Increased duration of extreme thermal events negatively affects cold acclimation ability in a high-latitude, freshwater ectotherm (Ischnura elegans; Odonata: Coenagrionidae)

ACKNOWLEDGEMENTS. We wish to thank the owners of the Midmar Stillwater Fishery for permission to sample larvae from their trout ponds. Thanks also to S. Areshi and R. Fitt for assistance in the field. This project was funded by the University of Aberdeen School of Biological Sciences, as part of their Ecology and Conservation MSc programme thesis project budget.Peer reviewedPublisher PD

Incidence of and risk factors for perineal trauma: A prospective observational study

Background: Our aim was to describe the range of perineal trauma in women with a singleton vaginal birth and estimate the effect of maternal and obstetric characteristics on the incidence of perineal tears. Methods: We conducted a prospective observational study on all women with a planned singleton vaginal delivery between May and September 2006 in one obstetric unit, three freestanding midwifery-led units and home settings in South East England. Data on maternal and obstetric characteristics were collected prospectively and analysed using univariable and multivariable logistic regression. The outcome measures were incidence of perineal trauma, type of perineal trauma and whether it was sutured or not. Results: The proportion of women with an intact perineum at delivery was 9.6% (125/1,302) in nulliparae, and 31.2% (453/1,452) in multiparae, with a higher incidence in the community (freestanding midwifery-led units and home settings). Multivariable analysis showed multiparity (OR 0.52; 95% CI: 0.30-0.90) was associated with reduced odds of obstetric anal sphincter injuries (OASIS), whilst forceps (OR 4.43; 95% CI: 2.02-9.71), longer duration of second stage of labour (OR 1.49; 95% CI: 1.13-1.98), and heavier birthweight (OR 1.001; 95% CI: 1.001-1.001), were associated with increased odds. Adjusted ORs for spontaneous perineal truama were: multiparity (OR 0.42; 95% CI: 0.32-0.56); hospital delivery (OR 1.48; 95% CI: 1.01-2.17); forceps delivery (OR 2.61; 95% CI: 1.22-5.56); longer duration of second stage labour (OR 1.45; 95% CI: 1.28-1.63); and heavier birthweight (OR 1.001; 95% CI: 1.000-1.001). Conclusions: This large prospective study found no evidence for an association between many factors related to midwifery practice such as use of a birthing pool, digital perineal stretching in the second stage, hands off delivery technique, or maternal birth position with incidence of OASIS or spontaneous perineal trauma. We also found a low overall incidence of OASIS, and fewer second degree tears were sutured in the community than in the hospital settings. This study confirms previous findings of overall high incidence of perineal trauma following vaginal delivery, and a strong association between forceps delivery and perineal trauma. © 2013 Smith et al; licensee BioMed Central Ltd

Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018

Background: Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15–24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15–24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among 15–24 year-old women in Nigeria. Methods: We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis and are reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for 15–24 year-old women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for reproductive health service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7). Conclusion: Our findings highlight the importance of disaggregating data for women across the reproductive Life course, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria

Characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service

INTRODUCTION: There are concerns about rising drug-related deaths and the potential contribution of prescription analgesics. There is limited understanding regarding the role of prescription analgesics in non-fatal overdoses (NFODs), nor is there a good understanding of what factors are associated with more severe overdose. OBJECTIVES: To explore risk factors and characteristics of NFODs among people attending a specialist community-based substance misuse service. METHODS: After Caldicott approval, data on NFODs, in people attending the Tayside Substance Misuse Service (TSMS), were extracted from the Scottish Ambulance Service database, along with opioid replacement therapy (ORT) prescribing data. Statistical analysis was performed using R studio and Microsoft Excel. RESULTS: 557 people (78% [434/556] male, mean age ± standard deviation 38.4 ± 7.95) had an NFOD. Repeat NFODs were more likely in males compared to females (p < .0065). Males were more likely to be administered naloxone (OR = 1.94, 95% CI = 1.10–3.40, p < .02). NFODs at home were more likely to be moderate to severe (categorized by Glasgow Comma Scale [p < .02, OR = 4.95, 95% CI = 1.24–24.38]). Methadone (321/557, 57.63%), benzodiazepines (281/557, 50.45%) and heroin (244/557, 43.81%) were the commonest substances: prescribed methadone overdose was more likely than buprenorphine (p < .00001). Opioids and benzodiazepines were often taken together (275/557, 49.40%), with almost all gabapentinoid NFODs also involving opioids (60/61, 98.40%). CONCLUSIONS: Polysubstance use with opioids prescribed for ORT, such as methadone, is highly likely to be implicated in NFOD, with males being at the highest risk of severe and repeat NFOD. Future work should focus on strategies to further reduce NFODs

Promoting Health and Nutrition Through Sport: Attitudes of the Junior Sporting Community

Introduction: This study aimed to provide information on parents’, children’s and sporting officials’ attitudes to sponsorship arrangements, and their support of potential policy interventions to reorient sponsorship to be more health promoting. Methods: Sports clubs (n=20) known to have food and beverage sponsors in Sydney, Illawarra and Canberra/Queanbeyan were selected. Parents and children at sports clubs were recruited through convenience sampling by approaching those attending the sports club at the time of the survey and those children who had a signed consent form. Sports clubs were visited between May and November 2010. At each club, one sports club official, ten parents of players aged 5 to 14 years, and five children aged 10 to 14 years were surveyed. Results: The majority of sporting officials and parents were supportive of policies to restrict unhealthy food and beverage sponsorship of elite sport and children’s sports clubs. More than two-thirds of all children were able to correctly recall sponsors of their sports club and almost half could correctly name at least one sponsor of their favourite elite sports team. Most children thought that food and beverage companies sponsored sport to help out sports clubs and liked to return the favour to these sponsors by buying their products. Conclusion: Children’s high level of recall of food and beverage sponsors is concerning as this recall is likely to be linked to children’s product preferences and consumption behaviours. Alternative funding mechanisms are required to replace community and elite sport sponsorship from unhealthy food and beverage companies to reduce the promotional effects of this marketing on children’s food choices and eating behaviours

Promoting Health and Nutrition Through Sport: Attitudes of the Junior Sporting Community

Introduction: This study aimed to provide information on parents’, children’s and sporting officials’ attitudes to sponsorship arrangements, and their support of potential policy interventions to reorient sponsorship to be more health promoting. Methods: Sports clubs (n=20) known to have food and beverage sponsors in Sydney, Illawarra and Canberra/Queanbeyan were selected. Parents and children at sports clubs were recruited through convenience sampling by approaching those attending the sports club at the time of the survey and those children who had a signed consent form. Sports clubs were visited between May and November 2010. At each club, one sports club official, ten parents of players aged 5 to 14 years, and five children aged 10 to 14 years were surveyed. Results: The majority of sporting officials and parents were supportive of policies to restrict unhealthy food and beverage sponsorship of elite sport and children’s sports clubs. More than two-thirds of all children were able to correctly recall sponsors of their sports club and almost half could correctly name at least one sponsor of their favourite elite sports team. Most children thought that food and beverage companies sponsored sport to help out sports clubs and liked to return the favour to these sponsors by buying their products. Conclusion: Children’s high level of recall of food and beverage sponsors is concerning as this recall is likely to be linked to children’s product preferences and consumption behaviours. Alternative funding mechanisms are required to replace community and elite sport sponsorship from unhealthy food and beverage companies to reduce the promotional effects of this marketing on children’s food choices and eating behaviours

Building Solutions to Protect Children from Unhealthy Food and Drink Sport Sponsorship.

In Australia, and indeed across the world, the proportion of children who are overweight or obese is increasing. Almost one-quarter of school-aged children are now overweight or obese. While the causes of obesity are complex and many, children’s exposure to high levels of unhealthy food marketing is one factor that affects the food and drinks that children like, ask for, buy and consume. Extensive research evidence has found that, in general, children are exposed to high levels of food marketing, most of which is for unhealthy or high fat, sugar and/or salt food and drinks. The most commonly advertised foods have been found to be sugar-sweetened breakfast cereals, savoury snacks, fast food restaurants, onfectionery and soft drinks

Assessing the impact of a national clinical guideline for the management of chronic pain on opioid prescribing rates:a controlled interrupted time series analysis

Background: Opioids can be effective analgesics, but long-term use may be associated with harms. In 2013, the first national, comprehensive, evidence-based pain management guideline was published, from the Scottish Intercollegiate Guideline Network (SIGN 136: Management of Chronic Pain) with key recommendations on analgesic prescribing. This study aimed to examine the potential impact on national opioid prescribing rates in Scotland. Methods: Trends in national and regional community opioid prescribing data for Scotland were analysed from quarter one (Q1) 2005 to Q2 2020. Interrupted time series regression examined the association of SIGN 136 publication with prescribing rates for opioid-containing drugs. Gabapentinoid prescribing was used as a comparison drug. Results: After a positive prescribing trend pre-publication, the timing of SIGN 136 publication was associated with a negative change in the trend of opioid prescribing rates (−2.82 items per 1000 population per quarter [PTPPQ]; P < 0.01). By Q2 2020, the relative reduction in the opioid prescribing rate was −20.67% (95% CI: −23.61, −17.76). This persisted after correcting for gabapentinoid prescribing and was mainly driven by the reduction in weak opioids, whereas strong opioid prescribing rates continued to rise. Gabapentinoid prescribing showed a significant rise in level (8.00 items per 1000 population; P = 0.01) and trend (0.27 items PTPPQ; P = 0.01) following SIGN 136 publication. Conclusions: The publication of SIGN 136 was associated with a reduction in opioid prescribing rates. This suggests that changes in clinical policy through evidence-based national clinical guidelines may affect community opioid prescribing, though this may be partially replaced by gabapentinoids, and other factors may also contribute