Prostaglandin-induced cervical remodelling in humans in the first trimester is associated with increased expression of specific tight junction, but not gap junction proteins

<p>Abstract</p> <p>Background</p> <p>Prostaglandins (PG) are widely employed to induce cervical remodelling (CR) in pregnancy. However, the underlying molecular mechanisms are not fully elucidated. Tight junctions (TJ) and gap junctions (GJ) regulate paracellular and intercellular solute transport respectively but their role in the process of CR remains unexplored. We hypothesized that the synthetic prostaglandin E1 analogue Misoprostol (M), widely used in clinical practice to induce CR, may alter TJ and GJ expression as part of the changes in the extracellular matrix (ECM) associated with remodelling. We investigated the effects of Misoprostol exposure on the expression of cervical TJ (claudins 1, 2, 4, 5, 7 and occludin) and GJ (connexins 43, 30 and 26) in the 1st trimester.</p> <p>Methods</p> <p>Cervical biopsies were obtained from pregnant women and comparisons of TJ and GJ protein expression (by western blotting) and immunolocalisation (laser scanning confocal microscopy) made between those who were administered vaginal Misoprostol (n = 10) and those who were not (n = 5).</p> <p>Results</p> <p>We found that Misoprostol-treated tissue (M+) had higher expression of Claudins 1,2,4,7 and occludin (p < 0.05) than untreated (M-) tissue. Expression levels of Claudins 1, 2 and 4 were positively correlated to interval from Misoprostol treatment to biopsy, whilst occludin was negatively correlated. Misoprostol-treated cervical tissue demonstrated more endothelial claudin-5 and occludin, whilst expression of GJs were unchanged.</p> <p>Conclusion</p> <p>Our observations suggest, for the first time, that increased expression of tight junction proteins may be one of the mechanisms by which Misoprostol induces CR in humans. Further studies are needed to explore if TJ proteins may be therapeutic targets to alter timing of CR in clinical practice.</p

Comparative Performance between Two Photogrammetric Systems and a Reference Laser Tracker Network for Large-Volume Industrial Measurement

This paper determines the capability of two photogrammetric systems in terms of their measurement uncertainty in an industrial context. The first system – V-STARS inca3 from Geodetic Systems Inc. – is a commercially available measurement solution. The second system comprises an off-the-shelf Nikon D700 digital camera fitted with a 28 mm Nikkor lens and the research-based Vision Measurement Software (VMS). The uncertainty estimate of these two systems is determined with reference to a calibrated constellation of points determined by a Leica AT401 laser tracker. The calibrated points have an average associated standard uncertainty of 12·4 μm, spanning a maximum distance of approximately 14·5 m. Subsequently, the two systems’ uncertainty was determined. V-STARS inca3 had an estimated standard uncertainty of 43·1 μm, thus outperforming its manufacturer's specification; the D700/VMS combination achieved a standard uncertainty of 187 μm

Interventions for reducing unplanned paediatric admissions: an observational study in one hospital

Objective Evidence on how best to intervene to improve paediatric acute care and therefore reduce unplanned hospital admissions is weak. We describe service evaluation work at one hospital to assess interventions at critical clinical and service decision points.Design We conducted an observational study using routine daily-collected data (April 2009–December 2015) from a medium-sized district general hospital in south-west UK, using before-and-after comparisons of admissions-related data to evaluate two interventions implemented in April and November 2014, respectively: (1) an advice and guidance (A&amp;amp;G) phone line, where a senior paediatrician is available for general practitioners (GPs) and emergency department (ED) and (2) a Short Stay Paediatric Assessment Unit (SSPAU). We analysed data on all admitted children (&amp;lt;18 years) in the catchment area (population estimate 27 740 in 2015). Outcomes were GP-referred attendances, ward admissions, less than 1 day admissions and length of stay.Results A&amp;amp;G phone line was associated with a reduction in the mean number of less than 1 day admissions per month (difference in means before and after intervention −16.6 (95% CI −0.2 to −32.9)) and an increase in overall monthly bed-days (difference 72.5 (95% CI 21.0 to 124.0)), but there was little evidence of a change in GP-referred attendances or ward admissions. SSPAU was associated with a reduction in the mean number of monthly ward admissions (difference −34.6 (95% CI –21.3 to −48.0)) and less than 1 day admissions (difference in means −21.7 (95% CI −8.4 to −35.1)) and a reduction in the mean number of overall bed-days per month (difference −50.2 (95% CI −12.1 to −88.3)).Conclusions Interventions for reducing time taken to senior clinician review may be effective in better managing paediatric acute care. Further work should explore results by age, condition and injury/illness status

The Children’s Attention Project: A community-based longitudinal study of children with ADHD and non-ADHD controls.

NHMR

Moabi (Baillonella toxisperma Pierre): Arbre à usage multiple de forêt dense humide du Cameroun

Le Moabi est un grand arbre de la for&#234;t dense humide du Cameroun. Cet arbre &#224; usages multiples, est recherch&#233; par l&#8217;industrie foresti&#232;re pour la qualit&#233; de son bois et par les populations rurales pour ses produits autres que le bois tels l&#8217;&#233;corce et les racines pour leurs importances m&#233;dicinales, les fruits pour la fabrication d&#8217;huile. Ces formes d&#8217;exploitations concurrentielles, tr&#232;s souvent sans soucis de durabilit&#233; ont consid&#233;rablement r&#233;duit les populations d&#8217;arbres, avec pour cons&#233;quence la raret&#233; des produits d&#233;riv&#233;s. Face &#224; cette forte pression anthropique qui s&#8217;exerce sur le Moabi dans le sud Cameroun, il a paru n&#233;cessaire d&#8217;effectuer une &#233;tude socio&#233;conomique et &#233;cologique dans les villages &#224; fortes activit&#233;s d&#8217;exploitation. En effet, la compr&#233;hension des atouts socioculturels et des divers liens et usages que les ruraux tissent autour de cet arbre, l&#8217;estimation des stocks disponibles dans les terroirs villageois est un pr&#233;alable imp&#233;ratif &#224; l&#8217;&#233;laboration des r&#232;gles de gestion durable. Les enqu&#234;tes aupr&#232;s des utilisateurs et les inventaires forestiers ont &#233;t&#233; r&#233;alis&#233;s dans sept villages. La distribution de cette esp&#232;ce est estim&#233;e &#224; 0,8 arbre/ha pour les individus d&#8217;un diam&#232;tre &#224; 1,3 m sup&#233;rieur &#224; 10 cm. Cet arbre rev&#234;t une importance socioculturelle et incarne des pouvoirs divins ind&#233;niables pour 65% des ruraux. Les femmes repr&#233;sentent 56,5% des exploitants des produits forestiers non ligneux issus de cet arbre. Elles sont plus que les hommes, tributaires de l&#8217;exploitation des fruits et des &#233;corces du Moabi. De ce fait, elles sont les principales victimes des conflits d&#8217;int&#233;r&#234;ts. Les &#233;corces et le latex sont utilis&#233;s en pharmacop&#233;e. La production d&#8217;huile &#224; partir des fruits peut g&#233;n&#233;rer jusque 1 050 000 Fcfa de rentr&#233;es financi&#232;res dans le village Melondo. L&#8217;importance de ce gain incite &#224; promouvoir l&#8217;extraction d&#8217;huile de Moabi dans le cadre de la diversification des sources de revenus et de la lutte contre la pauvret&#233;.Mots cl&#233;s: Moabi, usages multiples, gestion soutenue, communaut&#233; rurale, Camerou

‘How I feel About My School’: The construction and validation of a measure of wellbeing at school for primary school children

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.There is a growing focus on child wellbeing and happiness in schools, but we lack self-report measures for very young children. Three samples (N = 2345) were combined to assess the psychometric properties of the How I Feel About My School (HIFAMS) questionnaire, which was designed for children aged 4-8 years. Test re-test reliability was moderate (intraclass correlation coefficient = 0.62). HIFAMS assessed a single concept and had moderate internal consistency (Cronbach’s alpha values from 0.62 to 0.67). There were low correlations between scores on the child-reported HIFAMS and parent- and teacher reports. Children at risk of exclusion had significantly lower HIFAMS scores than the community sample (mean difference = 2.4; 95% CI: 1.6 to 3.2; p < 0.001). Schools contributed only 4.5% of the variability in HIFAMS score; the remaining 95.5% reflecting pupil differences within schools. Girls’ scores were 0.37 units (95% CI: 0.16 to 0.57; p < 0.001) higher than boys, while year group and deprivation did not predict HIFAMS score. HIFAMS is a promising measure that demonstrates moderate reliability and discriminates between groups even among very young children

Effectiveness and micro-costing of the KiVa school-based bullying prevention programme in Wales: study protocol for a pragmatic definitive parallel group cluster randomised controlled trial

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Bullying refers to verbal, physical or psychological aggression repeated over time that is intended to cause harm or distress to the victims who are unable to defend themselves. It is a key public health priority owing to its widespread prevalence in schools and harmful short- and long-term effects on victims' well-being. There is a need to strengthen the evidence base by testing innovative approaches to preventing bullying. KiVa is a school-based bullying prevention programme with universal and indicated elements and an emphasis on changing bystander behaviour. It achieved promising results in a large trial in Finland, and now requires testing in other countries. This paper describes the protocol for a cluster randomised controlled trial (RCT) of KiVa in Wales. METHODS/DESIGN: The study uses a two-arm waitlist control pragmatic definitive parallel group cluster RCT design with an embedded process evaluation and calculation of unit cost. Participating schools will be randomised a using a 1:1 ratio to KiVa plus usual provision (intervention group) or usual provision only (control group). The trial has one primary outcome, child self-reported victimisation from bullying, dichotomised as 'victimised' (bullied at least twice a month in the last couple of months) versus 'not victimised'. Secondary outcomes are: bullying perpetration; aspects of child social and emotional well-being (including emotional problems, conduct, peer relations, prosocial behaviour); and school attendance. Follow-up is at 12 months post-baseline. Implementation fidelity is measured through teacher-completed lesson records and independent school-wide observation. A micro-costing analysis will determine the costs of implementing KiVa, including recurrent and non-recurrent unit costs. Factors related to the scalability of the programme will be examined in interviews with head teachers and focus groups with key stakeholders in the implementation of school-based bullying interventions. DISCUSSION: The results from this trial will provide evidence on whether the KiVa programme is transportable from Finland to Wales in terms of effectiveness and implementation. It will provide information about the costs of delivery and generate insights into factors related to the scalability of the programme. TRIAL REGISTRATION: Current Controlled Trials ISRCTN23999021 Date 10-6-13.BIG Lottery Wales (REF: B/l/1/010430196) is funding the costs of the trial, including recruitment conferences, provision of programme resources for schools, translation of resources into Welsh, support and feedback sessions, and central organisational meetings. The design, management, statistical analysis and dissemination of the trial are fully independent of the BIG Lottery and KiVa Finland. The programme is delivered by teachers and other school staff during school hours and no supply costs are provided to schools for staff training

Comparison of human uterine cervical electrical impedance measurements derived using two tetrapolar probes of different sizes

BACKGROUND We sought to compare uterine cervical electrical impedance spectroscopy measurements employing two probes of different sizes, and to employ a finite element model to predict and compare the fraction of electrical current derived from subepithelial stromal tissue. METHODS Cervical impedance was measured in 12 subjects during early pregnancy using 2 different sizes of the probes on each subject. RESULTS Mean cervical resistivity was significantly higher (5.4 vs. 2.8 Ωm; p < 0.001) with the smaller probe in the frequency rage of 4–819 kHz. There was no difference in the short-term intra-observer variability between the two probes. The cervical impedance measurements derived in vivo followed the pattern predicted by the finite element model. CONCLUSION Inter-electrode distance on the probes for measuring cervical impedance influences the tissue resistivity values obtained. Determining the appropriate probe size is necessary when conducting clinical studies of resistivity of the cervix and other human tissues

Enhancing the early home learning environment through a brief group parenting intervention: study protocol for a cluster randomised controlled trial.

BACKGROUND: The quality of the home learning environment has a significant influence on children's language and communication skills during the early years with children from disadvantaged families disproportionately affected. This paper describes the protocol and participant baseline characteristics of a community-based effectiveness study. It evaluates the effects of 'smalltalk', a brief group parenting intervention (with or without home coaching) on the quality of the early childhood home learning environment. METHODS/DESIGN: The study comprises two cluster randomised controlled superiority trials (one for infants and one for toddlers) designed and conducted in parallel. In 20 local government areas (LGAs) in Victoria, Australia, six locations (clusters) were randomised to one of three conditions: standard care (control); smalltalk group-only program; or smalltalk plus (group program plus home coaching). Programs were delivered to parents experiencing socioeconomic disadvantage through two existing age-based services, the maternal and child health service (infant program, ages 6-12 months), and facilitated playgroups (toddler program, ages 12-36 months). Outcomes were assessed by parent report and direct observation at baseline (0 weeks), post-intervention (12 weeks) and follow-up (32 weeks). Primary outcomes were parent verbal responsivity and home activities with child at 32 weeks. Secondary outcomes included parenting confidence, parent wellbeing and children's communication, socio-emotional and general development skills. Analyses will use intention-to-treat random effects ("multilevel") models to account for clustering. RECRUITMENT AND BASELINE DATA: Across the 20 LGAs, 986 parents of infants and 1200 parents of toddlers enrolled and completed baseline measures. Eighty four percent of families demonstrated one or more of the targeted risk factors for poor child development (low income; receives government benefits; single, socially isolated or young parent; culturally or linguistically diverse background). DISCUSSION: This study will provide unique data on the effectiveness of a brief group parenting intervention for enhancing the early home learning environment of young children from disadvantaged families. It will also provide evidence of the extent to which additional one-on-one support is required to achieve change and whether there are greater benefits when delivered in the 1st year of life or later. The program has been designed for scale-up across existing early childhood services if proven effective. TRIAL REGISTRATION: 8 September 2011; ACTRN12611000965909 .This research was commissioned and funded by the Victorian Government Department of Education and Early Childhood (now the Department of Education and Training, DET). JN, MT, SB, TH, VH, EW and NH were employees of the Parenting Research Centre when this study was designed and conducted. JN, SB, EW & NH are currently supported by the Australian Communities Foundation through the Roberta Holmes Transition to Contemporary Parenthood Program (Coronella sub-fund); EW was part-funded by the Centre for Research Excellence in Child Language at Murdoch Children’s Research Institute (NHMRC grant 1023493). OU is funded by the UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust. The views expressed in this publication are those of the authors and not necessarily those of the funding bodies