A Critical Appraisal of Guidelines for Antenatal Care: Components of Care and Priorities in Prenatal Education

There are a variety of published prenatal care (PNC) guidelines that claim a scientific basis for the information included. Four sets of PNC guidelines published between 2005 and 2009 were examined and critiqued. The recommendations for assessment procedures, laboratory testing, and education/counseling topics were analyzed within and between these guidelines. The PNC components were synthesized to provide an organized, comprehensive appendix that can guide providers of antepartum care. The appendix may be used to locate which guidelines addressed which topics to assist practitioners to identify evidence sources. The suggested timing for introducing and reinforcing specific topics is also presented in the appendix. Although education is often assumed to be a vital component of PNC, it was inconsistently included in the guidelines that were reviewed. Even when education was included, important detail was lacking. Addressing each woman\u27s needs as the first priority was suggested historically and remains relevant in current practice to systematically provide care while maintaining the woman as the central player. More attention to gaps in current research is important for the development of comprehensive prenatal guidelines that contribute effectively to the long‐term health and well‐being of women, families, and their communities

Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis.

The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Residential exposure to nitrogen oxides (NO\u2082, NOx) and particulate matter (PM) was modelled and traffic indicators were assessed in a standardised manner. The spirometric parameters forced expiratory volume in 1 s (FEV\u2081) and forced vital capacity (FVC) from 7613 subjects were considered as outcomes. Cohort-specific results were combined using meta-analysis. We did not observe an association of air pollution with longitudinal change in lung function, but we observed that a 10 \u3bcg\ub7m(-3) increase in NO\u2082 exposure was associated with lower levels of FEV\u2081 (-14.0 mL, 95% CI -25.8 to -2.1) and FVC (-14.9 mL, 95% CI -28.7 to -1.1). An increase of 10 \u3bcg\ub7m(-3) in PM10, but not other PM metrics (PM2.5, coarse fraction of PM, PM absorbance), was associated with a lower level of FEV\u2081 (-44.6 mL, 95% CI -85.4 to -3.8) and FVC (-59.0 mL, 95% CI -112.3 to -5.6). The associations were particularly strong in obese persons. This study adds to the evidence for an adverse association of ambient air pollution with lung function in adults at very low levels in Europe

Should the poultry red mite Dermanyssus gallinae be of wider concern for veterinary and medical science?

The poultry red mite Dermanyssus gallinae is best known as a threat to the laying-hen industry; adversely affecting production and hen health and welfare throughout the globe, both directly and through its role as a disease vector. Nevertheless, D. gallinae is being increasingly implemented in dermatological complaints in non-avian hosts, suggesting that its significance may extend beyond poultry. The main objective of the current work was to review the potential of D. gallinae as a wider veterinary and medical threat. Results demonstrated that, as an avian mite, D. gallinae is unsurprisingly an occasional pest of pet birds. However, research also supports that these mites will feed from a range of other animals including: cats, dogs, rodents, rabbits, horses and man. We conclude that although reported cases of D. gallinae infesting mammals are relatively rare, when coupled with the reported genetic plasticity of this species and evidence of permanent infestations on non-avian hosts, potential for host-expansion may exist. The impact of, and mechanisms and risk factors for such expansion are discussed, and suggestions for further work made. Given the potential severity of any level of host-expansion in D. gallinae, we conclude that further research should be urgently conducted to confirm the full extent of the threat posed by D. gallinae to (non-avian) veterinary and medical sectors

A low-power 1-GHz super-regenerative transceiver with time-shared PLL control

A low-power transceiver for ISM applications in the 868-MHz band has been integrated in a 0.8-μm BiCMOS technology. The receiver part is based on the super-regenerative principle. The system includes two time-shared control loops, one for the selectivity and sensitivity control and one for the frequency control (PLL). The receiver with its PLL draws 3.6 mW for a sensitivity of -105 dBm and the emitter current consumption is 6mA for a 0-dBm output power. A 2.4-V operation voltage allow the usage of a two-batteries solution

Diversiteit en complexiteit van kennis in zorginteracties

The empirical papers in this special issue show that how knowledge is made relevant and negotiated in interaction is a complex matter. Traditionally, research on knowledge conceptualizes knowledge as being distributed across patients and health care providers, who respectively have access to experiential knowledge and medical knowledge of illness. In this view, both forms of knowledge then need to be transferred from one party to the other. However, our contributions show that interactions are more complex in many ways. First of all, there are more actors involved in medical interaction, such as translators and family members, who each uniquely contribute to what knowledge is constructed and how. Secondly, the forms and domains of knowledge cannot be reduced to medical and experiential knowledge, but for instance also concern knowledge on how health care interactions are structured. Thirdly, knowledge is not only about informing the other party in interaction but is for instance also used to account for decisions or to seek alignment. In this contribution we explore how these insights can inform future research and how it can help deepen our understanding of patient centredness and shared decision making in health care communication

Caspase-14 expression by epidermal keratinocytes is regulated by retinoids in a differentiation-associated manner

Caspase-14 is the only member of the caspase family that shows a restricted tissue expression. It is mainly confined to epidermal keratinocytes and in contrast to other caspases, is not activated during apoptosis induced by ultraviolet irradiation or cytotoxic substances. As it is cleaved under conditions leading to terminal differentiation of keratinocytes we suggested that caspase-14 plays a part in the physiologic cell death of keratinocytes leading to skin barrier formation. Here we show that retinoic acid, at concentrations inhibiting terminal differentiation of keratinocytes, strongly suppressed caspase-14 mRNA and protein expression by keratinocytes in monolayer culture and in a three-dimensional in vitro model of differentiating human epidermis (skin equivalent). By contrast, the expression of the caspases 3 and 8, which are both activated during conventional apoptosis, was increased and unchanged, respectively, after retinoic acid treatment. In addition to inhibition of differentiation in skin equivalents, retinoic acid treatment led to keratinocyte apoptosis and activation of caspase-3, both of which were undetectable in differentiated control skin equivalents. As this occurred in the absence of detectable caspase-14, our data demonstrate that caspase-14 is dispensable for keratinocyte apoptosis. The fact that in contrast to caspase-3 and caspase-8, caspase-14, similarly to other keratinocyte differentiation-associated proteins, is downregulated by retinoids, strongly suggests that this caspase, but not caspase-3 and -8, plays a part in terminal keratinocyte differentiation and skin barrier formation

Radiological and clinical outcome of arthroscopic labral repair with all-suture anchors

The aim of this study was to assess radiological and clinical outcome after arthroscopic all-suture anchor labral repair. 20 patients treated for anterior and superior labral instability (mean age 29, range 14-51 years) were assessed at a minimum follow-up time of 1 year (mean 19 months; range, 12-28 months). All patients were available for follow-up. In total, 58 all-suture anchors were implanted. Small cysts were found in two patients (2 anchors). Tunnel widening was apparent in 3 patients (3 anchors) with an average widening of 3.3 mm (range 3-4 mm). Bone edema at the anchor-site was seen in 6 patients (8 anchors). The remaining 9 patients (45 anchors) did not display reactive bone changes. Clinical outcomes showed a WOSI of 70.6, a DASH of 18.9 and a Constant score of 89.3, and no recurrence of instability. Satisfying radiological and clinical outcome was observed after arthroscopic instability surgery using all-suture anchors. Imaging revealed good labral healing without important bony reactions or the formation of large cysts at early follow-up