A comparison of neonatal outcomes between adolescent and adult mothers in developed countries: A systematic review and meta-analysis

Evidence suggests that adolescent pregnancies are at increased risk of adverse neonatal outcomes compared to adult pregnancies; however, there are significant inconsistencies in the literature, particularly in studies conducted in developed countries. The objective of this study therefore is to systematically review the current literature with regard to the relationship between adolescent pregnancy and neonatal outcomes. A literature search was conducted in eight electronic databases (AMED, ASSIA, Child Development and Adolescent Studies, CINAHL, Cochrane Library, Health Source: Nursing, Maternity and Infant Care, MEDLINE and Scopus. The reference lists of included studies were also hand searched. Studies were included if: they were conducted in countries with very high human development according to the United Nations Human Development Index; reported at least one comparison between adolescents (19 years or under) and adult mothers (20–34 years); and were published between January 1998 and March 2018. Studies were screened for inclusion and data extracted by one reviewer. A second reviewer independently reviewed a sub-set of studies. Disagreements were resolved by consensus. Meta-analysis was performed using RevMan 5.3 using crude counts reported in the included studies. Sub-group analyses of adolescents aged 17 and under and 18–19 were conducted. Pooled analysis of adjusted odds ratios was also undertaken in order to consider the effect of confounding factors. Meta-analysis effect estimates are reported as risk ratios (RR) and pooled association as adjusted odds ratios (aORs). Point estimates and 95% confidence intervals are presented. After removal of duplicates a total of 1791 articles were identified, of which 20 met the inclusion criteria. The results of the meta-analysis showed adolescents to have increased risk of all primary adverse outcomes investigated. Sub-group analysis suggests an increased risk of perinatal death and low birthweight for children born to adolescent mothers; 17 and under (perinatal death: RR 1.50, CI 1.32–1.71: low birthweight RR 1.43, CI 1.20–1.70); 18–19 (perinatal death RR 1.21, CI 1.06–1.37: low birthweight RR 1.10, CI 1.08–1.57). Mothers aged 17 and under were also at increased risk of preterm delivery (RR 1.64, CI 1.54–1.75). Analysis adjusted for confounders showed increased risk of preterm delivery (aOR 1.23, CI 1.09–1.38), very preterm delivery (aOR 1.22, CI 1.03–1.44) and neonatal death (aOR 1.31, CI 1.14–1.52). Findings show that young maternal age is a significant risk factor for adverse neonatal outcomes in developed countries. Adolescent maternal age therefore should be considered as a potential cause for concern in relation to neonatal health and it is recommended that health care professionals respond accordingly with increased support and monitoring

An FPGA-Based MIMO and Space-Time Processing Platform

Faced with the need to develop a research unit capable of up to twelve 20MHz bandwidth channels of real-time, space-time,and MIMO processing, the authors developed the STAR (space-time array research) platform. Analysis indicated that the possibledegree of processing complexity required in the platform was beyond that available from contemporary digital signal processors,and thus a novel approach was required toward the provision of baseband signal processing. This paper follows the analysis andthe consequential development of a flexible FPGA-based processing system. It describes the STAR platform and its use throughseveral novel implementations performed with it. Various pitfalls associated with the implementation of MIMO algorithms in realtime are highlighted, and finally, the development requirements for this FPGA-based solution are given to aid comparison withtraditional DSP development

Unveiling the Sketching Society (1799-1851)

In 1799, a group of young London-based artists founded a new Sketching Society. It was still in existence some fifty years or so later. Up until now, the Society has principally been of interest to scholars only insomuch as the names of Thomas Girtin and John Sell Cotman can be attached to its earliest activities and meetings. However, this has been to the neglect of the far better documented and longer-lived iteration of the group that was overseen by the brothers Alfred Edward Chalon and John James Chalon. This thesis will therefore look to re-assess the development of the Sketching Society, paying particular attention to its later, currently under-appreciated history under the Chalons in order to explore the place and wider importance of such affiliations in the art world of the early nineteenth century. This will mean looking at continuities in the aims and organisation of the Society over time, but also how the changing priorities of the increasingly better connected and established members of the Chalon-led group distinguish it from that pool of artists who first met around the turn of the century. Beginning with a brief history of the clubs associated with Girtin and Cotman, the thesis will then go on to examine the make-up of the Chalon group. Subsequent chapters discuss the actual activities of this later group, exploring the literary or thematic prompts employed at their regular evening meetings and reconstructing select sessions. They will then consider the public-facing aspects of the Society’s life, in the form of a series of publications and exhibitions it organised to promote its activities. All told, a survey of what might be termed the long history of the Sketching Society is revealing of the significance of such collaborative and communal activities in making and sustaining a career in the capital’s art world

Perspectives of youth-support professionals on encouraging healthy eating in adolescent pregnancies

Background. Nutrition during pregnancy has been identified as an important modifiable factor to reduce adverse outcomes in adolescent pregnancies. Young women are supported during their pregnancies by a variety of professionals with both clinical and non-clinical roles. Professionals with a non-clinical support role provide practical and emotional support for young women and often have longer lasting professional relationships with their clients. For this reason, this study aims to explore the perspectives of these professionals on how young women can be encouraged to improve their diet during pregnancy. Ethics. Ethical approval for this study was granted by Sheffield Hallam University Ethics Committee in July 2016. Methods. This exploratory, qualitative study recruited eight youth-support professionals to take part in semi-structured interviews. Recruitment and interviews were conducted by the lead author during February 2017, with project supervision and triangulation of data completed by the other two authors. Interviews were audio-recorded and transcribed. Interview transcripts were loaded into NVivo 11 software to facilitate analysis and emerging themes identified. Results. Five overarching themes were identified from the data: perceptions of dietary pattern; connection with baby; family and social stability; building relationships; and service availability. Youth-support professionals felt that young women encountered numerous complex barriers to eating healthily during pregnancy. Their lives are frequently chaotic and lack a stable partner and family relationships. They suggested that young women often needed specific practical support to make improvements, such as being accompanied to health appointments. There was also some concern that further cuts to services for this group would make it more difficult for vulnerable young women to access help. Conclusions. A higher level of consistent, holistic support delivered by joined-up networks of professionals is needed to help young women achieve healthier pregnancies. Further research is necessary to understand the context of young women’s lives, how this relates to their experiences of pregnancy, and what type of interventions or resources would have the biggest impact in supporting healthy behaviours

High resolution electron microscopy of biological systems

This thesis demonstrates the relevance of advanced transmission electron microscopy (TEM) techniques such as aberration corrected scanning transmission electron microscopy (STEM) to the study of biological samples. By developing the application of these techniques to biologically relevant systems, this study shows how advanced EM can be an effective tool by providing insight into the structure of biological systems at the highest (i.e. atomic) resolutions. High angle annular dark field (HAADF) STEM has been used to gain insight into the core structure and iron loading mechanisms of the iron storage protein, ferritin. The iron content of ferritin was quantified using size-selected gold clusters as a mass balance, the first application of this technique to a biological sample. Preliminary structural studies of a novel colorectal cancer therapy have been undertaken, where polymeric alginate molecules chelate chemotoxic luminal iron in the colon. In particular the nano-structures built when alginates bind iron under physiological conditions have been established and investigated for the first time, using HAADF-STEM. Finally using TEM, it has been revealed for the first time the structures formed, and morphology changes induced, when proteins are encapsulated by membrane mimicking nano-discs

Differences in dietary pattern by maternal age in the Born in Bradford cohort : A comparative analysis

Objective Explore associations between dietary patterns and maternal age Design Population based cohort study Setting Maternity department of a large hospital in northern England Sample Women delivering a singleton at Bradford Royal Infirmary between March 2007 and December 2010 (N = 5,083). Methods Survey data including maternal dietary patterns derived from food frequency questionnaire data using principal component analysis (PCA) were compared by maternal age using one-way ANOVA and chi-squared as appropriate. Main outcome measures Dietary pattern PCA scores, supplement use, familiarity and compliance with 5-a-day fruit and vegetable recommendations, consumption of cola, maternal BMI. Results Three distinct dietary patterns were derived from the data; snack and processed foods, meat and fish and grains and starches. Mean PCA score for snack and processed foods was higher among women aged ≤19 (0.6, CI 0.4 to 0.8) than women aged 20–34 (-0.02, CI -0.1 to 0.01) and those aged 35≥ (-0.3, CI -0.4 to -0.2). Women aged 35≥ had a significantly higher mean PCA score for the grains and starches dietary pattern (0.1, CI 0.03 to 0.3) compared to both the 20–34 years (-0.01, CI -0.05 to 0.02) and the ≤19 (-0.04, CI -0.2 to 0.1) groups. No differences were observed between groups in mean PCA scores for the meat and fish dietary pattern. Adolescent women also had higher intakes of sugar sweetened cola (0.9 cups per day, CI 0.7 to 1.1) and reported lower levels of fruit and vegetable and supplement intake. Women aged 35≥ had a higher mean BMI (28.0, CI 27.5 to 28.4) and higher prevalence of overweight (36.8%) and obesity (29.6%, p<0.001). Conclusions Significant differences were observed between age groups both in terms of diet quality and BMI. Interventions targeted by age group may be advantageous in improving maternal nutrition and contribute to healthy pregnancies