comparison is therefore most meaningful when presented on a local (farmhouse)/global (creamery) continuum.
Abstract:The protection of geographical indications (European regulation 1151/2012) is arguably the most significant initiative, certainly within Europe, that promotes foods with territorial associations and reorganises agri-food chain governance through a strategy of reterritorialisation. Research on Protected Designation of Origins (PDOs) and Protected Geographical Indications (PGIs) suggests that they generate significant economic value at an EU-level, especially in certain countries. They can also help to deliver territorial rural development policy and develop new food markets. In this paper we examine the way the PDO scheme has been developed and applied in one commodity sector (cheese) in two countries (Switzerland and the UK), where the uptake of PDOs is variable. We adopt a food chain approach and examine specific cheese product case studies (at micro and meso levels) in both countries to better understand how the PDO scheme (as a territorialisation and respacing strategy) is implemented. L'Etivaz and Le Gruyère are examined in Switzerland. Single Gloucester and West Country cheddar are examined in the UK. The PDO scheme is an important governance strategy and regulatory system, but despite strict guidelines regarding implementation and geographical infrastructure there are notable differences between the UK and Switzerland in terms of how the label is used to organise and respatialise food chains: it is framed as a strategy to protect the rural economy in Switzerland but is promoted more as a mechanism to communicate and reconnect with consumers in the UK.
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