Parenting and child development in families with a child conceived through embryo donation

Concerns have been raised regarding the potentially negative effects of conception using donated embryos on parenting and child development. Findings are presented of an exploratory study of families with a child conceived through embryo donation. Twenty-one embryo donation families were compared with 28 adoptive families and 30 in vitro fertilization families on standardized interview and questionnaire measures of the parents' marital and psychological state, the quality of parent-child relationships, and the child's development. In all 3 groups, the children were aged 2-5 years. The differences indicated higher emotional overinvolvement and defensive responding in the embryo donation families, along with greater secrecy about the child's origins. The children were not at increased risk of psychological problems. The study provides interesting but preliminary findings on parent-child relationships and child development in a new family form

Measuring Mitochondrial Dysfunction in Humans

Mitochondria are essential organelles found in almost every cell in the human body. They host a number of important metabolic pathways and carry out essential biological functions such as ATP synthesis and regulating cell death. There is a slow decline in mitochondrial function associated with ageing and mitochondrial dysfunction is proposed to act causally in a number of diseases. Previously it has been difficult to measure the health of human mitochondria as tests have required tissue from invasive muscle biopsies. The Seahorse XF Analyser is a recent technological advance that enables researchers to test mitochondrial function in small numbers of live cells. Recently, using the Seahorse analyser, peripheral blood cells such as platelets, monocytes and lymphocytes have been shown to display individually distinct bioenergetic profiles. During circulation, these cells are exposed to metabolic or environmental stressors throughout the body, potentially allowing them to act as biomarkers of bioenergetic health and ageing. Different cell preparations were trialled to purify and isolate platelets, monocytes and lymphocytes from freshly drawn whole blood. These protocols succeeded in preparing platelet and T-lymphocyte samples for XF analysis, however inconsistent results indicated that the protocols need further development. The Seahorse XF analyser was used to measure bioenergetic function in human platelets and T-lymphocytes from healthy donors ranging from 21 to 56 years of age. Each cell type required optimisation experiments to determine the optimal inhibitor and substrate concentrations to generate a meaningful bioenergetic profile. Similarly, seeding densities were determined to ensure oxygen consumption values that were suitable to the instruments sensitivity. These cell types have elastic metabolic phenotypes, and appeared sensitive to metabolic switching during early stages of the XF assay. Platelets were particularly difficult to work with because of their inclination to cease using oxidative phosphorylation and switch metabolism to using purely glycolytic pathways. Platelet susceptibility for metabolic switching is undetermined at this point. Lymphocyte optimization experiments also indicated possible premature activation during the assay. Further work is needed to fine tune this protocol to ensure consistent and uniform measurements before accurate BHI values are calculated for donors of different ages

What makes effective advocacy? An exploration of public health nutrition advocacy in England

Background: This research explores aspects of the widely discussed gap between the state of public health nutrition in England and the appropriateness of government and commercial responses. Specifically, it explores the role of NGO advocacy in altering and improving this situation. Recognising that NGOs conduct their advocacy to protect the public good and shape public health nutrition policy, this research analyses the role and effectiveness of NGO advocacy in shifting and shaping the dynamics of food and nutrition policy, and how it can be measured. Drawing on interdisciplinary political theories and existing models of advocacy, the research applies an academic lens to some of the practical challenges and issues faced by NGO advocates. Aim: The aim of this research was to understand the role and effectiveness of NGO advocacy in public health nutrition, a previously under-researched area. The research focuses on England, a country with an active NGO presence, and explored the different types of advocacy and the different ways in which advocacy success is, and could be, measured. The research has relevance for the academic literature, for our understanding of advocacy effectiveness in public health nutrition and, not least, for improving the way NGOs engage with policy and change. Research questions: Three research questions were posed: 1. What conditions support or hinder NGO advocacy in public health nutrition? 2. What advocacy tactics are adopted by NGOs working in public health nutrition? 3. How can the effectiveness of public health nutrition advocacy be measured? Methods: Qualitative research methods were used, primarily drawing on the experiences in England from three implemented public health nutrition policies (FOP labelling, marketing restrictions and salt reduction) and four NGOs working on public health nutrition. A combination of methods, including semi-structured interviews (N=29) and document analysis of grey literature from campaigning groups and government agencies, were used to answer each research question to aid triangulation and validation of the findings. Main findings: Advocacy was found to be a complex mix of positions and strategies, with no single model utilised by NGOs. There is a range of ‘advocacies’ which mean different things, at different times, in different contexts and to different people. Advocacy was found to be intrinsically linked to external conditions, and these conditions often dictate the most appropriate approach and likelihood of success. The research demonstrated different ways in which advocacy can react to, shape and navigate these conditions as part of efforts to achieve change. As a result of the conditions, advocacy was found to be rarely straightforward or predictable, adding a layer of complexity for measuring advocacy. A number of short- and long-term indicators for measuring advocacy were identified and, drawing on the overall findings, it is suggested that in order to get the most value from an advocacy monitoring framework, advocacy should always be contextualised within the wider conditions, and a range of different indicators should be used to reflect these different conditions. The thesis ends by reflecting on the practical implications of the research and proposing a practical framework for monitoring advocacy. Implications: The results of this research provide insights into public health nutrition advocacy and the complexity and dynamics within which it operates. The vital role of the conditions highlights the need to contextualise any assessment of advocacy and thus utilise measures across a range of domains. Progress was found to result from both abrupt and incremental change and as such advocacy which is fluid and dynamic will be necessary in order to react, shape and navigate different conditions. While needing further refinement and research, the monitoring framework presented in this thesis is valuable as a means to identify appropriate advocacy tactics and measures, while being underpinned by the conditions at play. The measuring challenge for advocacy remains, but the proposed framework developed can aid future monitoring and refinement of advocacy and thus help improve the ability of NGOs to support improvements to public health nutrition

Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children

In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. We examined the actions taken between 2010 and early 2016 – by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organizations, philanthropic institutions and transnational industries – to help decrease the prevalence of obesity and diet-related noncommunicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organizations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors we investigated appears variable and generally less robust. We suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from noncommunicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030

Co-creating obesity prevention policies with youth: Policy ideas generated through the CO-CREATE project

Despite growing recognition of the importance of applying a systems lens to action on obesity, there has only been limited analysis of the extent to which this lens has actually been applied. The CO-CREATE project used a youth-led participatory action research approach to generate policy ideas towards the reduction of adolescent overweight and obesity across Europe. In order to assess the extent to which these youth-generated policy ideas take a systems approach, we analyzed them using the Intervention Level Framework (ILF). The ILF ascribes actions to one of five system levels, from Structural Elements, the least engaged with system change, up to Paradigm, which is the system's deepest held beliefs and thus the most difficult level at which to intervene. Of the 106 policy ideas generated by young people during the CO-CREATE project, 91 (86%) were categorized at the level of Structural Elements. This emphasis on operational rather than systems level responses echoes findings from a previous study on obesity strategies. Analyzing the distribution of systems level responses using the ILF has the potential to support more effective action on obesity by allowing identification of opportunities to strengthen systems level responses overall.publishedVersio

Surrogacy

Surrogacy is a promising treatment for infertility. It can potentially solve many intolerable difficulties that the infertile couples and their families face. Although initially frowned upon, evidence shows that the surrogacy arrangements are more acceptable now than when it was first introduced. Therefore, changes in the attitude in decision making about surrogacy can also be seen in some countries, but there are still indications of the degree of divergence between discourse and the actual practice of different forms of surrogacy around the world. Social, ethical and legal problems are subject to major debates and disagreements in natural or partial surrogacy or genetically unrelated full surrogacy. Genetic gestation surrogacy may largely free from social, legal and moral complications. It is a great choice of infertility treatment if the couple want their own genetic baby, but it still requires more thoughts and discussion. This chapter attempts to discuss the different notions related to surrogacy worldwide