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Adolescence is a critical time point in the lifecourse. LifeLab is an educational intervention engaging adolescents in understanding Developmental Origins of Health and Disease (DOHaD) concepts and the impact of the early life environment on future health, benefitting both their long-term health and that of the next generation. We aimed to assess whether engaging adolescents with DOHaD concepts improves scientific literacy and whether engagement alone improves health behaviours.
Six schools were randomized, three to intervention and three to control. Outcome measures were changed in knowledge, and intended and actual behaviour in relation to diet and lifestyle. A total of 333 students completed baseline and follow-up questionnaires. At 12 months, intervention students showed greater understanding of DOHaD concepts. No sustained changes in behaviours were identified.
Adolescents’ engagement with DOHaD concepts can be improved and maintained over 12 months. Such engagement does not itself translate into behaviour change. The intervention has consequently been revised to include additional components beyond engagement alone.
In the above article (Paddick, 2017) The corresponding author's details were previously listed incorrectly. The correct details are; contact number +44 191 293 2709 and email address William.firstname.lastname@example.org. The original article has been updated with the correct contact details. The publishers apologise for any inconvenience and confusion this error has caused.
Cognitive stimulation therapy (CST) is a psychosocial group-based intervention for dementia shown to improve cognition and quality of life with a similar efficacy to cholinesterase inhibitors. Since CST can be delivered by non-specialist healthcare workers, it has potential for use in low-resource environments, such as sub-Saharan Africa (SSA). We aimed to assess the feasibility and clinical effectiveness of CST in rural Tanzania using a stepped-wedge design.
Participants and their carers were recruited through a community dementia screening program. Inclusion criteria were DSM-IV diagnosis of dementia of mild/moderate severity following detailed assessment. No participant had a previous diagnosis of dementia and none were taking a cholinesterase inhibitor. Primary outcomes related to the feasibility of conducting CST in this setting. Key clinical outcomes were changes in quality of life and cognition. The assessing team was blind to treatment group membership.
Thirty four participants with mild/moderate dementia were allocated to four CST groups. Attendance rates were high (85%) and we were able to complete all 14 sessions for each group within the seven week timeframe. Substantial improvements in cognition, anxiety, and behavioral symptoms were noted following CST, with smaller improvements in quality of life measures. The number needed to treat was two for a four-point cognitive (adapted Alzheimer's Disease Assessment Scale-Cognitive) improvement.
This intervention has the potential to be low-cost, sustainable, and adaptable to other settings across SSA, particularly if it can be delivered by non-specialist health workers.
This study aimed to determine whether age at introduction of solid foods was associated with feeding difficulties at 3 years of age. The present study was carried out using data from the Southampton Women’s Survey (SWS). Women enrolled in the SWS who subsequently became pregnant were followed-up during pregnancy and postpartum, and the offspring have been studied through childhood. Maternal socio-demographic and anthropometric data and child anthropometric and feeding data were collected through interviews and self-administered questionnaires. When the children were 3 years of age, mothers/carers rated six potential child feeding difficulty questions on a four-point Likert scale, including one general question and five specific feeding difficulty questions. Age at introduction of solids as a predictor of feeding difficulties was examined in 2389 mother–child pairs, adjusting for child (age last breast fed, sex, gestation) and maternal characteristics (parity, pre-pregnancy BMI, age, education, employment, parenting difficulties, diet quality). The majority of mothers/carers (61 %) reported some feeding difficulties (general feeding difficulty question) at 3 years of age, specifically with their child eating enough food (61 %), eating the right food (66 %) and being choosy with food (74 %). Children who were introduced to solids ≥6 months had a lower risk of feeding difficulties (RR 0·73; 95 % CI 0·59, 0·91, P=0·004) than children who were introduced to solids between 4 and 6 months. No other significant associations were found. There were few associations between feeding difficulties in relation to age at introduction of solid foods. However, general feeding difficulties were less common among infants introduced to solid foods ≥6 months of age.
Recently, large-scale trials of behavioural interventions have failed to show improvements in pregnancy outcomes. They have, however, shown that lifestyle support improves maternal diet and physical activity during pregnancy, and can reduce weight gain. This suggests that pregnancy, and possibly the whole periconceptional period, represents a ‘teachable moment’ for changes in diet and lifestyle, an idea that was made much of in the recent report of the Chief Medical Officer for England. The greatest challenge with all trials of diet and lifestyle interventions is to engage people and to sustain this engagement. With this in mind, we propose a design of intervention that aims simultaneously to engage women through motivational conversations and to offer access to a digital platform that provides structured support for diet and lifestyle change. This intervention design therefore makes best use of learning from the trials described above and from recent advances in digital intervention design.
Evidence from both human and animal studies has shown that the prenatal and early postnatal environments influence susceptibility to chronic disease in later life and suggests that epigenetic processes are an important mechanism by which the environment alters long-term disease risk. Epigenetic processes, including DNA methylation, histone modification and non-coding RNAs, play a central role in regulating gene expression. The epigenome is highly sensitive to environmental factors in early life, such as nutrition, stress, endocrine disruption and pollution, and changes in the epigenome can induce long-term changes in gene expression and phenotype. In this review we focus on how the early life nutritional environment can alter the epigenome leading to an altered susceptibility to disease in later life.
Both maternal 25-hydroxyvitamin D (25(OH)D) concentrations during pregnancy and
placental amino acid transporter gene expression have been associated with
development of the offspring in terms of body composition and bone structure.
Several amino acid transporter genes have vitamin D response elements in their
promoters suggesting the possible linkage of these two mechanisms. We aimed to
establish whether maternal 25(OH)D and vitamin D-binding protein (VDBP) levels
relate to expression of placental amino acid transporters. RNA was extracted
from 102 placental samples collected in the Southampton Women's Survey,
and gene expression was analysed using quantitative real-time PCR. Gene
expression data were normalised to the geometric mean of three housekeeping
genes, and related to maternal factors and childhood body composition. Maternal
serum 25(OH)D and VDBP levels were measured by radioimmunoassay. Maternal
25(OH)D and VDBP levels were positively associated with placental expression of
specific genes involved in amino acid transport. Maternal 25(OH)D and VDBP
concentrations were correlated with the expression of specific placental amino
acid transporters, and thus may be involved in the regulation of amino acid
transfer to the fetus. The positive correlation of VDBP levels and placental
transporter expression suggests that delivery of vitamin D to the placenta may
be important. This exploratory study identifies placental amino acid
transporters which may be altered in response to modifiable maternal factors and
provides a basis for further studies.
Various environmental factors have been associated with the timing of eruption of primary dentition, but the evidence to date comes from small studies with limited information on potential risk factors. We aimed to investigate associations between tooth emergence patterns and pre-conception, pregnancy and postnatal influences. Dentition patterns were recorded at ages 1 and 2 years in 2915 children born to women in the Southampton Women’s Survey from whom information had been collected on maternal factors before conception and during pregnancy. In mutually adjusted regression models we found that: children were more dentally advanced at ages 1 and 2 years if their mothers had smoked during pregnancy or they were longer at birth; mothers of children whose dental development was advanced at age 2 years tended to have poorer socioeconomic circumstances, and to have reported a slower walking speed pre-pregnancy; and children of mothers of Asian ethnicity had later tooth development than those of white mothers. The findings add to the evidence of environmental impacts on the timing of the eruption of primary dentition in indicating that maternal smoking during pregnancy, socio-economic status and physical activity (assessed by reported walking speed) may influence the child’s primary dentition. Early life factors, including size at birth are also associated with dentition patterns, as is maternal ethnicity.
As in many other African countries, tobacco in Kenya began as a product of British colonialism. In 1907, British American Tobacco (BAT) established a base in Mombasa, Kenya from which to market and distribute tobacco products in what are now Kenya, Uganda, Tanzania and the Democratic Republic of Congo. The establishment of a market for cigarettes in East Africa prompted the opening of a cigarette factory in Jinja, Uganda. By 1948, it was the largest in the region. After a series of expansions, including the purchase of the East African Tobacco Company in Tanzania, BAT opened a cigarette factory in Nairobi in 1957. Other companies eventually set up their own manufacturing centers. Kenya is currently the cigarette manufacturing and distribution hub for 17 African countries (Wanyonyi and Kimosop nd.; Kweyuh 1994; Patel et al. 2007).
To ensure a steady supply of raw tobacco leaf, BAT and other manufacturers created a system of contract buying with farmers. This involved the creation of tobacco markets, the supply of inputs and access to technical training and credit. These arrangements were modeled on similar systems in place for tea and sugarcane production and stimulated tobacco growing throughout the region. The industry that manufactures tobacco products in Kenya currently draws on tobacco production in Kenya, Uganda, Tanzania and Malawi. Despite international efforts to control tobacco use and production in Africa, the industry is also expanding into new areas such as South Sudan where tobacco production is set to begin on a large scale.
Consistent positive relationships have been found between birth weight and grip strength in adults but evidence in children is limited. In a prospective general population birth cohort (Southampton Women's Survey), grip strength and anthropometry (height and weight) were measured in 968 children at the age of 4 years. Mean (standard deviation (s.d.)) birth weight was 3.48 (0.52) kg. Birth weight, adjusted for sex and gestational age, was positively associated with grip strength (β = 0.22 kg/s.d. increase in adjusted birth weight; 95% CI 0.11, 0.34). The relationship was attenuated after adjustment for current height and weight such that it became non-significant (β = 0.03 kg/s.d. increase in adjusted birth weight; 95% CI−0.08, 0.14), suggesting that body size may be on the causal pathway. Early influences on muscle development appear to impact on grip strength in children, as well as adults.
The 2-dimensional electron gas (2DEG) in an Al0.6Ga0.4Sb/InAs single quantum well (SQW) is studied using cyclotron resonance (CR) and Shubnikov - de Haas (SdH) techniques. SdH results show spin-splitting in Landau levels at magnetic field strength (B) as low as 1.5T. The effective mass (m*) of the 2DEG was obtained from the peak positions of the CR transmission spectra. The results exhibit oscillatory behavior as a function of B. The m* value extracted from die temperature dependence of the SdH oscillations is in good agreement with the average value of m* obtained from CR measurements. The effective mass is calculated as a function of B using an electron self-energy model based on the Hartree-Fock approximation. The calculated m* values also show oscillatory behavior similar to that of the measured CR m*. Both experiment and theory show that m* maxima are shifted from the integral values (both odd and even) of the filling factors.
The diffusion and activation of implanted boron in silicon during rapid thermal annealing (RTA) has been studied using the analytical techniques of SIMS, TEM, and sheet resistance measurements. Both crystalline and pre-amorphised silicon substrates were investigated. Data analysis in conjunction with a range of numerical models indicates some novel features of boron RTA, as well as accounting for previously observed features. In particular, a large transient diffusion enhancement coupled with an increase of electrical activity, are seen at short anneal times, in the case of crystalline silicon substrates. A non-equilibrium diffusion enhancement of a different type is also seen at much longer times, in both crystalline and pre-amorphised samples implanted to high doses. This second enhancement persists after all the precipitated boron formed on implantation has become substitutional. TEM studies show that the transient enhancement may be associated with the evolution of extended defect structures during the early stages of annealing. Both types of enhancement can be well represented by multiplying the ‘normal’ concentration-dependent diffusivity (with β=0.5) by a factor f>1.
Ga0.5In0.5P has been investigated using optically detected cyclotron resonance and photoluminescence techniques. For the disordered alloy, the electron mass is determined to m*=0.092 m0, and for ordered material (band gap reduction ~ 50 meV) the value m*=0.088 m0 is found. The experimentally deduced values are compared with those obtained from a five-band kp calculation.
II-VI semiconductor alloys have recently received considerable attention for their possible use in double heterostructure (DH) blue laser diodes (LDs).1-4 The purpose of this paper is to present the empirical pseudopotential method within virtual crystal approximation for calculating the band structure of MgZnSSe quaternary alloy. The dependence of band gap energies on alloy composition has shown that MgZnSSe can be a direct or an indirect semiconductor. Electron and hole effective masses are calculated for different composition. Camel's back structure for the X valley conduction band has been found for certain composition range.
Band-gap luminescence from Si1-xGex/Si heterostructures grown by Low Pressure Chemical Vapour Deposition (LPCVD) is studied for a composition range of x=.04 to x=.22 and thickness from l00nm to 1300nm. Special attention is paid to the influence of the growth conditions. The growth temperature was varied between 820°C and 600°C. We compare results obtained from our samples with results in the literature obtained from similar samples grown by other techniques, namely by molecular beam epitaxy (MBE). We show that with a growth temperature of 650°C we have achieved samples exhibiting a luminescence spectrum dominated by the excitonic recombination at the alloy, free from dislocation lines and defect related recombination. The dependence of the luminescence with Ge concentration and thickness of the alloy layer is well described by theory. Results for boron doped layers are also presented.