Overview
Consumption of out-of-home (OOH) food is associated with significantly greater energy and less-healthy nutrient (i.e. fats, salt and sugar) intake. The price of food is a key consideration of food choice, particularly for individuals of lower socioeconomic position (SEP). Little research to date has examined the causal effect of removing price-based incentives on purchasing behaviour in OOH food settings. One online randomised controlled trial explored the effect of removing three types of price-based incentives individually and in combination, on food choice through a virtual food delivery platform. This study found that energy selection was 7-8% lower when price incentives were removed. While not statistically significant, Bayes factors indicted that data comparing control vs "all promotions removed" conditions were inconclusive (BF10 = 0.55) and therefore could not provide support for the alternative or null hypotheses. A limitation of this study is that the outcome was hypothetical food choice. As participants would not pay for or receive their selected meals, the prices of foods may have been less salient, thus reducing the potential for impact. In the present study, exploring real-world consumer behaviour (as opposed to hypothetical choice) will better determine the potential impact of removing price-based incentives in the OOH food sector.
Description
Children with congenital heart disease need surgery. However, extracorporeal circulation surgery can lead to systemic inflammatory reaction and ischemia, while reperfusion injury leads to metabolic disorders, with increased metabolism, hyperbolism and reduced anabolism. The redistribution of systemic blood and the ischemic and microcirculatory disorder state of gastrointestinal tract cause damage to the gastrointestinal mucosa and indigestion. Excessive fluid limitation after surgery and positive application of positive inotropic drugs were positively correlated with energy metabolism rate. Additionally, the lack of scientific feeding knowledge and poor eating habits of parents can increase the risk of malnutrition in children. Surgery is the most effective way of treating congenital heart disease. Although the cardiac malformation has been corrected and the heart function has been returned to normal, there are still some children cannot quickly get rid of malnutrition. To our knowledge, postoperative malnutrition affects wound healing in the short term. Long-term malnutrition and lack of calories and protein intake lead to the lack of trace elements, low immune function, easy secondary infection, and affect children's heart, organ function and intellectual development. In conclusion, this group of children with congenital heart disease should draw more extensive attention. And the scientific and reasonable feeding knowledge of infants should be widely carried out, which has far-reaching significance. Therefore, this multi-center cohort study is proposed.
We purposed to carry out a multi-center cohort study, and all infants under 1 year old with congenital heart disease undergone surgery in these hospitals were included. We aimed to follow up a long-term, tracking the nutrition status and motor development. The eligible patients in Guangzhou Women and Children's Medical Center, Shenzhen Children's Hospital, Gansu Provincial Maternity and Child-care Hospital, Zhengzhou Cardiovascular hospital, The Children's Hospital Zhejiang University school of medicine will be included. The baseline data will be collected before surgery, and physical, laboratory and imaging examination will be follow at pre and 1, 3, 6, 12 months post surgery to tracking the change of nutrition status (measured as WAZ, WHZ and HAZ). Questionnaires including emotional and social scales will be assigned pre and post surgery for causal inference and life quality evaluation.
The benefits of our follow up were:
- patients will be asked to come back to the clinic for periodic review at certain time；
- specialized people conduct follow up the cohort study；
- A website system had been established to collect the information of patients:
1\) professional CRF forms were unified; 2) the website has quality control features. 3) specialized people are responsible for maintaining the website. 4) the website guarantee the long-distance multi-center communication. 5) the website has a reminder of follow-up.
Eligibility
Inclusion Criteria:
- All children in the multi-center who met the following criteria:
- under 1 years old (including 1 years old);
- diagnosed as congenital heart disease and planed to surgery;
- parents have basic literacy skills, communication and accessibility
- parents are informed consent and volunteered to participate with the approval of the hospital ethics committee,
Exclusion Criteria:
- (1) suspected as chromosomal disease; (2) diagnosis of genetic metabolic diseases; (3) anyway affecting oral feeding (eg. Cleft palate) (4) previous gastrointestinal surgery (eg. Postoperative gastrointestinal fistula)
