Socioeconomic disadvantage in childhood as a predictor of excessive gestational weight gain and obesity in midlife adulthood.

BackgroundLower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men. Pregnancy-related weight changes may contribute to this gender difference. The objectives of this study were to determine the associations between: 1. childhood socioeconomic disadvantage and midlife obesity; 2. excessive gestational weight gain (GWG) and midlife obesity; and 3. childhood socioeconomic disadvantage and excessive GWG, among a representative sample of childbearing women.MethodsWe constructed marginal structural models for seven measures of childhood socioeconomic position for 4780 parous women in the United States, using National Longitudinal Survey of Youth (1979-2010) data. Institute of Medicine definitions were used for excessive GWG; body mass index ≥30 at age 40 defined midlife obesity. Analyses were separated by race/ethnicity. Additionally, we estimated controlled direct effects of childhood socioeconomic disadvantage on midlife obesity under a condition of never gaining excessively in pregnancy.ResultsLow parental education, but not other measures of childhood disadvantage, was associated with greater midlife obesity among non-black non-Hispanic women. Among black and Hispanic mothers, childhood socioeconomic disadvantage was not consistently associated with midlife obesity. Excessive GWG was associated with greater midlife obesity in all racial/ethnic groups. Childhood socioeconomic disadvantage was not statistically significantly associated with excessive GWG in any group. Controlled direct effects were not consistently weaker than total effects.ConclusionsChildhood socioeconomic disadvantage was associated with adult obesity, but not with excessive gestational weight gain, and only for certain disadvantage measures among non-black non-Hispanic mothers. Prevention of excessive GWG may benefit all groups through reducing obesity, but excessive GWG does not appear to serve as a mediator between childhood socioeconomic position and adult obesity in women

Measuring the Relational Aspects of Civic Engagement and Action

Civic leaders who are highly and effectively engaged often have strong relationships with key stakeholders across institutions and communities. The prevalence and nature of these relationships is not known among those with more typical levels of civic engagement. Via survey data of a random sample of residents of two neighboring French towns, we find that people perceive their neighbors to be, on average, more engaged than they perceive to be themselves, and that few individuals can provide specific action steps for how they would tackle social issues in their community. These results suggest that teaching civic action skills, including how to identify key decision makers as possible allies, is important for civic educators

The relationship between five different measures of structural social capital, medical examination outcomes, and mortality

Higher social capital is associated with improved mental and physical health and reduced risk of premature mortality. We explored the relationship between five measures of structural social capital and 1) intermediate health outcomes (elevated C-reactive protein, cholesterol, blood pressure, and serum fibrinogen) and 2) distal outcomes (cardiovascular and all cause mortality). We did so using the National Health and Nutrition Examination Survey III 1988–1994 linked to the National Death Index with mortality follow-up through 2006. We employed ordinary least squares regression for the intermediate outcomes, seemingly unrelated regression (SUR) to consider combined effects, and Cox proportionate hazards models for mortality outcomes. We then performed extensive sensitivity analyses, exploring the contribution of various variables and reverse causality. We find that our measures of social capital did not predict statistically significant changes in the laboratory biomarkers we study. Nevertheless, belonging to organizations or attending church > 12 times per year were associated with reduced all cause mortality (hazard ratio [HR] = 0.81, 95% confidence interval [CI] = 0.70–0.93 and HR = 0.72, 95% CI = 0.60–0.86, respectively). In SUR analyses, however, combined laboratory values were significant for all measures of social capital we study with the exception of visits to neighbors. This suggests that some forms of structural social capital improve survival through small changes in multiple measures of biological risk factors rather than moderate or large changes in any one measure

Social patterning of obesity in Spain: A systematic review of the relationship between education and obesity

Introduction: In high-income countries around the world, there appears to be an inverse association between educational attainment and obesity. However, the literature about this association in Spain remains disorganized and disparate. Material and Methods: We systematically reviewed peer-reviewed English- or Spanish language studies of this association in Spain from 10 databases from all periods of time available. Results: Our search identified twenty-four studies. In both nationally representative and subnational studies, women with less education had higher odds of obesity than their more educated counterparts. Men, despite exhibiting greater variability in the education-body weight relationship, also demonstrated a similar social patterning of body weight in many studies, with those at lower levels of educational attainment having higher odds of obesity relative to their more-educated counterparts. These associations in men and women were fairly consistent across time and place, though some regional variations did exist. Discussion and conclusions: We encourage future researchers to move towards more meaningful, unbiased estimates of the association between educational attainment and obesity by measuring height and weight with physical exams, controlling for a more robust set of possible confounders, and exploring potential modifying factors of the association. Additionally, when possible, we encourage researchers to employ prospective study designs that facilitate causal inference with respect to this association

Flipping the classroom in business and education one-shot sessions: a research study

In response to the challenge of maximising the effectiveness of one-shot information literacy (IL) sessions, library faculty at Lehman College experimented with the flipped classroom model. This research paper reports the results of a multi-semester quantitative study of the flipped classroom in business management and education one-shot sessions. Researchers explored two research questions: Do students in a flipped session demonstrate greater knowledge before their session than students in a control session? and Do flipped and control students demonstrate significant, positive improvement in knowledge after their session? The researchers used pre- and post-tests to evaluate two crucial aspects of the flipped model: pre-class homework assignments and in-class active learning. A significant finding supports the usefulness of homework assignments in preparing students for these library sessions. Both education and business classes also reported high degrees of satisfaction with the flipped model. The article provides evidence that the flipped classroom, especially those using the pre-class homework assignments, can be effective for student learning in IL one-shot sessions

Cascading the use of Web 2.0 technology in secondary schools in the United Kingdom: identifying the barriers beyond pre-service training

This paper reports on research that took place at Nottingham Trent University and Sheffield Hallam University, United Kingdom, over two years. The research focuses on the use of Web 2.0 technology, specifically web logs, with pre-service teachers, both during their university programme and the first year of teaching as full-time newly qualified teachers (NQTs). The purpose of this research was to add a developing body of knowledge by identifying whether technology used by pre-service teachers during their training course can be cascaded into their practice once qualified. Key findings identify a number of enablers and barriers to cascading technology in the classroom; these include curriculum time, pupil skills and support. The research concludes that early professional support and development should be on-going and assumptions about new teachers as champions of cascading innovative use of Web 2 technologies into their practice as NQTs may be over optimisti

A novel C-terminal HSP90 inhibitor KU135 induces apoptosis and cell cycle arrest in melanoma cells

Heat shock protein 90 (Hsp90) is differentially expressed in tumor cells including melanoma and involved in proper folding, stabilization and regulation of cellular proteins. We investigated a novobiocin-derived Hsp90 C-terminal inhibitor, KU135, for anti-proliferative effects in melanoma cells. The results indicate that KU135 reduced cell viability and cell proliferation in melanoma cells and IC50 values for A735(DRO), M14(NPA), B16F10 and SKMEL28 cells were 0.82, 0.92, 1.33 and 1.30 M respectively. KU135 induced a more potent anti-proliferative effect in most melanoma cells versus N-terminal Hsp90 inhibitor 17AAG. KU135 induced apoptosis in melanoma cells, as indicated by annexin V/PI staining, reduction in the mitochondrial membrane potential, mitochondrial cytochrome C release and caspase 3 activation. KU135 reduced levels of Hsp90 client proteins Akt, BRAF, RAF-1, cyclin B and cdc25 proteins. Additionally, it reduced Hsp70, Hsp90 paralog, GRP94 and HSF1 levels. KU135 induced strong G2/M cell cycle arrest, associated with decreased expression of cdc25c, cyclin B and increased phosphorylation of cdc25c. These finding show that KU135 reduced cell survival, proliferation, and induces apoptosis in melanoma cells. We suggest that KU135 may be a potential candidate for cancer therapy against melanoma

Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients

Background: Mortality rates in the Intensive Care Unit and subsequent hospital mortality rates in the UK remain high. Infections in Intensive Care are associated with a 2–3 times increased risk of death. It is thought that under conditions of severe metabolic stress glutamine becomes "conditionally essential". Selenium is an essential trace element that has antioxidant and anti-inflammatory properties. Approximately 23% of patients in Intensive Care require parenteral nutrition and glutamine and selenium are either absent or present in low amounts. Both glutamine and selenium have the potential to influence the immune system through independent biochemical pathways. Systematic reviews suggest that supplementing parenteral nutrition in critical illness with glutamine or selenium may reduce infections and mortality. Pilot data has shown that more than 50% of participants developed infections, typically resistant organisms. We are powered to show definitively whether supplementation of PN with either glutamine or selenium is effective at reducing new infections in critically ill patients. Methods/design: 2 × 2 factorial, pragmatic, multicentre, double-blind, randomised controlled trial. The trial has an enrolment target of 500 patients. Inclusion criteria include: expected to be in critical care for at least 48 hours, aged 16 years or over, patients who require parenteral nutrition and are expected to have at least half their daily nutritional requirements given by that route. Allocation is to one of four iso-caloric, iso-nitrogenous groups: glutamine, selenium, both glutamine & selenium or no additional glutamine or selenium. Trial supplementation is given for up to seven days on the Intensive Care Unit and subsequent wards if practicable. The primary outcomes are episodes of infection in the 14 days after starting trial nutrition and mortality. Secondary outcomes include antibiotic usage, length of hospital stay, quality of life and cost-effectiveness. Discussion: To date more than 285 patients have been recruited to the trial from 10 sites in Scotland. Recruitment is due to finish in August 2008 with a further six months follow up. We expect to report the results of the trial in summer 2009. Trial registration: This trial is registered with the International Standard Randomised Controlled Trial Number system. ISRCTN87144826Not peer reviewedPublisher PD

The natural history of thin melanoma and the utility of sentinel lymph node biopsy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141184/1/jso24765_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141184/2/jso24765.pd

Multi-centre parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based cognitive behavioural approach to managing fatigue in people with multiple sclerosis

Abstract (provisional) Background Fatigue is one of the most commonly reported and debilitating symptoms of multiple sclerosis (MS); approximately two-thirds of people with MS consider it to be one of their three most troubling symptoms. It may limit or prevent participation in everyday activities, work, leisure, and social pursuits, reduce psychological well-being and is one of the key precipitants of early retirement. Energy effectiveness approaches have been shown to be effective in reducing MS-fatigue, increasing self-efficacy and improving quality of life. Cognitive behavioural approaches have been found to be effective for managing fatigue in other conditions, such as chronic fatigue syndrome, and more recently, in MS. The aim of this pragmatic trial is to evaluate the clinical and cost-effectiveness of a recently developed group-based fatigue management intervention (that blends cognitive behavioural and energy effectiveness approaches) compared with current local practice. Methods This is a multi-centre parallel arm block-randomised controlled trial (RCT) of a six session group-based fatigue management intervention, delivered by health professionals, compared with current local practice. 180 consenting adults with a confirmed diagnosis of MS and significant fatigue levels, recruited via secondary/primary care or newsletters/websites, will be randomised to receive the fatigue management intervention or current local practice. An economic evaluation will be undertaken alongside the trial. Primary outcomes are fatigue severity, self-efficacy and disease-specific quality of life. Secondary outcomes include fatigue impact, general quality of life, mood, activity patterns, and cost-effectiveness. Outcomes in those receiving the fatigue management intervention will be measured 1 week prior to, and 1, 4, and 12 months after the intervention (and at equivalent times in those receiving current local practice). A qualitative component will examine what aspects of the fatigue management intervention participants found helpful/unhelpful and barriers to change. Discussion This trial is the fourth stage of a research programme that has followed the Medical Research Council guidance for developing and evaluating complex interventions. What makes the intervention unique is that it blends cognitive behavioural and energy effectiveness approaches. A potential strength of the intervention is that it could be integrated into existing service delivery models as it has been designed to be delivered by staff already working with people with MS. Service users will be involved throughout this research. Trial registration: Current Controlled Trials ISRCTN7651747