Association of birth weight and current body size to blood pressure in female twins

It has been proposed that low birth weight is associated with high levels of blood pressure in later life. The aim of this study was to assess the relationship of blood pressure to birth weight and current body size during growth and adulthood. A total of 711 female multiple births, with one group of 244 in their growth phase mean age 12.0 (2.3)(SD) years and the other of 467 adults (mean age 35.2 (12.6) years), had height, weight and both systolic (SBP) and diastolic (DBP) blood pressures measured, and self-reported their birth weight. Regression analyses were performed to assess the cross-sectional and within-pair associations of blood pressure to birth weight, with and without adjustments for current body size. Within-pair analysis was based on 296 twin pairs. Cross-sectionally, a reduction in birth weight of 1 kg was associated with 2 to 3 mm Hg higher age-adjusted SBP, which was of marginal significance and explained about 2% of the population variance. Adjustment for body mass index did not significantly change this association. Within-pair analyses found no association between birth weight and SBP or DBP,even after adjusting for current body size. After age, current body size was the strongest predictor of systolic BP. The weak association of blood pressure to birth weight cross-sectionally is of interest, but any within-pair effect of birth weight on blood pressure must be minimal compared with the effect of current body size.

Duly delivered : women's experiences of birth planning

Critically examines the construct of power differentials in the childbirth experiences of forty-two women following the birth of their first child. Detailed data was collected using questionnaires and in-depth interviews with women from a range of localities around the State. The research demonstrated that childbirth processes in Victoria effectively ignore the wishes of pregnant women leading to them suffering significant physical and psychological health consequences.

The place of birth in Kafa Zone, Ethiopia

In this qualitative study, I used an ethnographic approach to provide an understanding about the place of birth in rural and semiurban Kafa Zone, Ethiopia. I interviewed women about birth at home and asked what would happen if there were serious problems and a woman was taken to a health facility. The development of health services aimed at reducing maternal mortality implies that the place of birth must change from home to health facility, but the distance from international policy to its implementation is vast and the pathway is not a direct, linear route.

Influence of birth cohort on age of onset cluster analysis in bipolar I disorder

Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.

Changing the place of birth from home to health facilities in Kafa Zone, Ethiopia

Women in rural and semi-urban Kafa Zone, Ethiopia are being encouraged to give birth in health facilities rather than at home. Using an earlier 2007 study as a comparison point, this study explored the role of Health Extension Workers (HEWs) in referring women to health centres for birth. Semi-structured interviews were conducted with 11 HEWs and 6 health workers in May and June 2014. The results show that women prefer birth attendants they know, including HEWs, and not to go to health centres or the hospital except for emergencies. The ambulance service linking rural communities with health facilities works better in some areas than others. To improve maternal health, HEWs need better support at the community level. Inefficiencies in the referral system should be addressed.

Creatine pretreatment prevents birth asphyxia–induced injury of the newborn spiny mouse kidney

Background:
Acute kidney injury (AKI) is a major complication for infants following an asphyxic insult at birth. We aimed to determine if kidney structure and function were affected in an animal model of birth asphyxia and if maternal dietary creatine supplementation could provide an energy reserve to the fetal kidney, maintaining cellular respiration during asphyxia and preventing AKI.

Methods:
Pregnant spiny mice were maintained on normal chow or chow supplemented with creatine from day 20 gestation. On day 38 (term ~39 d), pups were delivered by cesarean section (c-section) or subjected to intrauterine asphyxia. Twenty-four hours after insult, kidneys were collected for histological or molecular analysis. Urine and plasma were also collected for biochemical analysis.

Results:
AKI was evident at 24 h after birth asphyxia, with a higher incidence of shrunken glomeruli (P < 0.02), disturbance to tubular arrangement, tubular dilatation, a twofold increase (P < 0.02) in expression of Ngal (early marker of kidney injury), and decreased expression of the podocyte differentiation marker nephrin. Maternal creatine supplementation prevented the glomerular and tubular abnormalities observed in the kidney at 24 h and the increased expression of Ngal.

Conclusion:
Maternal creatine supplementation may prove useful in ameliorating kidney injury associated with birth asphyxia.

Infant adiposity at birth and early postnatal weight gain predict increased aortic intima-media thickness at 6 weeks of age: a population-derived cohort study

Infant body composition and postnatal weight gain have been implicated in the development of adult obesity and cardiovascular disease, but there are limited prospective data regarding the association between infant adiposity, postnatal growth and early cardiovascular parameters. Increased aortic intima-media thickness (aortic IMT) is an intermediate phenotype of early atherosclerosis. The aim of the present study was to investigate the relationship between weight and adiposity at birth, postnatal growth and aortic IMT. The Barwon Infant Study (n=1074 mother-infant pairs) is a population-derived birth cohort. Infant weight and other anthropometry were measured at birth and 6 weeks of age. Aortic IMT was measured by trans-abdominal ultrasound at 6 weeks of age (n=835). After adjustment for aortic size and other factors, markers of adiposity including increased birth weight (β=19.9 μm/kg, 95%CI 11.1, 28.6; P<0.001) and birth skinfold thickness (β=6.9 μm/mm, 95%CI 3.3, 10.5; P<0.001) were associated with aortic IMT at 6 weeks. The association between birth skinfold thickness and aortic IMT was independent of birth weight. In addition, greater postnatal weight gain was associated with increased aortic IMT, independent of birth weight and age at time of scan (β=11.3 μm/kg increase, 95%CI 2.2, 20.3; P=0.01). Increased infant weight and adiposity at birth, as well as increased early weight gain, were positively associated with aortic IMT. Excessive accumulation of adiposity during gestation and early infancy may have adverse effects on cardiovascular risk.

Maternal creatine supplementation during pregnancy prevents acute and long-term deficits in skeletal muscle after birth asphyxia: a study of structure and function of hind limb muscle in the spiny mouse

BACKGROUND: Maternal antenatal creatine supplementation protects the brain, kidney, and diaphragm against the effects of birth asphyxia in the spiny mouse. In this study, we examined creatine's potential to prevent damage to axial skeletal muscles.

METHODS: Pregnant spiny mice were fed a control or creatine-supplemented diet from mid-pregnancy, and 1 d before term (39 d), fetuses were delivered by c-section with or without 7.5 min of birth asphyxia. At 24 h or 33 ± 2 d after birth, gastrocnemius muscles were obtained for ex-vivo study of twitch-tension, muscle fatigue, and structural and histochemical analysis.

RESULTS: Birth asphyxia significantly reduced cross-sectional area of all muscle fiber types (P < 0.05), and increased fatigue caused by repeated tetanic contractions at 24 h of age (P < 0.05). There were fewer (P < 0.05) Type I and IIa fibers and more (P < 0.05) Type IIb fibers in male gastrocnemius at 33 d of age. Muscle oxidative capacity was reduced (P < 0.05) in males at 24 h and 33 d and in females at 24 h only. Maternal creatine treatment prevented all asphyxia-induced changes in the gastrocnemius, improved motor performance.

CONCLUSION: This study demonstrates that creatine loading before birth protects the muscle from asphyxia-induced damage at birth.

The return of the traditional birth attendant

The World Health Organization has noted much progress towards the realisation of Millennium Development Goals related to maternal and child health. Eighty percent of women in many developing economies now receive at least one visit during pregnancy by a skilled birth attendant (although only 52% had the recommended four visits), and 68% of women across developing regions receive skilled health attendant care (up from 56% in 1990). However, disparities follow regional and urban-rural gaps. Sub-Saharan Africa and Southern Asia lag behind other regions in the provision of antenatal care and skilled attendance at birth (although typically attended by a family member or villager) and over 32 million of the 40 million births not attended by skilled health personnel in 2012 occurred in rural areas. Overall, one-quarter of women in developing nations still birth alone or with a relative to assist them. While increased numbers of medically-trained midwives and health workers or midwife assistants would increase coverage by up to 40%, these are longer-term solutions. In the short term, gross disparities in services in some resource-poor areas have been alleviated by recruiting Traditional Birth Attendants (TBAs) re-trained in emergency obstetric skills to deal with emergency situations and to refer women onto health facilities when necessary. Samoa and Bangladesh are examples. For many women for a range of reasons TBAs are preferable to hospital care. It therefore makes sense to recognise their place within maternity care, to offer basic and ongoing training and to set up registration procedures thus better ensuring the monitoring of outcomes. Incorporating TBAs into the formal healthcare system would meet both physiological and relational components of birth. In terms of the latter, TBAs would act as cultural brokers between Western and traditional cosmologies and provide women with continuity of care from a known carer; in the West a demonstrably simple but effective intervention promoting physiological safety and reducing the need for higher level medical interventions.

Effect of migration on food habits of Somali women living as refugees in Australia

This study aimed to assess the dietary changes that occur for migrants moving from a low-income to a high-income country. The sample included 45 females who had migrated to Australia from Somalia within the past 5years (1996-2001). The data for the study was derived from structured interviews conducted by a bilingual interviewer and anthropometry. Usual dietary intake and frequency of consumption of 54 foods were determined both for Australia (current home) and for Somalia (previous home). In Australia, subjects maintained the structure of the diet from their country of birth. They did increase their consumption of some processed food, such as instant noodles, crisps, and pizza. However, there was little evidence that the subjects adopted ready or partially prepared meals or takeaway meals. A significant addition to the diet in Australia was the use of breakfast cereals. Significant substitutions were of ready-baked bread for traditional bread and lamb for camel meat. The mean BMI of the sample was 27.4kg/m². Sixty percent of the sample were overweight or obese (BMI>25). Some of the dietary changes observed may be consistent with increased energy intake and altered nutrient density. Given the association between transition to a high-income diet and obesity, it is important that migrants are encouraged to retain the best of their traditional diet while adopting healthy foods from host country.

State sovereignty and migration control: the ultimate act of discrimination?

Nations zealously guard their borders and carefully vet migrants. This consigns many people to live in states not of their choice and often diminishes their opportunities and their level of flourishing. In some cases it is the difference between life and death. The practice of imposing migration controls is discriminatory. In fact it is the ultimate form of discrimination: 'super-discrimination.' There is no logical or moral reason why non-nationals of a state should not have the same opportunities and freedoms as nationals in that state. One of the most common forms of discrimination is race - treating a person differently simply because of their place of birth. This is one of the clearest and most repugnant forms of discrimination because the location where a person is born is of course merely a happy or unhappy circumstance over which the individual has no control. An accident of birth should not qualify a person for extra privileges or opportunities. The world is a fairer place if to the maximum extent possible luck is taken out of the process for allocating benefits and burdens - which ought to be distributed on the basis of merit and dessert. This paper examines whether there are sound reasons for restricting the flow of world-wide people movement. The main arguments in favour of this policy, relating to security and national building, are ultimately flawed. This exposes a tragic irony given the great efforts that many Western states - which typically have the strongest migration controls - make to stamp out discrimination at the domestic level, and the vast array of international law anti-discrimination instruments, loudly trumpeted by Western nations. This is hypocrisy nearing its finest. The substratum of sovereign states upon which available international law is built is inherently discriminatory and in fact is probably responsible for more harm as a result of the innately discriminatory immigration policies than results from the cumulative operation of all domestic discrimination. The world should move towards loosening migration controls. This would have an enormous number of humanistic benefits, not the least of which is largely eradicating world hunger and poverty.

Cultural sustainability of the arts through cross cultural market segmentation

The cultural characteristics attributed to individuals in their country of birth are likely to change through immigration and acculturation processes taking place in the host country. Immigrants are likely to develop their own unique cultural styles through a blending of their old culture and the host culture. With slightly less than half of the population born overseas or with at least one parent born overseas, and with some 200 languages Australia has one of the most cosmopolitan populations in the world, with a relatively small population of 20 million. This paper considers the cross cultural nature of the Australian population and the sustainability of culture through the Arts. This paper also considers the marketing of the arts from a cross cultural segmentation perspective. In so doing the paper identifies segmentation issues associated with cross cultural segmentation.

Evaluation of a brief pilot nutrition and exercise intervention for the prevention of weight gain in general practice patients

Objective To pilot-test a brief written prescription recommending lifestyle changes delivered by general practitioners (GPs) to their patients.

Design The Active Nutrition Script (ANS) included five nutrition messages and personalised exercise advice for a healthy lifestyle and/or the prevention of weight gain. GPs were asked to administer 10 scripts over 4 weeks to 10 adult patients with a body mass index (BMI) of between 23 and 30 kg m− 2. Information recorded on the script consisted of patients' weight, height, waist circumference, gender and date of birth, type and frequency of physical activity prescribed, and the selected nutrition messages. GPs also recorded reasons for administering the script. Interviews recorded GPs views on using the script.

Setting General practices located across greater Melbourne.

Subjects and results Nineteen GPs (63% female) provided a median of nine scripts over 4 weeks. Scripts were administered to 145 patients (mean age: 54 ± 13.2 years, mean BMI: 31.7 ± 6.3 kg m− 2; 57% female), 52% of whom were classified as obese (BMI >30 kg m− 2). GPs cited ‘weight reduction’ as a reason for writing the script for 78% of patients. All interviewed GPs (90%, n = 17) indicated that the messages were clear and simple to deliver.

Conclusions GPs found the ANS provided clear nutrition messages that were simple to deliver. However, GPs administered the script to obese patients for weight loss rather than to prevent weight gain among the target group. This has important implications for future health promotion interventions designed for general practice.