Abstract Background Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, ...guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland. Methods Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites. Resources were included if published, reviewed, or updated between January 2011 and May 2022. Data were extracted into Excel and coded using NVivo. The review design included the involvement of the “Healthy Reproductive Years” Patient and Public Involvement and Engagement advisory panel. Results The searches identified 273 resources, and a subsequent audit with healthcare professionals in Northern Ireland revealed five additional preconception health-related resources. A wide range of resource types were identified, and preconception health was often not the only focus of the resources reviewed. Resources proposed approaches to improve preconception health and care, such as the need for improved awareness and access to care, preconceptual counselling, multidisciplinary collaborations, and the adoption of a life-course approach. Many behavioural (e.g., folic acid intake, smoking), biomedical (e.g., mental and physical health conditions), and environmental and social (e.g., deprivation) factors were identified and addressed in the resources reviewed. In particular, pre-existing physical health conditions were frequently mentioned, with fewer resources addressing psychological factors and mental health. Overall, there was a greater focus on women’s, rather than men’s, behaviours. Conclusions This scoping review synthesised existing resources available in the UK and Ireland to identify a wide range of common approaches and factors that influence preconception health and care. Efforts are needed to implement the identified resources (e.g., strategies, guidelines) to support people of childbearing age to access preconception care and optimise their preconception health.
Neutral-current production of K^{+} by atmospheric neutrinos is a background in searches for the proton decay p→K^{+}νover ¯. Reactions such as νp→νK^{+}Λ are indistinguishable from proton decays ...when the decay products of the Λ are below detection threshold. Events with K^{+} are identified in MINERvA by reconstructing the timing signature of a K^{+} decay at rest. A sample of 201 neutrino-induced neutral-current K^{+} events is used to measure differential cross sections with respect to the K^{+} kinetic energy, and the non-K^{+} hadronic visible energy. An excess of events at low hadronic visible energy is observed relative to the prediction of the neut event generator. Good agreement is observed with the cross section prediction of the genie generator. A search for photons from π^{0} decay, which would veto a neutral-current K^{+} event in a proton decay search, is performed, and a 2σ deficit of detached photons is observed relative to the genie prediction.
The hypothalamus plays a key role in the regulation of both energy homeostasis and reproduction. Evidence suggests that relaxin-3, a recently discovered member of the insulin superfamily, is an ...orexigenic hypothalamic neuropeptide. Relaxin-3 is thought to act in the brain via the RXFP3 receptor, although the RXFP1 receptor may also play a role. Relaxin-3, RXFP3, and RXFP1 are present in the hypothalamic paraventricular nucleus, an area with a well-characterized role in the regulation of energy balance that also modulates reproductive function by providing inputs to hypothalamic gonadotropin-releasing hormone (GnRH) neurons. Other members of the relaxin family are known to play a role in the regulation of reproduction. However, the effects of relaxin-3 on reproductive function are unknown. We studied the role of relaxin-3 in the regulation of the hypothalamo-pituitary-gonadal (HPG) axis. Intracerebroventricular (5 nmol) and intraparaventricular (540-1,620 pmol) administration of human relaxin-3 (H3) in adult male Wistar rats significantly increased plasma luteinizing hormone (LH) 30 min postinjection. This effect was blocked by pretreatment with a peripheral GnRH antagonist. Central administration of human relaxin-2 showed no significant effect on plasma LH. H3 dose-dependently stimulated the release of GnRH from hypothalamic explants and GT(1)-7 cells, which express RXFP1 and RXFP3, but did not influence LH or follicle-stimulating hormone release from pituitary fragments in vitro. We have demonstrated a novel role for relaxin-3 in the stimulation of the HPG axis, putatively via hypothalamic GnRH neurons. Relaxin-3 may act as a central signal linking nutritional status and reproductive function.
The effects of acute and repeated intraparaventricular (iPVN) administration of human relaxin-3 (H3) were examined on food intake, energy expenditure, and the hypothalamo–pituitary thyroid axis in ...male Wistar rats. An acute high dose iPVN injection of H3 significantly increased food intake 1 h post-administration 0.4
±
0.1 g (vehicle) vs 1.6
±
0.5 g (180 pmol H3), 2.4
±
0.5 g (540 pmol H3) and 2.2
±
0.5 g (1620 pmol H3),
p
<
0.05 for all doses vs vehicle. Repeated iPVN H3 injection (180 pmol/twice a day for 7 days) significantly increased cumulative food intake in
ad libitum fed animals compared with vehicle 211.8
±
7.1 g (vehicle) vs 261.6
±
6.7 g (
ad libitum fed H3),
p
<
0.05. Plasma leptin was increased in the H3
ad libitum fed group. Plasma thyroid stimulating hormone was significantly decreased after acute and repeated administration of H3. These data suggest H3 may play a role in long-term control of food intake.
In this study, we tested the efficacy of a low-intensity lifestyle intervention aimed at reducing the risk of cardiovascular disease among mid-life individuals.
We conducted a randomized controlled ...trial in which participants were randomly assigned either to receive a health report card with counselling (from a Telehealth nurse) on smoking, exercise, nutrition and stress or to receive usual care. The patients were divided into 2 groups on the basis of risk: the primary prevention group, with a Framingham risk score of 10% or higher (intervention, n = 157; control, n = 158), and the secondary prevention group, who had a diagnosis of coronary artery disease (intervention, n = 153; control, n = 143). The primary outcome was a change in the Framingham global risk score between baseline and 1-year follow-up. Data were analyzed separately for the 2 prevention groups using an intention-to-treat analysis controlling for covariates.
Within the primary prevention group, there were statistically significant changes for the treatment group relative to the controls, from baseline to year 1, in Framingham score (intervention, -3.10 95% confidence interval (CI) -3.98 to -2.22; control, -1.30 95% CI -2.18 to -0.42; p < 0.01) and scores for total cholesterol (intervention, -0.41 95% CI -0.59 to -0.23; control, -0.14 95% CI -0.32 to 0.04; p < 0.05), systolic blood pressure (intervention, -7.49 95% CI -9.97 to -5.01; control, -3.58 95% CI -6.08 to -1.08; p < 0.05), nutrition level (intervention, 0.30 95% CI 0.13 to 0.47; control, -0.05 95% CI -0.22 to 0.12; p < 0.01), and health confidence (intervention, 0.20 95% CI 0.09 to 0.31; control, 0.04 95% CI -0.07 to 0.15; p < 0.05), with adjustment for covariates. No significant changes in outcome variables were found for the secondary prevention group.
We found evidence for the efficacy of an intervention addressing multiple risk factors for primary prevention at 1 year using Framingham risk score report cards and telephone counselling. (Requirement for clinical trial registration waived enrolment completed before requirement became applicable.).
Vehicular emissions of NO
x
and NH
3 result in elevated concentrations of nitrogen at roadside verges. To determine the extent that vehicular nitrogen emissions, disturbance and management affect the ...vegetation composition of road verges, a survey of 92 verges in Scotland was carried out with sites stratified by background nitrogen deposition and road type. NO
x
and NH
3 concentrations were monitored at 15 key sites for a year, and showed a decreasing gradient with increasing distance from the road. Ellenberg fertility indices of the vegetation communities also showed a general decrease with increasing distance from the road, but there was no straightforward correlation with NO
x
and NH
3 air concentrations between sites. Cover of bare ground, ruderal species and salt-tolerant species were highest at the verge edge. The proximity of the verge to traffic is important both in terms of NO
x
and NH
3 gradients, but also for deposited salt, grit and physical disturbance.
NO
x
, NH
3 and road verge vegetation Ellenberg fertility indices decline with distance from traffic.
Abstract
Background
Public health ethics and law (PHEL) is a core professional competency for the public health workforce. However, few data are available describing the extent to which UK public ...health workforce members experience ethical and legal issues or have sufficient educational and/or training background to adequately deal with such issues.
Methods
An anonymous online survey was developed for dissemination via member mailing lists of the: Faculty of Public Health, Royal Society of Public Health, and UK Public Health Register. Public Health England also included a link to the survey in their newsletter. The survey included questions about education, training, and experience in relation to PHEL. The survey was deployed from October 2017 to January 2018.
Results
The survey was completed by a diverse sample of five hundred and sixty-two individuals. The majority of respondents reported: (i) regularly encountering ethical issues, (ii) resolving ethical issues through personal reflection, (iii) having little or no education and training in PHEL, and (iv) questioning whether they have dealt with ethical issues encountered in practice in the best way.
Conclusions
The results suggest that there is a need to develop and support wider PHEL capacity within the UK public health workforce through the provision of PHEL education, training, guidance, and mentoring.
Enrichment of heterozygous missense and truncating SMAD6 variants was previously reported in nonsyndromic sagittal and metopic synostosis, and interaction of SMAD6 variants with a common polymorphism ...nearBMP2 (rs1884302) was proposed to contribute to inconsistent penetrance. We determined the occurrence of SMAD6 variants in all types of craniosynostosis, evaluated the impact of different missense variants on SMAD6 function, and tested independently whether rs1884302 genotype significantly modifies the phenotype.
We performed resequencing of SMAD6 in 795 unsolved patients with any type of craniosynostosis and genotyped rs1884302 in SMAD6-positive individuals and relatives. We examined the inhibitory activity and stability of SMAD6 missense variants.
We found 18 (2.3%) different rare damaging SMAD6 variants, with the highest prevalence in metopic synostosis (5.8%) and an 18.3-fold enrichment of loss-of-function variants comparedwith gnomAD data (P < 10
). Combined with eight additional variants, ≥20/26 were transmitted from an unaffected parent but rs1884302 genotype did not predict phenotype.
Pathogenic SMAD6 variants substantially increase the risk of both nonsyndromic and syndromic presentations of craniosynostosis, especially metopic synostosis. Functional analysis is important to evaluate missense variants. Genotyping of rs1884302 is not clinically useful. Mechanisms to explain the remarkable diversity of phenotypes associated with SMAD6 variants remain obscure.
Serratia sp. ATCC 39006 produces the carbapenem antibiotic, carbapen‐2‐em‐3‐carboxylic acid and the red pigment, prodigiosin. We have previously reported the characterization of a gene, carR, ...controlling production of carbapenem in this strain. We now describe further characterization of the carR locus to locate the genes encoding carbapenem biosynthetic and resistance functions. A novel family of diverse proteins showing sequence similarity to the C‐terminal domain of CarF (required for carbapenem resistance) is described. We also report the isolation of the locus involved in the biosynthesis of the red pigment, prodigiosin. A cosmid containing ≈ 35 kb of the Serratia chromosome encodes synthesis of the pigment in the heterologous host, Erwinia carotovora, demonstrating, for the first time, that the complete prodigiosin biosynthetic gene cluster had been cloned and functionally expressed. We report the isolation of a third locus in Serratia, containing convergently transcribed genes, smaI and smaR, encoding LuxI and LuxR homologues respectively. SmaI directs the synthesis of N‐acyl homoserine lactones involved in the quorum sensing process. We demonstrate that biosynthesis of the two secondary metabolites, carbapenem antibiotic and prodigiosin pigment, is under pheromone‐mediated transcriptional regulation in this bacterium. Finally, we describe a new prodigiosin‐based bioassay for detection of some N‐acyl homoserine lactones.
Summary Background Early mobility facilitated by physiotherapy has been shown to reduce the incidence of hospital-acquired pneumonia (HAP) in patients with hip fractures but its effect on HAP ...incidence in medical patients has not yet been studied. Aim To determine whether early mobility aided by physiotherapy reduces the incidence of HAP and length of stay in patients on medical wards. Methods One respiratory and one elderly care medicine ward in one hospital association in Birmingham, UK, received the ‘Early Mobility Bundle’. The bundle consisted of extra targeted physiotherapy and collaboration with ward staff to encourage and promote activity. The incidence of HAP, falls, pressure sores, length of stay (LOS) and activity level were then compared to two matched wards within the same hospital association. Results HAP incidence was significantly lower in the intervention group ( P < 0.0001) and remained so after adjusting for confounders ( P = 0.001). Activity levels were higher ( P = 0.04) and patients' LOS was more likely to fall in the lowest quartile (OR: 1.44; P = 0.009) in the intervention group. There was no significant difference in other outcomes. Conclusion The Early Mobility Bundle demonstrates a promising method to reduce the incidence of HAP and to increase activity in medical inpatients.
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