The essential role of calcium in ADAMTS13 function

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The Maternal Diet Can Prevent Neural Tube Defects

Maternal diet and nutritional status have a direct impact on pregnancy course and outcome. Nutrition is critical to the development of the human embryo and fetus. Each year in the United States, approximately 4000 pregnancies are affected by neural tube defects (NTD). The most important finding in recent years has been the relationship between maternal folic acid status and NTDs. Other studies have found an association between zinc deficiency and an increased risk for having an NTD-affected pregnancy. Furthermore, some of the latest research has linked maternal obesity with the development of NTDs. The cumulative data from several studies have clearly indicated enormous savings in direct medical costs associated with the prevention of NTDs. Improving the nutritional status of women of childbearing age can help to prevent NTDs, resulting in substantial savings

Denitrification enzyme activity as an indicator of nitrate loading in a wetland receiving diverted Mississippi River water

The Davis Pond freshwater diversion discharges nutrient-rich Mississippi River water to a 3,760 ha receiving marsh in upper Barataria Basin, LA. Excess nitrate in the Mississippi River has been linked to algal blooms and hypoxia in the Gulf of Mexico with potential to negatively impact Barataria Basin. We hypothesized that 1) soil denitrification enzyme activity (DEA) will increase with higher surface water nitrate concentrations, and 2) the spatial distribution of DEA in Davis Pond marsh will provide information about the extent nitrate loading at a specific discharge rate. Intact soil cores collected from the marsh received a continuous flow of nitrate solution (0.0, 0.5, 1.0, or 2.0 mg NO3-N l-1) for a period of 7, 20, or 45 days. Overall, DEA for the 1.0 mg NO3-N l-1 was significantly higher than the control treatment (P \u3c 0.05). A strong positive correlation between DEA and surface water nitrate in the 0-5 cm (P \u3c 0.05) and 5-10 cm (P \u3c 0.001) soil horizons was observed on day 20. However, the correlation between DEA and nitrate was not significant on days 7 and 45. Measureable DEA was observed in the 0.0 mg NO3-N l-1 on all days, indicating the contribution of internal biochemical N cycling to DEA in organic wetland soils. Approximately 92% of all DEA was observed in the top 5 cm of soil, 7% occurred at 5-10 cm, and \u3c1% below 10 cm. DEA was also quantified for 88 randomly distributed soil cores in Davis Pond marsh collected May - July, 2007. At a mean discharge rate of 39 m3 s-1, high rates of DEA (0.41 to 2.10 mg N2O-N kg-1 h-1) occurred in a 715 ha area proximal to the diversion inflow, while background rates (0 to 0.30 mg N2O-N kg-1 h-1) were observed outside this area. The 715 ha area contained \u3e 80% of all the DEA observed in Davis Pond marsh, yet encompassed only 19% of the total marsh area. The area of elevated DEA included the highest observed surface water nitrate concentrations, suggesting DEA is a potential indicator of nitrate loading

Indonesia: Analysis of conflicting crisis-related research results

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in the timing of data collection are a key reason for differences in findings; differences in methodologies limit the comparability of data; and indicators of crisis impact are not always comparable or relevant. The conclusions and recommendations presented here will have relevance for program managers and decisionmakers who are in the process of reviewing any crisis-related research results and should not be seen as being mutually exclusive. There is much interaction between the key factors affecting the comparability of crisis-related data identified in this review, and these issues should be addressed in their totality when reviewing data or developing monitoring activities

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Social media and mobile apps for health promotion in Australian indigenous populations: Scoping review

Background: Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited.Objective: The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit?Methods: We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas.Results: The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion criteria. No evidence of benefit was found for these projects.Conclusions: Although social media technologies have the unique capacity to reach Indigenous Australians as well as other underserved populations because of their wide and instant disseminability, evidence of their capacity to do so is limited. Current interventions are neither evidence-based nor widely adopted. Health promotion organizations need to gain a more thorough understanding of their technologies, who engages with them, why they engage with them, and how, in order to be able to create successful social media projects

Neuropsychological Outcome following Perinatal HIE: Utility of MR Spectroscopy

Outcome following hypoxic-ischemic encephalopathy (HIE), a neurodegenerative process caused by prolonged asphyxiation during birth, can vary between minimal impairment and cerebral palsy, mental retardation, or death (30%) (McCulloch, Taylor, & Whyte, 1991). Prognosis after HIE is often difficult to establish because traditional predictors, such as Sarnat scores, Apgar scores, and pH, do not always account for adequate variance in outcome. The prognostic utility of MR Spectroscopy in the pathogenesis of asphyxia is promising (Wyatt, 1994). Innovative research indicates that MR Spectroscopy can accurately predict outcome at one year in 91% of neonates with central nervous system injuries (Holshouser et al., 1997). The current study examined neuropsychological functioning following birth asphyxia-related HIE in nine children 3 years 4 months old to 7 years 8 months old (M = 5 years old, SD = 20 months) using ^HMRS as a predictor of outcome in the following areas: (1) memory and learning; (2) language; (3) visuospatial; (4) attention and executive functioning; and (5) sensorimotor abilities. Results found that both NAA/Cre and NAA/Cho were not correlated with outcome. Elevated Cho/Cre and lactate, however, were the most common finding among more severe HIE, with both metabolites correlated with all outcome areas

Improving coordination through information continuity: a framework for translational research

BACKGROUND There is good evidence that coordination can have beneficial impacts on patient care and outcomes but the mechanisms by which coordination is to be achieved are poorly understood and rarely identified in relevant policies. One approach suggests that continuity of information is a key element but research is yet to provide guidance on how to optimise coordination through improving continuity in healthcare settings. DISCUSSION In this paper we report on the development of a conceptual framework of information continuity in care coordination. We drew on evidence from systematic reviews of coordination and empirical studies on information use in integrated care models to develop the framework. It identifies the architecture, processes and scope of practices that evidence suggests is required to support information continuity in a population based approach to care coordination. The framework offers value to policy makers and practitioners as a map that identifies the multi-level elements of an integrated system capable of driving better coordination. Testing of the framework in different settings could aid our understanding of information continuity as a mechanism for linking coordination strategies that operate at different levels of the health system and enable synthesis of findings for informing policy and practice.This study was supported by a grant from the Ian Potter Foundation to the Menzies Centre for Health Policy. The Australian Primary Health Care Research Institute is supported by a grant from the Australian Government Department of Health and Ageing

Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models

BACKGROUND Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient's experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. METHODS Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. RESULTS The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. CONCLUSIONS The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader 'fit' with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved.This study was supported by a grant from the Ian Potter Foundation to the Menzies Centre for Health Policy. The Australian Primary Health Care Research Institute is supported by a grant from the Australian Government Department of Health and Ageing. The Menzies Centre for Health Policy is supported by a grant from the Sir Robert Menzies Memorial Foundation