Lived experiences of young pregnant women who smoke

Background Smoking tobacco during pregnancy can lead to adverse pregnancy and child health outcomes. Aim To gain insight of smoking during pregnancy from young pregnant women’s lived experience. Method A descriptive phenomenological approach was used. Semi-structured interviews were conducted with five women aged 18-20 years who had smoked tobacco during pregnancy. Findings Themes that emerged from the data were related to culture and routine, psychological wellbeing, self-efficacy, public opinion, recognition of harm, whom they spoke to about smoking, and the approaches that helped behaviour change. Conclusions Midwives were seen as the trusted health professional by the young women and a non-judgemental approach was valued to promote self-efficacy. Smoking cessation services were not recognised as beneficial, and cutting down, rather than using nicotine replacement therapy or e-cigarettes, was preferred

A Prospective Surveillance Study of Candidaemia : Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients

Funding This work was supported by the Wellcome Trust Strategic Award for Medical Mycology and Fungal Immunology 097377/Z/11/Z. Data collection was supported by a grant from Pfizer. GR was also supported by a research fellowship grant from Gilead Sciences. The collection of the isolates was funded by a Gilead Fellowship to GR. Acknowledgments We are grateful to microbiology colleagues throughout Scotland for submitting isolates. Antimicrobial sensitivity testing was performed by the Mycology Reference Laboratory, Public Health England, Bristol.Peer reviewedPublisher PD

Dietary Patterns and their Association with Hypertension Among Pakistani Urban Adults

Hypertension is one of the most common chronic diseases affecting more than 25% of adults worldwide. In Pakistan, 33% of the adult population suffers from hypertension. Numerous epidemiological studies have demonstrated the critical role of dietary patterns in the causation, prevention and management of hypertension. There’s a dearth of evidence from South Asia in this regard. The present study aimed to identify the association between dietary patterns and hypertension among 4304 low income urban adults who participated in the Control of Blood Pressure and Risk Attenuation (COBRA) study in Karachi, Pakistan. Dietary information was collected by a 33- item food frequency questionnaire and 3 unique dietary patterns namely; fat and sweet, fruit and vegetable, and seafood and yogurt patterns were derived using principal component factor analyses. We used univariate and multivariable logistic regression to examine the association between dietary patterns and hypertension. Men were more likely to have hypertension, while increase in age, and body mass index were also associated with hypertension (p\u3c0.001). After adjusting for age, gender, education, marital status, body mass index, and tobacco use; the seafood and yogurt pattern was less likely (OR=0.78: 95% CI: 0.63, 0.98; p-value 0.03) to be associated with hypertension, whereas no significant associations were seen for other two dietary patterns. These findings suggest that certain dietary patterns may be associated with hypertension among Pakistani low income urban adults

Do Dietary Patterns Explain High Prevalence of Cardiovascular Risk Factors Among Pakistani Urban Adults? A Cross-Sectional Study

Background The prevalence of cardiovascular disease (CVD) in South Asia is higher than in any other developing countries. The diversity of diets in populations among developing countries may be one explanation for the differences in CVD. This study was carried out to explore the association between dietary patterns and the presence of cardiovascular risk factors among Pakistani low income urban adults. Methods Socio demographic, physical activity and dietary information was collected from 1546 Pakistani subjects aged ≥40 years from the Control of Hypertension and Risk Attenuation (COBRA) study. Anthropometric, clinical and biomarker measures were assessed. Cluster analysis was used to identify dietary patterns from a food frequency questionnaire (FFQ) and multinomial regression was employed to investigate the association between dietary clusters and cardiovascular risk factors, using one of the dietary clusters as a reference category. Results The most prevalent CVD risk factors among participants were elevated low density lipoprotein- cholesterol (LDL-C) (69.8 %) and systolic blood pressure (SBP) (68.2 %), followed by central obesity (57.1 %), low levels of high density lipoprotein-Cholesterol (HDL-C) (56.3 %), overall obesity (46.0 %), high total cholesterol (32.3 %), and elevated fasting blood sugar (FBS) (34.9 %). The cluster analysis generated 3 non-overlapping diet patterns. Cluster 1(Traditional Pakistani Diet), was dominated by fruits, vegetables, milk products and chicken, included participants with high mean body mass index (BMI), waist circumference (WC), HDL-C and low mean SBP. Cluster 2 (Moderate Diet) reflected a moderate intake of most food items and included participants with significantly higher mean SBP. Cluster 3 (Fatty Diet) was characterized by high intake of beef, whole milk, paratha and lentils and those following this cluster had a low mean HDL-C and high SBP. In analyses controlling for age, gender, tobacco use and physical activity, participants in the Traditional diet cluster were more likely to be overweight (OR 1.39, 95 % CI 1.08 to 1.78) and high central adiposity (1.33, 95 % CI 1.04 to 1.71) than participants in the Moderate diet cluster, though less likely to have elevated SBP (OR 0.67, 95 % CI 0.51 to 0.86). LDL-C levels were higher in both the traditional Pakistani diet and Fatty diet cluster compared to the Moderate diet cluster. Low HDL-C was also more prevalent among the Traditional Pakistani diet cluster. Conclusion Among Pakistani population discernable diet patterns can be derived using clusters analysis. CVD risk factors prevalence differed by cluster membership, though relations for specific CVD risk are not consistent across clusters

Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer

BACKGROUND: The criterion-related validity and measurement bias of the long form of the International Physical Activity Questionnaire (IPAQ) was compared to the 7-Day Physical Activity Recall (PAR). METHODS: Participants were women who have been diagnosed with breast cancer and enrolled in the ongoing Women's Healthy Eating and Living Study. Women (N = 159, average age 57 years) wore an accelerometer for one week and then completed the IPAQ or the PAR. RESULTS: The validity correlation of the PAR was significantly higher (p < 0.001) than the IPAQ (0.73 vs. 0.33, respectively). The PAR and IPAQ overestimated total physical activity by 13% vs. 247%, respectively. The PAR had better sensitivity (p = 0.14) and specificity (p < .01) than the IPAQ (100% vs. 71% and 84% vs. 59%, respectively) in predicting attainment of the ACSM physical activity guideline. CONCLUSION: The PAR was superior to the IPAQ in terms of validity, measurement bias, and screening statistics

Teaching the Newly Essential Knowledge, Skills, and Values in a Changing World

This chapter of Building on Best Practices: Transforming Legal Education in a Changing World has contributions from many authors: Section A, Professional Identity Formation, includes: Teaching Knowledge, Skills, and Values of Professional Identity Formation, by Larry O. Natt Gantt, II & Benjamin V. Madison III, Integrating Professionalism into Doctrinally-Focused Courses, by Paula Schaefer, Learning Professional Responsibility, by Clark D. Cunningham, and Teaching Leadership, by Deborah L. Rhode. Section B, Pro Bono as a Professional Value, is by Cynthia F. Adcock, Eden E. Harrington, Elizabeth Kane, Susan Schechter, David S. Udell & Eliza Vorenberg. Section C, The Relational Skills of the Law, includes: Teaching Relational Skills: The Evidence, by Susan Daicoff, and Cultivating Students\u27 Relational Skills, by Susan L. Brooks. Section D, Teamwork, is by Linda Morton & Janet Weinstein. Section E, Intercultural Effectiveness, is by Mary A. Lynch with Robin Boyle, Rhonda Magee & Antoinette Sedillo López. Section F, Social Justice Across the Curriculum, is by Susan Bryant. Section G, Problem-Solving and Conflict Resolution, includes: Teaching Students to Be Healers: The Comprehensive Law Movement, by Susan Daicoff, Teaching Alternative Dispute Resolution, by Andrea Kupfer Schneider, and Integrating Alternative Dispute Resolution and Problem-Solving Across the Curriculum, by Jill Gross & John Lande Section H, Interprofessional Education, is by Lisa Radtke Bliss, Sylvia B. Caley, Patty Roberts, Emily F. Suski & Robert Pettignano. Section I, Technology in the Profession, is by Conrad Johnson. Section J, Business and Financial Literacy, is by Dwight Drake. Chapter 1 is available at: http://ssrn.com/abstract=2637100 Chapter 2 is available at: http://ssrn.com/abstract=2637068 Chapter 3 is available at: http://ssrn.com/abstract=2637102 Chapter 4 is available at: http://ssrn.com/abstract=2637490 Chapter 5 is available at: http://ssrn.com/abstract=2637495 Chapter 7 is available at: http://ssrn.com/abstract=2637541 Chapter 8 is available at: http://ssrn.com/abstract=2637544 The content of this SSRN posting is material that was published in the book Building on Best Practices: Transforming Legal Education in a Changing World, Maranville, et al., Lexis Nexis 2015. The content has been posted on SSRN with the express permission of Lexis Nexis and of Carolina Academic Press, publisher of the book as of January 1, 2016