The Effectiveness of Weight Management Interventions in Breastfeeding Women—A Systematic Review and Critical Evaluation

Background: The postpartum period is a vulnerable time for excess weight retention, particularly for the increasing number of women who are overweight at the start of their pregnancy and subsequently find it difficult to lose additional weight gained during pregnancy. Although postpartum weight management interventions play an important role in breaking this potentially vicious cycle of weight gain, the effectiveness of such interventions in breastfeeding women remains unclear. Our aim was to systematically review the literature about the effectiveness of weight management interventions in breastfeeding women.

Methods: Seven electronic databases were searched for eligible papers. Intervention studies included were carried out exclusively in breastfeeding mothers, ≤2 years postpartum and with a body mass index greater than 18.5 kg/m2, with an outcome measure of change in weight and/or body composition.

Results: Six studies met the selection criteria, and were stratified according to the type of intervention and outcome measures. Despite considerable heterogeneity among studies, the dietary-based intervention studies appeared to be the most efficacious in promoting weight loss; however, few studies were tailored toward the needs of breastfeeding women.

Conclusions: Weight management interventions which include an energy-restricted diet may play a key role in successful postpartum weight loss for breastfeeding mothers.

Genetic pleiotropy between multiple sclerosis and schizophrenia but not bipolar disorder: differential involvement of immune-related gene loci

Converging evidence implicates immune abnormalities in schizophrenia (SCZ), and recent genome-wide association studies (GWAS) have identified immune-related single-nucleotide polymorphisms (SNPs) associated with SCZ. Using the conditional false discovery rate (FDR) approach, we evaluated pleiotropy in SNPs associated with SCZ (n=21 856) and multiple sclerosis (MS) (n=43 879), an inflammatory, demyelinating disease of the central nervous system. Because SCZ and bipolar disorder (BD) show substantial clinical and genetic overlap, we also investigated pleiotropy between BD (n=16 731) and MS. We found significant genetic overlap between SCZ and MS and identified 21 independent loci associated with SCZ, conditioned on association with MS. This enrichment was driven by the major histocompatibility complex (MHC). Importantly, we detected the involvement of the same human leukocyte antigen (HLA) alleles in both SCZ and MS, but with an opposite directionality of effect of associated HLA alleles (that is, MS risk alleles were associated with decreased SCZ risk). In contrast, we found no genetic overlap between BD and MS. Considered together, our findings demonstrate genetic pleiotropy between SCZ and MS and suggest that the MHC signals may differentiate SCZ from BD susceptibility.Molecular Psychiatry advance online publication, 28 January 2014; doi:10.1038/mp.2013.195.

Ecological Impacts of Alien Species: Quantification, Scope, Caveats, and Recommendations

Despite intensive research during the past decade on the effects of alien species, invasion science still lacks the capacity to accurately predict the impacts of those species and, therefore, to provide timely advice to managers on where limited resources should be allocated. This capacity has been limited partly by the context-dependent nature of ecological impacts, research highly skewed toward certain taxa and habitat types, and the lack of standardized methods for detecting and quantifying impacts. We review different strategies, including specific experimental and observational approaches, for detecting and quantifying the ecological impacts of alien species. These include a four-way experimental plot design for comparing impact studies of different organisms. Furthermore, we identify hypothesis-driven parameters that should be measured at invaded sites to maximize insights into the nature of the impact. We also present strategies for recognizing high-impact species. Our recommendations provide a foundation for developing systematic quantitative measurements to allow comparisons of impacts across alien species, sites, and time.

Creating an eLearning Resource to Improve Knowledge and Understanding of Pregnancy in the Context of HIV Infection

Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby.

Fathers and Parenting

The aim of this chapter is to present a contextual and empirical account of men as fathers in Ireland along with an analysis of recent, relevant developments in policies and laws. Much of parenting of a child occurs in the home. Consequently, how couples inhabit the home greatly influences how their children experience childhood and, in many ways, the story of fatherhood in Ireland is the product of the on-going changes in the domestic sphere. Whether men are driving these changes, embracing or resisting them will provide the substance of much of this chapter. Section one presents basic demographic figures and trends based on census data to answer the questions: who are the fathers, what type of families do the live in and how involved are they in childcare? Section two presents recent research on contemporary fatherhood, both international and, where possible, national. Section three explores the policies and legal measures that affect fathers, their duties and their rights in the home and at work. Section four will discuss the historical legacy of fatherhood that is particular to Ireland. The final section will draw together these threads and ask what might be the future of fatherhood in Ireland, its challenges and possible successes.

Executive functioning deficits in young adult survivors of bronchopulmonary dysplasia

Purpose: To assess long-term impairments of executive functioning in adult survivors of bronchopulmonary dysplasia (BPD). 
Method: Participants were assessed on measures of executive functioning, health-related quality of life (HRQoL) and social functioning. Survivors of BPD (n = 63; 34 males; mean age 24.2 years) were compared with groups comprising preterm (without BPD) (<1500 g; n = 45) and full-term controls (n = 63). Analysis of variance was used to explore differences among groups for outcome measures. Multiple regression analyzes were performed to identify factors predictive of long-term outcomes. 
Results: Significantly more BPD adults, compared with preterm and term controls, showed deficits in executive functioning relating to problem solving (OR: 5.1, CI: 1.4–19.3), awareness of behavior (OR: 12.7, CI: 1.5–106.4) and organization of their environment (OR: 13.0, CI: 1.6–107.1). Birth weight, HRQoL and social functioning were predictive of deficits in executive functioning. 
Conclusions: This study represents the largest sample of survivors into adulthood of BPD and is the first to show that deficits in executive functioning persist. Children with BPD should be assessed to identify cognitive impairments and allow early intervention aimed at ameliorating their effects.

Barrier characteristics of PtSi/p-Si schottky diodes as determined from I-V-T measurements

The current-voltage-temperature characteristics of PtSi/p-Si Schottky barrier diodes were measured in the temperature range 60-115 K. Deviation of the ideality factor from unity below 80 K may be modelled using the so-called T-0 parameter with T-0 = 18 K. It is also shown that the curvature in the Richardson plots may be remedied by using the flatband rather than the zero-bias saturation current density. Physically, the departure from ideality is interpreted in terms of an inhomogeneous Schottky contact. Here we determine a mean barrier height at T = 0 K, phi(b)(-0) = 223 mV, with an (assumed) Gaussian distribution of standard deviation sigma(phi) = 12.5 mV. These data are correlated with the zero-bias barrier height, phi(j)(0) = 192 mV (at T = 90 K), the photoresponse barrier height, phi(ph) = 205 mV, and the flatband barrier height, phi(fb) = 214 mV. Finally, the temperature coefficient of the flatband barrier was found to be -0.121 mV K-1, which is approximately equal to 1/2(dE(g)(i)/dT), thus suggesting that the Fermi level at the interface is pinned to the middle of the band gap.