4,255 research outputs found
Key Components of Antenatal Lifestyle Interventions to Optimize Gestational Weight Gain: Secondary Analysis of a Systematic Review
Importance: Randomized clinical trials have found that antenatal lifestyle interventions optimize gestational weight gain (GWG) and pregnancy outcomes. However, key components of successful interventions for implementation have not been systematically identified. Objective: To evaluate intervention components using the Template for Intervention Description and Replication (TIDieR) framework to inform implementation of antenatal lifestyle interventions in routine antenatal care. Data Sources: Included studies were drawn from a recently published systematic review on the efficacy of antenatal lifestyle interventions for optimizing GWG. The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, MEDLINE, and Embase were searched from January 1990 to May 2020. Study Selection: Randomized clinical trials examining efficacy of antenatal lifestyle interventions in optimizing GWG were included. Data Extraction and Synthesis: Random effects meta-analyses were used to evaluate the association of intervention characteristics with efficacy of antenatal lifestyle interventions in optimizing GWG. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data extraction was performed by 2 independent reviewers. Main Outcomes and Measures: The main outcome was mean GWG. Measures included characteristics of antenatal lifestyle interventions comprising domains related to theoretical framework, material, procedure, facilitator (allied health staff, medical staff, or researcher), delivery format (individual or group), mode, location, gestational age at commencement (<20 wk or ≥20 wk), number of sessions (low [1-5 sessions], moderate [6-20 sessions], and high [≥21 sessions]), duration (low [1-12 wk], moderate [13-20 wk], and high [≥21 wk]), tailoring, attrition, and adherence. For all mean differences (MDs), the reference group was the control group (ie, usual care). Results: Overall, 99 studies with 34546 pregnant individuals were included with differential effective intervention components found according to intervention type. Broadly, interventions delivered by an allied health professional were associated with a greater decrease in GWG compared with those delivered by other facilitators (MD, -1.36 kg; 95% CI, -1.71 to -1.02 kg; P <.001). Compared with corresponding subgroups, dietary interventions with an individual delivery format (MD, -3.91 kg; 95% CI -5.82 to -2.01 kg; P =.002) and moderate number of sessions (MD, -4.35 kg; 95% CI -5.80 to -2.89 kg; P <.001) were associated with the greatest decrease in GWG. Physical activity and mixed behavioral interventions had attenuated associations with GWG. These interventions may benefit from an earlier commencement and a longer duration for more effective optimization of GWG. Conclusions and Relevance: These findings suggest that pragmatic research may be needed to test and evaluate effective intervention components to inform implementation of interventions in routine antenatal care for broad public health benefit.
Is mitochondrial dysfunction a driving mechanism linking COPD to nonsmall cell lung carcinoma?
© ERS 2017. Chronic obstructive pulmonary disease (COPD) patients are at increased risk of developing nonsmall cell lung carcinoma, irrespective of their smoking history. Although the mechanisms behind this observation are not clear, established drivers of carcinogenesis in COPD include oxidative stress and sustained chronic inflammation. Mitochondria are critical in these two processes and recent evidence links increased oxidative stress in COPD patients to mitochondrial damage. We therefore postulate that mitochondrial damage in COPD patients leads to increased oxidative stress and chronic inflammation, thereby increasing the risk of carcinogenesis. The functional state of the mitochondrion is dependent on the balance between its biogenesis and degradation (mitophagy). Dysfunctional mitochondria are a source of oxidative stress and inflammasome activation. In COPD, there is impaired translocation of the ubiquitin-related degradation molecule Parkin following activation of the Pink1 mitophagy pathway, resulting in excessive dysfunctional mitochondria. We hypothesise that deranged pathways in mitochondrial biogenesis and mitophagy in COPD can account for the increased risk in carcinogenesis. To test this hypothesis, animal models exposed to cigarette smoke and developing emphysema and lung cancer should be developed. In the future, the use of mitochondria-based antioxidants should be studied as an adjunct with the aim of reducing the risk of COPD-associated cancer
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Student anti-bullying and harassment policies at UK universities
This article provides the first analysis of all available UK university anti-bullying policies, summarising, comparing, and contrasting the content of policies acquired from university websites. The importance of anti-bullying policies is known from policy research in schools and workplaces but has previously not been investigated in Higher Education. A new coding framework and guidelines were developed to enable our analysis, and universities were given a score. Scores indicated variation between policies, suggesting some students may have inadequate support when consulting their university policy. The findings indicate that all universities should create and implement an anti-bullying policy. Students could be involved in the development of interventions or policies, as co-created initiatives may be more influential. University policy must be up-to-date, inclusive, comprehensive yet concise, and it must be publicised. We propose that our novel coding framework could be of use to policy makers and researchers investigating bullying policy within higher education
Semi-analytical approach to magnetized temperature autocorrelations
The cosmic microwave background (CMB) temperature autocorrelations, induced
by a magnetized adiabatic mode of curvature inhomogeneities, are computed with
semi-analytical methods. As suggested by the latest CMB data, a nearly
scale-invariant spectrum for the adiabatic mode is consistently assumed. In
this situation, the effects of a fully inhomogeneous magnetic field are
scrutinized and constrained with particular attention to harmonics which are
relevant for the region of Doppler oscillations. Depending on the parameters of
the stochastic magnetic field a hump may replace the second peak of the angular
power spectrum. Detectable effects on the Doppler region are then expected only
if the magnetic power spectra have quasi-flat slopes and typical amplitude
(smoothed over a comoving scale of Mpc size and redshifted to the epoch of
gravitational collapse of the protogalaxy) exceeding 0.1 nG. If the magnetic
energy spectra are bluer (i.e. steeper in frequency) the allowed value of the
smoothed amplitude becomes, comparatively, larger (in the range of 20 nG). The
implications of this investigation for the origin of large-scale magnetic
fields in the Universe are discussed. Connections with forthcoming experimental
observations of CMB temperature fluctuations are also suggested and partially
explored.Comment: 40 pages, 13 figure
Vitamin D in polycystic ovary syndrome: Relationship to obesity and insulin resistance
Scope: Polycystic ovary syndrome (PCOS) is underpinned by insulin resistance (IR). In PCOS, the relationships between vitamin D, adiposity, and IR are unclear. We aim to explore these relationships in lean and overweight women with PCOS. Methods and results: This is a cross-sectional study conducted in a tertiary medical center. Participants included 42 women with PCOS and 34 controls without PCOS. Vitamin D and metabolic markers were measured. Detailed body composition and gold standard hyperinsulinemic euglycemic clamps were performed. The main outcome measures were plasma levels of vitamin D, adiposity measures, and glucose infusion rate. Vitamin D levels were lower in overweight women with PCOS compared with overweight controls (31.6 and 46.1 nmol/L, respectively, p = 0.01). Vitamin D was not associated with IR after adjustment for confounders; however, there was a significant interaction between PCOS and percentage body fat. Further analysis by PCOS status revealed that vitamin D was associated with IR in the PCOS group (β coefficient 2.1, 95% CI 0.2–4.0, p = 0.03), but not in the non-PCOS group. Conclusion: Vitamin D is associated with IR in women with PCOS, but not in controls. Large intervention studies are needed to determine if vitamin D supplementation can improve IR in PCOS.Anju E. Joham, Helena J. Teede, Samantha Cassar, Nigel K. Stepto, Boyd J. Strauss, Cheryce L. Harrison, Jacqueline Boyle and Barbora de Courte
Initial conditions, Discreteness and non-linear structure formation in cosmology
In this lecture we address three different but related aspects of the initial
continuous fluctuation field in standard cosmological models. Firstly we
discuss the properties of the so-called Harrison-Zeldovich like spectra. This
power spectrum is a fundamental feature of all current standard cosmological
models. In a simple classification of all stationary stochastic processes into
three categories, we highlight with the name ``super-homogeneous'' the
properties of the class to which models like this, with , belong. In
statistical physics language they are well described as glass-like. Secondly,
the initial continuous density field with such small amplitude correlated
Gaussian fluctuations must be discretised in order to set up the initial
particle distribution used in gravitational N-body simulations. We discuss the
main issues related to the effects of discretisation, particularly concerning
the effect of particle induced fluctuations on the statistical properties of
the initial conditions and on the dynamical evolution of gravitational
clustering.Comment: 28 pages, 1 figure, to appear in Proceedings of 9th Course on
Astrofundamental Physics, International School D. Chalonge, Kluwer, eds N.G.
Sanchez and Y.M. Pariiski, uses crckapb.st pages, 3 figure, ro appear in
Proceedings of 9th Course on Astrofundamental Physics, International School
D. Chalonge, Kluwer, Eds. N.G. Sanchez and Y.M. Pariiski, uses crckapb.st
Flexible working arrangements and their influence on work-family conflicts and worker?s exhaustion.
A mesma tecnologia que eliminou os limites f?sicos para a realiza??o do trabalho trouxe ainda um conjunto de possibilidades no que se refere ? flexibiliza??o laboral, viabilizando modelos como o home-office e o hor?rio flex?vel, cujos efeitos sobre o trabalhador ainda carecem de investiga??o. Neste sentido, delimitou-se como objetivo de pesquisa analisar a rela??o entre a flexibiliza??o dos arranjos laborais no ?mbito organizacional, os conflitos trabalho-fam?lia e a exaust?o emocional do trabalhador. Para atingir tal objetivo, adotou-se uma abordagem descritiva quantitativa. Para coleta de dados, optou-se pelo m?todo survey, sendo a popula??o do estudo composta pelos habitantes de Mariana e Ouro Preto, ambas cidades localizadas no Estado de Minas Gerais, que estavam empregados no momento em que os dados foram coletados. Para an?lise dos dados, utilizou-se a t?cnica de Modelagem de Equa??es Estruturais. Com base nos resultados alcan?ados, constatou-se que, mesmo que a flexibiliza??o laboral n?o afete diretamente a exaust?o emocional do trabalhador, exerce sobre ela uma influ?ncia indireta, pois reduz os conflitos trabalho-fam?lia, que, por sua vez, impactam o desgaste individual experimentado no universo do trabalho.The same technology that eliminated the physical limits to perform the work has also brought a set of possibilities with regard to labor flexibility, enabling models such as home-office and flexible hours, whose effects on the worker still need to be investigated. In this sense, the objective of this research was to analyze the relationship between the flexibilization of the work arrangements in the organizational environment, the work-family conflicts and the emotional exhaustion of the worker. In order to achieve the mentioned objective, a quantitative descriptive approach was adopted. For data collection, the survey method was chosen. The population of the study was composed of the inhabitants of Mariana and Ouro Preto, both cities located in the State of Minas Gerais, who were employed at the time the data were collected. For data analysis, the Structural Equation Modeling technique was used. Based on the results achieved, it was observed that, although labor flexibility does not directly affect the emotional exhaustion of the worker, it exerts an indirect influence, reducing the labor-family conflicts, which, in turn, affect the individual exhaustion experienced in the universe of work
Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series
BACKGROUND: The combination of spinal manipulation and various physiotherapeutic procedures used to correct the curvatures associated with scoliosis have been largely unsuccessful. Typically, the goals of these procedures are often to relax, strengthen, or stretch musculotendinous and/or ligamentous structures. In this study, we investigate the possible benefits of combining spinal manipulation, positional traction, and neuromuscular reeducation in the treatment of idiopathic scoliosis. METHODS: A total of 22 patient files were selected to participate in the protocol. Of these, 19 met the study criterion required for analysis of treatment benefits. Anteroposterior radiographs were taken of each subject prior to treatment intervention and 4–6 weeks following the intervention. A Cobb angle was drawn and analyzed on each radiograph, so pre and post comparisons could be made. RESULTS: After 4–6 weeks of treatment, the treatment group averaged a 17° reduction in their Cobb angle measurements. None of the patients' Cobb angles increased. A total of 3 subjects were dismissed from the study for noncompliance relating to home care instructions, leaving 19 subjects to be evaluated post-intervention. CONCLUSIONS: The combined use of spinal manipulation and postural therapy appeared to significantly reduce the severity of the Cobb angle in all 19 subjects. These results warrant further testing of this protocol
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