Association between adherence to the Mediterranean Diet and the Eatwell Guide and changes in weight and waist circumference in post-menopausal women in the UK Women's Cohort Study

Objective This study investigated the associations between adherence to the Mediterranean Diet and the Eatwell Guide (EWG) and changes in weight and waist circumference in post-menopausal women. Study Design Post-hoc analysis of post-menopausal women from the UK Women’s Cohort Study. Main outcome measures Changes in weight, waist circumference and the risk of abdominal and general obesity. Results 4162 post-menopausal women were selected. Higher adherence to both the EWG and the Mediterranean Diet was associated with smaller increases in waist circumference over 4 years (EWG: β −0.47, CI −0.75, −0.20 per 1 tertile increase in score), (Mediterranean Diet: β −0.29, CI −0.58, −0.01 per 1 tertile increase in score); and lower risk of abdominal obesity (EWG: OR 0.55, CI 0.43, 0.70 third versus the first tertile), (Mediterranean Diet: OR 0.60, CI 0.46, 0.76 third versus the first tertile), but was not associated with weight changes (EWG: β 0.14, CI −0.07, 0.36 per 1 tertile increase in score), (Mediterranean Diet: β 0.03, CI −0.19, 0.25 per 1 tertile increase in score) or risk of becoming overweight or obese (EWG: OR 1.09, CI 0.77, 1.52 third versus the first tertile), (Mediterranean Diet: OR 0.91, CI 0.65, 1.27 third versus the first tertile). Conclusions The results suggest that adherence to either the Mediterranean Diet or the EWG can help to prevent abdominal obesity in post-menopausal women

The improved prognosis of hypoplastic left heart:A Population-Based Register Study of 343 Cases in England and Wales

Background: Hypoplastic Left Heart Syndrome (HLHS) is a severe congenital heart defect (CHD) characterised by the underdevelopment of the left side of the heart with varying levels of hypoplasia of the left atrium, mitral valve, left ventricle, aortic valve and aortic arch. In the UK, age 12 survival for cases born between 1991 and 1993 was 21%. UK survival estimates corresponding to cases born between 2000 and 2015 were improved at 56%, but survival was examined up to age five only. Contemporary long-term survival estimates play a crucial role in counselling parents following diagnosis. The aim of this study was to report survival estimates up to age 15 for children born with HLHS or hypoplastic left ventricle with additional CHD in England and Wales between 1998 and 2012. Methods: Cases of HLHS notified to four congenital anomaly registers in England and Wales during 1998–2012, matched to Office for National Statistics mortality information, were included. Kaplan-Meier survival estimates to age 15 were reported. Cox regression models were fitted to examine risk factors for mortality. Results: There were 244 cases of HLHS and 99 cases of hypoplastic left ventricle co-occurring with other CHD, with traced survival status. Kaplan-Meier survival estimates for HLHS were 84.4% at age 1 week, 76.2% at 1 month, 63.5% at age 1 year, 58.6% at age 5 years, 54.6% at age 10 years, and 32.6% to age 15 years. The Kaplan-Meier survival estimates for cases of hypoplastic left ventricle co-occurring with additional CHD were 90.9% at age 1 week, 84.9% at 1 month, 73.7% at age 1 year, 67.7% to age 5 years, 59.2% to age 10 years, and 40.3% to age 15 years. Preterm birth (p = 0.007), low birth weight (p = 0.005), and female sex (p = 0.01) were associated with mortality. Conclusions: We have shown that prognosis associated with HLHS in the twenty first century exceeds that of many previous population-based studies, likely due to improvements in intensive care technologies and advances in surgical techniques over the last few decades

Talking with parents of children with learning disabilities: Parents’ ideas about the Circle of Security parenting programme

The Circle of Security Parenting (COS-P) programme can be helpful for some parents of children with learning disabilities to think about their relationship with their child. Parenting a child with learning disabilities is different, and COS-P can highlight this difference. This can feel painful for parents and may stop them engaging with the programme. Abstract: Background Background: The promotion of secure attachment relationships in childhood leads to better outcomes in later life (British Psychological Society 2017, Incorporating Attachment Theory into Practice: Clinical Practice Guideline for Clinical Psychologists Working with People who have Intellectual Disabilities). The Circle of Security Parenting Programme (COS-P) provides a clear framework for reflecting on attachment relationships (Cooper et al 2009, Zero to Three, 37, 27). Methods Methods: Semi-structured interviews were conducted with parents of children with learning disabilities who attended a COS-P programme to find out about their experiences of the course and how applicable it was to them. The data were analysed using thematic analysis. Findings Findings: Four key themes were identified: these related to (1) COS-P concepts are relevant to all children but (2) parenting a child with a learning disability is different and (3) COS-P can create a focus on their child as different, which can be painful, and (4) changes recommended to make COS-P suitable for parents of children with learning disabilities. Conclusions Conclusions: This paper outlines the benefits and challenges of COS-P in sharing concepts related to attachment, whilst highlighting differences for parents of children and young people with learning disabilities, which can be painful.</p

Homeless drug users' awareness and risk perception of peer "Take Home Naloxone" use – a qualitative study

BACKGROUND Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. METHODS In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. RESULTS Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. CONCLUSION There is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users

The XMM Cluster Survey: The interplay between the brightest cluster galaxy and the intra-cluster medium via AGN feedback

Using a sample of 123 X-ray clusters and groups drawn from the XMM-Cluster Survey first data release, we investigate the interplay between the brightest cluster galaxy (BCG), its black hole, and the intra-cluster/group medium (ICM). It appears that for groups and clusters with a BCG likely to host significant AGN feedback, gas cooling dominates in those with Tx > 2 keV while AGN feedback dominates below. This may be understood through the sub-unity exponent found in the scaling relation we derive between the BCG mass and cluster mass over the halo mass range 10^13 < M500 < 10^15Msol and the lack of correlation between radio luminosity and cluster mass, such that BCG AGN in groups can have relatively more energetic influence on the ICM. The Lx - Tx relation for systems with the most massive BCGs, or those with BCGs co-located with the peak of the ICM emission, is steeper than that for those with the least massive and most offset, which instead follows self-similarity. This is evidence that a combination of central gas cooling and powerful, well fuelled AGN causes the departure of the ICM from pure gravitational heating, with the steepened relation crossing self-similarity at Tx = 2 keV. Importantly, regardless of their black hole mass, BCGs are more likely to host radio-loud AGN if they are in a massive cluster (Tx > 2 keV) and again co-located with an effective fuel supply of dense, cooling gas. This demonstrates that the most massive black holes appear to know more about their host cluster than they do about their host galaxy. The results lead us to propose a physically motivated, empirical definition of 'cluster' and 'group', delineated at 2 keV.Comment: Accepted for publication in MNRAS - replaced to match corrected proo

Domain-specific neuropsychological investigation of CAA with and without intracerebral haemorrhage

Background: Cerebral amyloid angiopathy (CAA) is associated with cognitive impairment, but the contributions of lobar intracerebral haemorrhage (ICH), underlying diffuse vasculopathy, and neurodegeneration, remain uncertain. We investigated the domain-specific neuropsychological profile of CAA with and without ICH, and their associations with structural neuroimaging features. // Methods: Data were collected from patients with possible or probable CAA attending a specialist outpatient clinic. Patients completed standardised neuropsychological assessment covering seven domains. MRI scans were scored for markers of cerebral small vessel disease and neurodegeneration. Patients were grouped into those with and without a macro-haemorrhage (CAA-ICH and CAA-non-ICH). // Results: We included 77 participants (mean age 72, 65% male). 26/32 (81%) CAA-non-ICH patients and 41/45 (91%) CAA-ICH patients were impaired in at least one cognitive domain. Verbal IQ and non-verbal IQ were the most frequently impaired, followed by executive functions and processing speed. We found no significant differences in the frequency of impairment across domains between the two groups. Medial temporal atrophy was the imaging feature most consistently associated with cognitive impairment (both overall and in individual domains) in both univariable and multivariable analyses. // Discussion: Cognitive impairment is common in CAA, even in the absence of ICH, suggesting a key role for diffuse processes related to small vessel disease and/or neurodegeneration. Our findings indicate that neurodegeneration, possibly due to co-existing Alzheimer’s disease pathology, may be the most important contributor. The observation that general intelligence is the most frequently affected domain suggests that CAA has a generalised rather than focal cognitive impact

Novel superparamagnetic micro-devices based on magnetised PLGA/PLA microparticles obtained by supercritical fluid emulsion and coating by carboxybetaine-functionalised chitosan allowing the tuneable release of therapeutics

When superparamagnetic nanoparticles are loaded within micro-carriers of thermosensitive and injectable biopolymers, “smart” microdevices are obtained: they respond to an external magnetic field (EMF) through the release of any co-encapsulated molecules with a remote on-off control. Creating reliable and effective fabrication technologies for the production of these smart nano/micro-devices remains a challenge. In this work Supercritical Emulsion Extraction technology (SEE) is proposed for the fabrication of microcapsules with a core of poly-lactic-co-glycolic acid (PLGA) or poly-lactic acid (PLA) covered by carboxybetaine-functionalized chitosan (f-chi) and loaded with paramagnetic nanoparticles (MAG, mean size of 6.5±3.0 nm) and water soluble fluorescein (Fluo). Fluo is co-encaspulated as a fluorescent marker for the release study. Microcarriers showed a mean size of 800±60nm with an encapsulation efficiency of up to 90%. The inversion of surface charge, after the f-chitosan coating, suggested the presence of a uniform functionalized surface available for further chemical linkage. The external chitosan layer had a thickness of 200±50nm. An excellent MAG dispersion was confirmed within the biopolymer matrix that was shown to be responsive to EMF; indeed, Fluo was released over 3 or 5 days from PLGA or f-chiPLGA microdevices into PBS medium at 37°C; whereas, remote on-off controlled release was achieved when an Alternating Magnetic Field (AMF) was applie

Tobacco, e-cigarette and alcohol content in popular UK soap operas: a content analysis to explore changes in social norms and scene location

Background: Exposure to tobacco and alcohol on-screen promotes use and despite regulations and policies to limit impact, these behaviours remain common. We report a longitudinal analysis of tobacco, e-cigarette and alcohol content in three popular UK television soap operas, to examine changing social norms between 2002 and 2022. Methods: We used one-minute interval coding to measure content in programmes in two one-week periods in three years (2002, 2012 and 2022). Change in the probability of actual and implied use of tobacco, e-cigarette and alcohol over time was examined using logistic regression. Results: We coded 2505 intervals from 78 episodes. Tobacco content occurred in 22% of episodes and significantly decreased from 2002 to 2022 (OR 0.15 95% CI 0.06–0.40). Tobacco use changed over time with decreasing use indoors and increasing use outdoors. No e-cigarette use was identified. Alcohol content was found in 88% of episodes and while it also significantly decreased over time (OR 0.78 95% CI 0.61–0.99) it featured in 20% of broadcast minutes in 2022. Alcohol use in homes increased over time. Conclusion: While tobacco imagery is increasingly rare in these three UK soap operas, alcohol content has remained common. Tightening the UK Ofcom regulations would help to reduce young people’s exposure to these harmful behaviours and their potential influence on social norms now and in the future

Tobacco, e-cigarette and alcohol content in popular UK soap operas: a content analysis to explore changes in social norms and scene location

Background: Exposure to tobacco and alcohol on-screen promotes use and despite regulations and policies to limit impact, these behaviours remain common. We report a longitudinal analysis of tobacco, e-cigarette and alcohol content in three popular UK television soap operas, to examine changing social norms between 2002 and 2022. Methods: We used one-minute interval coding to measure content in programmes in two one-week periods in three years (2002, 2012 and 2022). Change in the probability of actual and implied use of tobacco, e-cigarette and alcohol over time was examined using logistic regression. Results: We coded 2505 intervals from 78 episodes. Tobacco content occurred in 22% of episodes and significantly decreased from 2002 to 2022 (OR 0.15 95% CI 0.06–0.40). Tobacco use changed over time with decreasing use indoors and increasing use outdoors. No e-cigarette use was identified. Alcohol content was found in 88% of episodes and while it also significantly decreased over time (OR 0.78 95% CI 0.61–0.99) it featured in 20% of broadcast minutes in 2022. Alcohol use in homes increased over time. Conclusion: While tobacco imagery is increasingly rare in these three UK soap operas, alcohol content has remained common. Tightening the UK Ofcom regulations would help to reduce young people’s exposure to these harmful behaviours and their potential influence on social norms now and in the future

Diet, Physical Activity and Gestational Weight Gain Patterns among Pregnant Women Living with Obesity in the North East of England: The GLOWING Pilot Trial

Maternal diet, physical activity (PA) behaviours, and gestational weight gain (GWG) are important for optimum health of women and their babies. This secondary analysis of the GLOWING pilot cluster trial explored these among women living with obesity in high deprivation. Pregnant women completed food frequency, PA and psychosocial questionnaires. Weights were retrieved from medical records and measured during routine appointments with midwives. Descriptive and regression analyses were stratified by obesity class. A total of 163 women were recruited; 54.0% had class 1 obesity, 25.8% class 2, 20.2% class 3, and 76.1% lived in the two most deprived quintiles. Women had suboptimal dietary intake, particularly for oily fish, fruit and vegetables. PA was predominantly light intensity, from household, care and occupational activities. Most women gained weight outside of Institute of Medicine (IOM) guideline recommendations (87.8%); women in class 3 obesity were most likely to have inadequate GWG below IOM recommendations (58.3%, p 0.01) and reduced odds of excessive GWG compared with class 1 (AOR 0.13, 95% 0.04–0.45). Deprived women with obesity have a double inequality as both increase pregnancy risks. This population requires support to meet guideline recommendations for diet, PA and GWG. Further research exploring obesity classes would inform policies and care to achieve the best pregnancy outcomes