Diet behaviour among young people in transition to adulthood (18–25 year olds) : a mixed method study

Peer reviewedPublisher PD

Effects of probiotics on child growth : a systematic review

Peer reviewedPublisher PD

Long-term weight loss effects on all cause mortality in overweight/obese populations

This systematic review assesses the long-term effectiveness of weight loss on all cause mortality in overweight/obese people. Medline, Embase and Cinahl were searched (1966–2005). Cohort studies and trials on participants with Body Mass Index ¡Ý25 kg/m2, with weight change and mortality with ¡Ý 2 years follow-up were included finally identifying 11 papers based on 8 studies. There may be gender differences in the benefits for all cause mortality. The impact of weight loss in men on mortality was not clear with some studies indicating weight loss to be detrimental, while a recent cohort study showed benefits, if it were a personal decision. Other studies with no gender separation had similarly mixed results. However, one study indicated that overweight/obese women with obesity related illness, who lost weight intentionally within one year, had significantly reduced mortality rates of 19% -25%. In contrast, studies of overweight/obese diabetics irrespective of gender, showed significant benefit of intentional weight loss on mortality in a metaanalysis, HR=0.75(0.67- 0.83). There is some evidence that intentional weight loss has long-term benefits on all cause mortality for women and more so for diabetics. Long-term effects especially for men are not clear and need further investigation.National Health Service (NHS) R&D Health Technology Assessment Board

Analysis of the UK recommendations on obesity based on a proposed implementation framework

Background: There is considerable expertise in the obesity field in identifying, appraising, and synthesising evidence to develop guidelines and recommendations for policy and practice. The recommendations, while based on evidence, are not formulated in a way that readily leads to implementation. This paper analyses the recent UK recommendations on obesity using a proposed implementation framework. Methods: Two bibliographic databases (Medline and Embase) and various health related and government websites were systematically searched for obesity recommendations published between 1996 and 2007. All the documents published on recommendations for either prevention or treatment of obesity in the UK were assessed. A proposed implementation framework was developed for the Purpose of this review. All the UK recommendations were critically appraised and results summarised according to the criteria used within the framework. Cross-country applicability of the proposed framework was assessed using the Swedish policy recommendations on obesity. Results: Most recommendations on obesity while demonstrating their basis in evidence, fail to meet the implementation standards. They tend to be non-specific in identifying who is responsible for implementation and monitoring, and often no timescale is indicated. The costs of implementation are rarely estimated and those responsible for such funding are not specified. There are some notable exemptions to the general pattern emanating from more operational and locally based groups. The Swedish policy details 79 proposals with responsibility clearly identified and costs are presented for 20 of them. This policy satisfied most of the framework criteria but failed to give details on evaluation, monitoring and the timeframe for implementation. Conclusions: Public health has developed skills in appraising evidence and formulating recommendations based on appropriate evidence but these are often not implemented. Different skills are required to translate these recommendations into actions. Public health clearly needs to develop the implementation skills to a level comparable to the ability to synthesise evidence

Maternal obesity in Africa : a systematic review and meta-analysis

Background: Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a ‘double burden’, especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. Methods: MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Results: Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. Conclusions: These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects

Increasing Engagement for Breast Cancer Screening and Treatment : The "ICANTREAT" Community of Expertise Initiative

Funding The workshop and the travel for four researchers – AP, SN, RS and SJM was enabled through the Scottish Funding Council (grant number SF10192) grant.Peer reviewedPublisher PD

Factors associated with teenage pregnancy in South Asia: a systematic review

Background: South Asia has a large proportion of young people in the world and teenage pregnancy has emerged as one of the major public health problem among them. The objective of this study is to systematically review to identify the risk factors associated with teenage pregnancy in South Asian countries. Methods: We systematically searched MEDLINE, EMBASE and CINAHL database (1996 to April 2007) and web-based information. Inclusion criteria were the English-language papers available in the UK and describing teenage pregnancy in South Asia. Results: Out of the seven countries in South Asia, most of the studies were related to Nepal, Bangladesh, India and Sri Lanka. Socio-economic factors, low educational attainment, cultural and family structure were all consistently identified as risk factors for teenage pregnancy. Majority of teenage girls are reported with basic knowledge on sexual health however, very few of them have used the knowledge into practice. Both social and medical consequences of teenage pregnancies are reported consistently along the most of the studies. Utilization of health services, which is a protective factor, remains low and consistent. However, teenagers agreed to delay the indexed pregnancy if they would know its consequences. Conclusions: In South Asia, many risk factors are a part of socio-economic and cultural influences. This systematic review is limited by the amount and the quality of papers published on factors associated with teenage pregnancy. In particular, future research in South Asian countries is needed with standardised measures and methodologies to gain an insight into observed variations in pregnancy rates

Effects of probiotics on child growth: a systematic review

Background: Child undernutrition has short and long term consequence for both individuals and society. Previous studies show probiotics may promote child growth and have an impact on under-nutrition. Methods: A systematic review of the literature was carried out on three electronic databases to assess evidence. The outcome measured was change in weight or height. A narrative analysis was conducted due to heterogeneity of included studies. Results: Twelve studies were included in the review of which ten were randomised controlled trials. A total of 2757 children were included, with 1598 from developing countries. The studies varied in type and quantity of probiotics given, duration of interventions, characteristics of participants, setting and units of outcome measures. Overall, five studies found a positive effect of probiotics on child growth. All five were conducted in developing countries with four studies conducted in mostly under-nourished children and one in well-nourished children. No significant effect on growth was found in the seven studies that were conducted in developed countries. Conclusion: The limited evidence suggests that probiotics have the potential to improve child growth in developing countries and in under-nourished children. More research is needed to explore this further

Knowledge, anxiety levels and attitudes of infertile couples towards COVID-19 and its impact on self-funded fertility treatment : a cross-sectional questionnaire survey

Acknowledgement We thank the couples who were willing to participate in the study. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Peer reviewedPublisher PD

Physical activity attitudes, intentions and behaviour among 18-25 year olds: a mixed method study

Peer reviewedPublisher PD