Maternal creatine supplementation during pregnancy prevents long-term changes in diaphragm muscle structure and function after birth asphyxia

Using a model of birth asphyxia, we previously reported significant structural and functional deficits in the diaphragm muscle in spiny mice, deficits that are prevented by supplementing the maternal diet with 5% creatine from mid-pregnancy. The long-term effects of this exposure are unknown. Pregnant spiny mice were fed control or 5% creatine-supplemented diet for the second half of pregnancy, and fetuses were delivered by caesarean section with or without 7.5 min of in-utero asphyxia. Surviving pups were raised by a cross-foster dam until 33±2 days of age when they were euthanized to obtain the diaphragm muscle for ex-vivo study of twitch tension and muscle fatigue, and for structural and enzymatic analyses. Functional analysis of the diaphragm revealed no differences in single twitch contractile parameters between any groups. However, muscle fatigue, induced by stimulation of diaphragm strips with a train of pulses (330 ms train/sec, 40 Hz) for 300 sec, was significantly greater for asphyxia pups compared with controls (p<0.05), and this did not occur in diaphragms of creatine + asphyxia pups. Birth asphyxia resulted in a significant increase in the proportion of glycolytic, fast-twitch fibres and a reduction in oxidative capacity of Type I and IIb fibres in male offspring, as well as reduced cross-sectional area of all muscle fibre types (Type I, IIa, IIb/d) in both males and females at 33 days of age. None of these changes were observed in creatine + asphyxia animals. Thus, the changes in diaphragm fatigue and structure induced by birth asphyxia persist long-term but are prevented by maternal creatine supplementation.

Young maternal age at first birth and mental health later in life: does the association vary by birth cohort?

BACKGROUND: It is well established that maternal age at childbirth has implications for women's mental health in the short term, however there has been little research regarding longer term implications and whether this association has changed over time. We investigated longer term mental health consequences for young mothers in Australia and contrasted the effects between three birth cohorts. METHODS: Using thirteen waves of data from 4262 women aged 40 years or above participating in the Household, Income and Labour Dynamics in Australia Survey, we compared the mental health of women who had their first child aged 15-19 years, 20-24 years, and 25 years and older. Mental health was measured using the mental health component summary score of the SF-36. We used random-effects linear regression models to generate estimates of the association between age at first birth and mental health, adjusted for early life socioeconomic characteristics (country of birth, parents' employment status and occupation) and later life socioeconomic characteristics (education, employment, income, housing tenure, relationship status and social support). We examined whether the association changed over time, testing for effect modification across three successive birth cohorts. RESULTS: In models adjusted for early life and later life socioeconomic characteristics, there was strong evidence of an association between teenage births and poor mental health, with mental health scores on average 2.76 to 3.96 points lower for mothers aged younger than 20 years than for mothers aged 25 years and older (Late Baby Boom (born 1936-1945): -3.96, 95% CI -5.38, -2.54; Early Baby Boom (born 1946-1955): -3.01, 95% CI -4.32, -1.69; Lucky Few (born 1956-1965): -2.76, 95% CI -4.34, -1.18), and evidence of an association for mothers aged 20-24 years compared to mothers aged 25 years and older in the most recent birth cohort only (-1.09, 95% CI -2.01, -0.17). There was some indication (though weak) that the association increased in more recent cohorts. CONCLUSION: This study highlights that young mothers, and particularly teenage mothers, are a vulnerable group at high risk of poor mental health outcomes compared to mothers aged 25 years and above, and there was some suggestion (though weak) that the health disparities increased over time.

Family presence during management of acute deterioration: clinician attitudes, beliefs and perceptions of current practices

BACKGROUND: The nature of acute clinical deterioration has changed over the last three decades with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite this change, research related to family presence continues to focus on care during resuscitation rather than during acute deterioration. AIM: To explore healthcare clinician attitudes, beliefs and perceptions of current practices surrounding family presence during episodes of acute deterioration in adult Emergency Department patients. METHODS: Clinicians (n=156) from a single study site in Melbourne, Australia completed a 17-item survey. RESULTS: Participants disagreed that family members would interrupt (59.0%) or interfere (61.5%) with patient care if present during episodes of patient deterioration. Most (77.6%) participants stated that they included family during episodes of patient deterioration. Females, nurses and Australians/New Zealanders had a more positive attitude towards including family during episodes of patient deterioration when compared to males, doctors and clinicians of other ethnicities. Nurses with post-graduate qualifications and those with more years of experience had a more positive attitude towards including family during episodes of patient deterioration than nurses without post-graduation qualification and with less years of experience. CONCLUSIONS: Clinicians had predominantly positive attitudes towards including family during episodes of patient deterioration and perceived it to be a common day-to-day practice. Gender, profession, country of birth, education level and years of experience all impacted on clinician attitudes, beliefs and perceptions of family presence during acute deterioration.

Women's autonomy, education and birth intervals in India: visiting the less familiar

Using data from the third National Family Health Survey (NFHS-3) on currently married fecund women who have had at least one birth during 2001–2002 and Cox-proportional hazard models, this study examines the less researched association between women's autonomy and birth-to-conception intervals in India. It also examines whether women's autonomy mediates or moderates the relationship between education and birth-to-conception interval. Our results indicate that after adjusting for demographic and socioeconomic factors, women's autonomy was a significant predictor of birth-to-conception intervals, with higher autonomy positively associated with larger birth-to-conception intervals. Education of women was also independently associated with longer birth-to-conception intervals. However, this study did not provide any support to the general perception that women's autonomy mediates the association between women's education and birth-to-conception interval. Women's autonomy rather than being a mediator acted as a moderator in this association. Policy measures to increase the spacing between births should emphasise not only improving the education of women but also their autonomy.

Using kernel density estimation to understand the influence of neighbourhood destinations on BMI

OBJECTIVES: Little is known about how the distribution of destinations in the local neighbourhood is related to body mass index (BMI). Kernel density estimation (KDE) is a spatial analysis technique that accounts for the location of features relative to each other. Using KDE, this study investigated whether individuals living near destinations (shops and service facilities) that are more intensely distributed rather than dispersed, have lower BMIs.

STUDY DESIGN AND SETTING: A cross-sectional study of 2349 residents of 50 urban areas in metropolitan Melbourne, Australia.

METHODS: Destinations were geocoded, and kernel density estimates of destination intensity were created using kernels of 400, 800 and 1200 m. Using multilevel linear regression, the association between destination intensity (classified in quintiles Q1(least)-Q5(most)) and BMI was estimated in models that adjusted for the following confounders: age, sex, country of birth, education, dominant household occupation, household type, disability/injury and area disadvantage. Separate models included a physical activity variable.

RESULTS: For kernels of 800 and 1200 m, there was an inverse relationship between BMI and more intensely distributed destinations (compared to areas with least destination intensity). Effects were significant at 1200 m: Q4, β -0.86, 95% CI -1.58 to -0.13, p=0.022; Q5, β -1.03 95% CI -1.65 to -0.41, p=0.001. Inclusion of physical activity in the models attenuated effects, although effects remained marginally significant for Q5 at 1200 m: β -0.77 95% CI -1.52, -0.02, p=0.045.

CONCLUSIONS: This study conducted within urban Melbourne, Australia, found that participants living in areas of greater destination intensity within 1200 m of home had lower BMIs. Effects were partly explained by physical activity. The results suggest that increasing the intensity of destination distribution could reduce BMI levels by encouraging higher levels of physical activity.

Establishment and development of infant gut microbiota

The nascent gut microbiota at birth is established in concert with numerous developmental parameters. Here, in the INFAMTET study, we chronicled the impact of some factors which are key determinants of the infant gut microbiota, namely; mode of birth, gestational age, and type of feeding. We determined that the aggregated microbiota profile of naturally delivered, initially breastfed infants are relatively stable from one week to six months of age and are not significantly altered by increased duration of breastfeeding. Contrastingly, there is significant development of the microbiota profile of C-section delivered infants, and this development is significantly influenced by breastfeeding duration. Preterm infants, born by either mode of birth, initially have a high proportion of Proteobacteria, and demonstrate significant development of the gut microbiota from week 1 to later time-points. The microbiota is still slightly, but significantly, affected by birth mode at one year of age although no specific genera were found to be significantly altered in relative abundance. By two years of age, there is no effect of either birth mode or gestational age. However this does not preclude the possibility that symptoms developed later in life, which are associated with preterm or C-section birth, are as a result of the early perturbation of the neonatal gut microbiota. It is likely that the combination of relatively low exposure (breast fed), high exposure (formula fed) or delayed exposure (C-section and preterm) to specific antigens and the resulting inflammatory responses, in this crucial window of host-microbiota interaction, influence systemic health of the individual throughout life.

The official roster of South Carolina soldiers, sailors and marines in the World War, 1917-18, volume 1, part 1

This is the Official Roster of the South Carolina soldiers, sailors and marines who served in the World War and contains the names and records, briefly compiled, of the men and women from this state who responded to the call of the President when the United States entered the great conflict. This record gives in as compact form as practicable the following : name; serial number; residence; branch of service; date and place of entry into service; place of birth and age; organizations served in, with dates of assignments and transfers; grades with dates of appointment; engagements, if any; wound received in action, with degree and date; if killed in action or died while in service; person notified, relationship and address; oversea service; date of discharge; citations.

The official roster of South Carolina soldiers, sailors and marines in the World War, 1917-18, volume 1, part 2

This is the Official Roster of the South Carolina soldiers, sailors and marines who served in the World War and contains the names and records, briefly compiled, of the men and women from this state who responded to the call of the President when the United States entered the great conflict. This record gives in as compact form as practicable the following : name; serial number; residence; branch of service; date and place of entry into service; place of birth and age; organizations served in, with dates of assignments and transfers; grades with dates of appointment; engagements, if any; wound received in action, with degree and date; if killed in action or died while in service; person notified, relationship and address; oversea service; date of discharge; citations.

The official roster of South Carolina soldiers, sailors and marines in the World War, 1917-18, volume 1, part 3

This is the Official Roster of the South Carolina soldiers, sailors and marines who served in the World War and contains the names and records, briefly compiled, of the men and women from this state who responded to the call of the President when the United States entered the great conflict. This record gives in as compact form as practicable the following : name; serial number; residence; branch of service; date and place of entry into service; place of birth and age; organizations served in, with dates of assignments and transfers; grades with dates of appointment; engagements, if any; wound received in action, with degree and date; if killed in action or died while in service; person notified, relationship and address; oversea service; date of discharge; citations.

The official roster of South Carolina soldiers, sailors and marines in the World War, 1917-18, volume 2, part 1

This is the Official Roster of the South Carolina soldiers, sailors and marines who served in the World War and contains the names and records, briefly compiled, of the men and women from this state who responded to the call of the President when the United States entered the great conflict. This record gives in as compact form as practicable the following : name; serial number; residence; branch of service; date and place of entry into service; place of birth and age; organizations served in, with dates of assignments and transfers; grades with dates of appointment; engagements, if any; wound received in action, with degree and date; if killed in action or died while in service; person notified, relationship and address; oversea service; date of discharge; citations.

The official roster of South Carolina soldiers, sailors and marines in the World War, 1917-18, volume 2, part 2

This is the Official Roster of the South Carolina soldiers, sailors and marines who served in the World War and contains the names and records, briefly compiled, of the men and women from this state who responded to the call of the President when the United States entered the great conflict. This record gives in as compact form as practicable the following : name; serial number; residence; branch of service; date and place of entry into service; place of birth and age; organizations served in, with dates of assignments and transfers; grades with dates of appointment; engagements, if any; wound received in action, with degree and date; if killed in action or died while in service; person notified, relationship and address; oversea service; date of discharge; citations.

Members abroad - Australia : Lindy Osborne

When I arrived in Queensland's capital in 1996, Brisbane was commonly referred to as an 'overgrown country town'. This might have been an acceptable description in the 1990s, but it cannot be applied any longer. Brisbane, affectionaly referred to by the locals as Bris-Vegas, has now come of age. Following Sydney and Melbourne, Brisbane is the third most populous city in Australia with a population of approximately two million. Interestingly, the 2006 Census showed that 22 per cent of Brisbane's population was born overseas, the three main countries of birth being the UK, New Zealand and South Africa. Brisbane City is centred on its most dominant environmental element, the Brisbane River, which effectively carves Brisbane into two areas - the Northside and the Southside. The 2001 addition of Cox Rayner's Goodwill Pedestrian and Cycle Bridge signified Brisbane's acceptance and affectionate embrace of its River resulting in a long overdue linage between Brisbane's North and South. It connects the City's key precincts - the Northside CBD through Queensland University of Technology (QUT), across Brisbane River, to the recreational precinct of the Southside Southbank Parklands. The Southside cultural precinct of Southbank is the home to Queensland's Art Gallery, Performing Arts Complex, State Library and Museum -each of which were designed by Brisbane Stalwart Architect Robin Gibson, in the 1970s and '80s. The CBD component of the Brisbane River is flanked by a number of Institutional Facilities, including the campuses of QUT, Griffith University and the Southbank Education and Training Precinct (SETP), which combine to form a cross-river educational precinct. The past decade has born witness to a city which has keenly supported emerging architects in addition to the more entrenched stalwarts of the profession, resulting in a youthful, relaxed and unpretentious sub-tropical city. Viva Bris-Vegas!

The relative age effect in Australian Football League players

Youth sports teams are usually grouped into yearly age groups based on fixed cut-off date (September 1st in the UK and January 1st in Australia). Children born just after this cut-off will be the oldest and most mature in their age group. This gives them an advantage in competitive sport, an advantage which has persisted into adulthood as shown by seasonal patterns in the dates of birth of professional ice hockey, football and basketball players. We were interested in whether a similar seasonal pattern exists in professional Australian Football League (AFL) players. We examined all AFL players in the 2009 season excluding foreign-born players. We compared the observed number of players’ born in each month with the expected number based on national statistics. There was a marked and statistically significant seasonality in players’ dates of birth. There were 33% more players than expected with dates of birth in January, and 25% fewer in December. Players who are relatively older in youth AFL teams have a better chance of turning professional.

Listening to late discovery adoption and donor offspring stories : adoption, ethics and implications for contemporary donor insemination practices

For most of the 20th Century a ‘closed’ system of adoption was practised throughout Australia and other modern Western societies. This ‘closed’ system was characterised by sealed records; amended birth certificates to conceal the adoption, and prohibited contact with all biological family. Despite claims that these measures protected these children from the taint of illegitimacy the central motivations were far more complex, involving a desire to protect couples from the stigma of infertility and to provide a socially acceptable family structure (Triseliotis, Feast, & Kyle, 2005; Marshall & McDonald, 2001). From the 1960s significant evidence began to emerge that many adopted children and adults were experiencing higher incidences of psychological difficulties, characterised by problems with psychological adjustment, building self-esteem and forming a secure personal identity. These difficulties became grouped under the term ‘genealogical bewilderment’. As a result, new policies and practices were introduced to try to place the best interests of the child at the forefront. These changes reflected new understandings of adoption; as not only an individual process but also as a social and relational process that continues throughout life. Secrecy and the withholding of birth information are now prohibited in the overwhelming majority of all domestic adoptions processed in Australia (Marshall & McDonald, 2001). One little known consequence of this ‘closed’ system of adoption was the significant number of children who were never told of their adoptive status. As a consequence, some have discovered or had this information disclosed to them, as adults. The first study that looked at the late discovery of genetic origins experiences was conducted by the Post Adoption Resource Centre in New South Wales in 1999. This report found that the participants in their study expressed feelings of disbelief, confusion, anger, sorrow and loss. Further, the majority of participants continued to struggle with issues arising from this intentional concealment of their genetic origins (Perl & Markham, 1999). A second and more recent study (Passmore, Feeney & Foulstone, 2007) looked at the issue of secrecy in adoptive families as part of a broader study of 144 adult adoptees. This study found that secrecy and/or lies or misinformation on the part of adoptive parents had negative effects on both personal identity and relationships with others. The authors noted that those adoptees who found out about their adoption as adults were ‘especially likely to feel a sense of betrayal’ (p.4). Over recent years, stories of secrecy and late discovery have also started to emerge from sperm donor conceived adults (Spencer, 2007; Turner & Coyle, 2000). Current research evidence shows that although a majority of couples during the donor assisted conception process indicate that they intend to tell the offspring about their origins, as many as two-thirds or more of couples continue to withhold this information from their children (Akker, 2006; Gottlieb, A. McWhinnie, 2001; Salter-Ling, Hunter, & Glover, 2001). Why do they keep this secret? Infertility involves a range of complex factors that are often left unresolved or poorly understood by those choosing insemination by donor as a form of family building (Schaffer, J. A., & Diamond, R., 1993). These factors may only impact after the child is born, when resemblance talk becomes most pronounced. Resemblance talk is an accepted form of public discourse and a social convention that legitimises the child as part of the family and is part of the process of constructing the child’s identity within the family. Couples tend to become focused on resemblance as this is where they feel most vulnerable, and the lack of resemblance to the parenting father may trigger his sense of loss (Becker, Butler, & Nachtigall, 2005).

Caring for women suffering depression in the postnatal period

The research and theoretical perspectives that underpin knowledge of depression in the postnatal period have tended to rely on standardized measures and 'objective' data which combine to disempower women's individual experiences. From a feminist perspective, contradictions exist between women's accounts of the early days and months following childbirth and the diagnosis of postnatal depression made by some health professionals. A framework for nursing care that uses the strengths of feminist and cognitive therapies is suggested. From this feminist-cognitive perspective, mental health nursing care will provide opportunities for women suffering depression to debrief the experience of birth and pregnancy, manage conflicts about identity, gain a sense of survival, and develop a new perspective.