How to assess and manage hypertension during and after pregnancy.

Hypertensive disorders of pregnancy are increasingly important complications of which clinicians should have an up-to-date knowledge to facilitate prompt recognition, diagnosis and management. These disorders affect a growing number of pregnancies worldwide, with incidence rates likely to increase in the future commensurate with increasing maternal age and maternal comorbidities independent of age, with consequent effects on maternal and fetal/neonatal morbidity and mortality rates. This article mainly focuses on management within the UK of these disorders, examining their current working definitions, detection methods and recent developments in screening tool development. The current NICE-recommended strategies for treating these disorders and minimizing their occurrence in pregnancy are also explored. In addition, the association between adverse pregnancy outcome and increased risk of future maternal and offspring cardiovascular disease is described, with comments on future strategies to help minimize these potential risks

Frequency of Traditional Food Use by Three Yukon First Nations Living in Four Communities

This study documented the frequency of use of traditional food species among 122 adults from three Yukon First Nations. The informants resided in four communities: Haines Junction, Old Crow, Teslin, and Whitehorse. Food patterns were examined in two ways: (1) estimated frequency of household use of traditional food species over a one-year period, and (2) frequency of traditional foods in four daily diet recalls of men and women, collected once per season. On average, Yukon Indian households used traditional foods over 400 times annually. Moose was consumed on average 95 times yearly, caribou 71, chinook salmon 22, Labrador tea 20, cranberries and crowberries each 14, and blueberries 11 times yearly. According to household estimates, traditional foods were consumed almost as often in Whitehorse as in Haines Junction. Teslin surpassed both these, while Old Crow had the highest frequency. Daily diets of adult individuals indicated that traditional foods were consumed on average 1.14 times per day. Traditional foods were reported twice daily in Old Crow diets, once daily in each of Teslin and Haines Junction, and 0.5 times daily in Whitehorse diets. Measured by frequency of use, traditional foods - especially moose, caribou and salmon - remain extremely important in contemporary diets of these Yukon Indian people.Key words: traditional foods, aboriginal foods, Yukon First Nations, Yukon Indian peopleCette étude documente la fréquence d'utilisation des aliments traditionnels parmi 122 adultes venant de trois Premières Nations du Yukon. Les informateurs résidaient dans quatre communautés: Haines Junction, Old Crow, Teslin et Whitehorse. Le mode d'alimentation a été examiné de deux façons: (1) la fréquence d'utilisation des aliments traditionnels au foyer, estimée sur une période d'un an, et (2) la fréquence des aliments traditionnels dans quatre enquêtes par interview sur le régime quotidien d'hommes et de femmes, effectuées une fois par saison. Les foyers indiens du Yukon utilisent les aliments traditionnels plus de 400 fois par an, en moyenne. L'orignal était consommé en moyenne 95 fois par an, le caribou 71 fois, le saumon du Pacifique 22 fois, le thé du Labrador 20 fois, les airelles et les camarines noires 14 fois chacune, et les bleuets 11 fois. D'après les estimations dans les foyers, les aliments traditionnels étaient consommés presqu'aussi souvent à Whitehorse qu'à Haines Junction. La fréquence de consommation était supérieure à Teslin, et elle était la plus grande à Old Crow. Le régime quotidien des adultes indiquait que les aliments traditionnels étaient consommés en moyenne 1,14 fois par jour. On a relevé la présence d'aliments traditionnels deux fois par jour à Old Crow, une fois par jour à Teslin et à Haines Junction, et 0,5 fois par jour à Whitehorse. Lorsqu'on les juge par leur fréquence d'utilisation, les aliments traditionnels - en particulier l'orignal, le caribou et le saumon - demeurent extrêmement importants dans le régime contemporain des Indiens du Yukon.Mot clés: aliments traditionnels, nourriture aborigène, Premières Nations du Yukon, Indiens du Yuko

Use of and Preference for Traditional Foods among the Belcher Island Inuit

To document the extent of use of traditional foods (marine and land mammals, birds, fish, and plants) and degree of preference for these foods in contemporary diets and culture, 102 households (98% of Inuit households) in the community of Sanikiluaq, Northwest Territories, Canada, were studied. During personal interviews, individuals estimated their frequency of use of traditional foods, systematically by season. In addition, 100 adults (from 96% of households) and 64 young people (84% of those in Grades 6-11) rated 41 foods (32 traditional and 9 market foods) for preference on a 5-point hedonic scale. According to respondents' estimates, traditional foods were used by all households, on average 1171±852 times annually. Fish and shellfish were most frequently consumed (523±490 times annually), followed by birds (254±204), sea mammals (184±161), berries (166±115), and land mammals (45±70). Preference ratings showed that most traditional foods were well-liked by both adults and young people, although adults rated 25 traditional foods higher (p<0.01) and 2 market foods lower (p<0.01) than young people did. Traditional foods remain an important part of contemporary Sanikiluaq lifestyle.Afin de documenter l'importance de l'utilisation des aliments traditionnels (mammifères marins et terrestres, oiseaux, poissons et plantes) et le degré de préférence pour ces aliments dans les régimes alimentaires et la culture actuels, on a fait une étude auprès de 102 foyers (98 p. cent de foyers inuit) dans la collectivité de Sanikiluaq (Territoires du Nord-Ouest [Canada]). Au cours d'interviews individuelles, les personnes estimaient la fréquence de leur utilisation des aliments traditionnels, de façon systématique, sur une base saisonnière. En outre, 100 adultes (provenant de 96 p. cent des foyers) et 64 jeunes (dont 84 p. cent scolarisés de la 6e à la 11e année) ont classé 41 aliments (32 traditionnels et 9 commerciaux) selon leur préférence sur une échelle hédonique de 5 points. Selon l'évaluation des répondants, les aliments traditionnels étaient consommés par tous les foyers, sur une base annuelle moyenne de 1171 ± 852 fois. C'est le poisson et les fruits de mer qui étaient consommés le plus souvent (523 ± 490 fois par an), suivis des oiseaux (254 ± 204), des mammifères marins (184 ± 161), des baies (166 ± 115), et des mammifères terrestres (45 ± 70). Le classement par préférence révèle que les adultes comme les jeunes apprécient la majorité des aliments traditionnels, bien que les adultes donnent à 25 aliments traditionnels une cote supérieure (p < 0,01) et à 2 aliments commerciaux une cote inférieure (p < 0,01) à celles données par les jeunes. Les aliments traditionnels continuent à jouer un rôle important dans le mode de vie contemporain de Sanikiluaq

High Prevalence of Obesity Among Inner-City Adolescent Boys in the Bronx, New York: Forgetting Our Boys

We examined sex differences in overweight and obesity in a sample of 1,619 inner-city adolescents. Participants were enrolled from 11 public schools in the Bronx, New York. The prevalence of overweight and obesity was 21.7% and 22.5%, respectively; prevalence of obesity was significantly higher among adolescent boys than adolescent girls (24.9 vs 20.1%). Childhood obesity is a public health concern in the United States, and the higher prevalence of obesity in adolescent boys requires additional attention

Evaluation of the intercultural understanding field trial

In 2011, the Innovation and Next Practice Division (INP) of the Department of&nbsp;Education and Early Childhood Development (DEECD) conducted a field trial&nbsp;on intercultural understanding in partnership with a research and evaluation&nbsp;team from the University of Melbourne and La Trobe University. The field trial&nbsp;was sponsored by the Languages, English as another Language (EAL) and&nbsp;Multicultural Education Division of DEECD.The primary research question guiding the field trial was:1. What is the impact on student outcomes of teaching and learning&nbsp;practice for intercultural understanding?2. The secondary research questions were:3. What knowledge and skills do both learners and educators need for&nbsp;intercultural understanding?4. How is effective practice identified and measured?5. What intercultural understanding capabilities can be developed at&nbsp;each developmental stage of children and young people in different&nbsp;cultural contexts?In order to explore these questions, schools across Victoria were initially&nbsp;nominated by International Division, the Multicultural Education Unit and by&nbsp;regional directors and INP based on three core criteria, which included school&nbsp;culture, capability and connections within the school and the wider community.&nbsp;Following an expression of interest process, 26 schools, including one&nbsp;independent school and two catholic schools were selected. Participation in&nbsp;the field trial included the following aims:&bull; to stimulate thinking about current school policy and practice around&nbsp;intercultural understanding and interaction (ICU)&bull; to trial projects that support the field trial&rsquo;s primary research question&nbsp;&bull; to evaluate innovative &lsquo;next practice&rsquo; and consider its relevance for&nbsp;the education system&bull; to support the intercultural understanding general capability under&nbsp;consideration for inclusion in the Australian National Curriculum in&nbsp;2013.The field trial was implemented by DEECD INP from February 2011 to&nbsp;December 2011 over three stages.</div

Hereditary sensory and autonomic neuropathy in a family of mixed breed dogs associated with a novel RETREG1 variant.

BACKGROUND: Hereditary sensory and autonomic neuropathies (HSANs) are a group of genetic disorders affecting the peripheral nervous system. Two different associated variants have been identified in dogs: 1 in Border Collies and 1 in Spaniels and Pointers. OBJECTIVES: Clinically and genetically characterize HSAN in a family of mixed breed dogs. ANIMALS: Five 7-month-old mixed breed dogs from 2 related litters were presented for evaluation of a 2-month history of acral mutilation and progressive pelvic limb gait abnormalities. METHODS: Complete physical, neurological, electrodiagnostic, and histopathological evaluations were performed. Whole genome sequencing of 2 affected dogs (1 from each litter) was used to identify variants that were homozygous or heterozygous in both cases, but wild type in 217 control genomes of 100 breeds. Immunohistochemistry was used to assess protein expression. RESULTS: Complete physical, neurological, electrodiagnostic, and histopathological evaluations confirmed a disorder affecting sensory and autonomic nerves. Whole genome sequencing identified a missense variant in the RETREG1 (reticulophagy regulator 1) gene (c.656C > T, p.P219L). All affected dogs were homozygous for the variant, which was not detected in 1193 dogs from different breeds. Immunohistochemistry showed no expression of RETREG1 in the cerebellum of affected dogs. One of the affected dogs lived for 5 years and showed gradual progression of the clinical signs. CONCLUSIONS AND CLINICAL IMPORTANCE: We confirmed the diagnosis of HSAN in a family of mixed breed dogs and identified a novel and possibly pathogenic RETREG1 variant. Affected dogs experienced gradual deterioration over several years

Scoping review of end-of-life decision-making models used in dogs, cats and equids

Background: End-of-life decisions for companion animals can be stressful for veterinarians and owners, and when delayed result in poor animal welfare. Delayed euthanasia has been identified as a particularly prominent issue for horses. This scoping review aimed to identify the available literature on veterinary decision-making models, which can support end-of-life planning. Methods: A protocol was preregistered, and a structured literature search was performed on six electronic databases. Publications were reviewed against specifically developed eligibility criteria. Data from original studies and narrative-type reviews were extracted separately, and the components of each model were charted. Results: A total of 2211 publications were identified, 23 met the inclusion criteria and were included in the final review. Eight were original research studies and 15 were narrative reviews or similar. Publications were not indexed uniformly, increasing the difficulty of discovering relevant sources. The end-of-life decision-making process comprised three stages: (1) making the decision, (2) enacting the decision and (3) aftercare. Twenty key components of decision-making models were identified, although no publication reflected all of these. Conclusions: A lack of original research studies and equine-specific publications was identified. Shared decision-making models for euthanasia in veterinary practice should include all three stages and consider species-specific issues

Hepatitis B virus (HBV) viral load, liver and renal function in adults treated with tenofovir disoproxil fumarate (TDF) vs. untreated:a retrospective longitudinal UK cohort study

Abstract Background Current clinical guidelines recommend treating chronic hepatitis B virus (HBV) infection in a minority of cases, but there are relatively scarce data on evolution or progression of liver inflammation and fibrosis in cases of chronic HBV (CHB) that do not meet treatment criteria. We aimed to assess the impact of TDF on liver disease, and the risk of renal impairment in treated CHB patients in comparison to untreated patients. Methods We studied a longitudinal ethnically diverse CHB cohort in the UK attending out-patient clinics between 2005 and 2018. We examined TDF treatment (vs. untreated) as the main exposure, with HBV DNA viral load (VL), ALT, elastography scores and eGFR as the main outcomes, using paired tests and mixed effects model for longitudinal measurements. Additionally, decline of eGFR during follow-up was quantified within individuals by thresholds based on clinical guidelines. Baseline was defined as treatment initiation for TDF group and the beginning of clinical follow-up for untreated group respectively. Results We included 206 adults (60 on TDF, 146 untreated), with a median ± IQR follow-up duration of 3.3 ± 2.8 years. The TDF group was significantly older (median age 39 vs. 35 years, p = 0.004) and more likely to be male (63% vs. 47%, p = 0.04) compared to the untreated group. Baseline difference between TDF and untreated groups reflected treatment eligibility criteria. As expected, VL and ALT declined significantly over time in TDF-treated patients. Elastography scores normalised during treatment in the TDF group reflecting regression of inflammation and/or fibrosis. However, 6/81 (7.4%) of untreated patients had a progression of fibrosis stage from F0-F1 to F2 or F3. There was no evidence of difference in rates or incidence of renal impairment during follow-up in the TDF vs. untreated group. Conclusions Risk of liver inflammation and fibrosis may be raised in untreated patients compared to those receiving TDF, and TDF may benefit a larger percentage of the CHB population

Decoding information in the human hippocampus: a user's guide

Multi-voxel pattern analysis (MVPA), or 'decoding', of fMRI activity has gained popularity in the neuroimaging community in recent years. MVPA differs from standard fMRI analyses by focusing on whether information relating to specific stimuli is encoded in patterns of activity across multiple voxels. If a stimulus can be predicted, or decoded, solely from the pattern of fMRI activity, it must mean there is information about that stimulus represented in the brain region where the pattern across voxels was identified. This ability to examine the representation of information relating to specific stimuli (e.g., memories) in particular brain areas makes MVPA an especially suitable method for investigating memory representations in brain structures such as the hippocampus. This approach could open up new opportunities to examine hippocampal representations in terms of their content, and how they might change over time, with aging, and pathology. Here we consider published MVPA studies that specifically focused on the hippocampus, and use them to illustrate the kinds of novel questions that can be addressed using MVPA. We then discuss some of the conceptual and methodological challenges that can arise when implementing MVPA in this context. Overall, we hope to highlight the potential utility of MVPA, when appropriately deployed, and provide some initial guidance to those considering MVPA as a means to investigate the hippocampus

Increasing low-carbon energy in Scottish agriculture through a whole systems approach

The Climate Change Plan update sets out targets to reduce emissions from the agriculture sector. Carbon dioxide emissions associated with stationary combustion sources and off-road machinery use in agriculture contribute significantly to agricultural emissions and have increased between 2020 and 2021. The impact of agriculture’s energy use can be difficult to account for, with emissions being captured within grouped sectors (electricity, gas and other) of the GHG inventory. This report examines the energy use and associated emissions baseline on farms and crofts in Scotland, and explores the potential for efficiency measures and new, low-carbon technologies to support energy emissions reductions in the longer term