Folic acid in pregnancy and mortality from cancer and cardiovascular disease : further follow-up of the Aberdeen folic acid supplementation trial

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. Acknowledgements The authors wish to acknowledge Professor Marion Hall, who set up the original randomised trial of folic acid supplementation. The authors also thank Ms Katie Wilde and the Data Management Team, University of Aberdeen, for their help with the extraction and linking of data and the data analysts from ISD Scotland.Peer reviewedPublisher PD

Project management in higher education

This study identified factors that influenced the use of project management in higher education research projects. Using a qualitative grounded theory approach that included in-depth interviews with assistant professors, the researcher examined how these individuals were using project management processes and tools and factors that enabled, motivated, and/or inhibited the use of project management processes and tools in research projects. A total of 22 participants (12 women, 10 men) from 21 different universities across 13 states took part in the study. Participants were selected based on specific inclusion criteria. All participants were assistant professors working in colleges of education or other education-related areas at doctoral-granting universities. Participants were currently working on funded research projects or had worked on funded research projects in the past two years. Focusing on participants in a single discipline (education) enabled a meaningful grounded theory to be developed from the data and has established a method for study and comparison with other disciplines in the future

Effects of maternal, gestational, and perinatal variables on neonatal line width observed in a modern UK birth cohort

OBJECTIVES: The objective of this study was to explore potential relationships between neonatal line (NNL) width and early life history variables such as maternal health, gestation, the birth process, and perinatal health. MATERIALS AND METHODS: Histological thin sections of deciduous canines were studied from 71 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). The width of the NNL was measured in three locations on the tooth crown using spatial mapping techniques (ArcGIS) from digital images from an Olympus VS-120 microscope. Life history variables were collected prospectively through a combination of clinical observations and questionnaires. RESULTS: Infants born late term or post term had narrower neonatal lines than those born prematurely or at full term. Infants born in Autumn (September to November) had narrower NNLs than those born at other times of year. NNLs in infants born to mothers with hypertension were wider than those without. Infants resuscitated at birth or born to obese mothers had narrower NNLs than those that were not. There was no association between NNL width and either the type or duration of delivery. DISCUSSION: The NNL in enamel is an irregular accentuated line, but the factors underlying its formation and width remain unclear. In contrast to some previous studies, we found no association between wider NNLs and long or difficult births. Instead, we found that the width of the neonatal line NNL varied in relation to parameters that reflected the prenatal environment and length of gestation

The long-term impact of folic acid in pregnancy on offspring DNA methylation : follow-up of the Aberdeen folic acid supplementation trial (AFAST)

Funding This work was supported by the NIHR Bristol Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. R.C.R., G.C.S., N.K., T.G., G.D.S. and C.L.R. work in a unit that receives funds from the University of Bristol and the UK Medical Research Council (MC_UU_12013/1, MC_UU_12013/2 and MC_UU_12013/8). This work was also supported by CRUK (grant number C18281/A19169) and the ESRC (grant number ES/N000498/1). C.M.T. is supported by a Wellcome Trust Career Re-entry Fellowship (grant number 104077/Z/14/Z).Peer reviewedPublisher PD

IV. Discours

Abstract Background The Enhanced Recovery After Surgery (ERAS) programme is an approach to the perioperative care of patients which aims to improve outcomes and speed up recovery after surgery. Although the evidence base appears strong for this programme, the implementation of ERAS has been slow. This study aimed to gain an understanding of the facilitating factors and challenges of implementing the programme with a view to providing additional contextual information to aid implementation. The study had a particular focus on the nutritional elements as these have been highlighted as important. Methods The study employed qualitative research methods, guided by the Normalisation Process Theory (NPT) to explore the experiences and opinions of 26 healthcare professionals from a range of disciplines implementing the programme. Results This study identified facilitating factors to the implementation of ERAS: alignment with evidence based practice, standardising practice, drawing on the evidence base of other specialties, leadership, teamwork, ERAS meetings, patient involvement and education, a pre-operative assessment unit, staff education, resources attached to obtaining The Commissioning for Quality and Innovation (CQUIN) money, the ward layout, data collection and feedback, and adapting the care pathway. A number of implementation challenges were also identified: resistance to change, standardisation affecting personalised patient care, the buy-in of relevant stakeholders, keeping ERAS visible, information provision to patients, resources, palatability of nutritional drinks, aligning different ward cultures, patients going to non-ERAS departments, spreading the programme within the hospital, differences in health issue, and utilising a segmental approach.  Conclusions The findings presented here provide useful contextual information from diverse surgical specialties to inform healthcare providers when implementing ERAS in practice. Addressing the challenges and utilising the facilitating factors identified in this study, could speed up the rate at which ERAS is adopted, implemented and embedded

Misunderstandings, communicative expectations and resources in illness narratives: Insights from beyond interview transcripts.

Interactional misunderstandings in interviews are often glossed over in analysing narratives, so overlooking important clues about how interactants frame the interview discussion. Such misunderstandings will influence ongoing talk, shaping knowledge researchers produce about participants. We discuss whether interpretations of illness narratives may be enhanced if we analyse misunderstandings in conjunction with other contextually-available data not visible within interview transcripts. Using research interviews with people with asthma, we adopted linguistic ethnographic methods to analyse the manifestation and specific consequences of interactional tensions and misunderstandings between interviewer and interviewee. Misunderstandings can indicate inequalities in communicative expectations and discursive resources available to interactants, which may lead to participants’ talk being inappropriately identified as indicating a particular narrative. Incorporating ethnographic contextual features may make visible pertinent discourses not overtly evident within interviews. This may help theorise interview talk, like health and illness narratives, as manifesting within cycles of discourse that will intersect differently in each interaction