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Continuity of care by a primary midwife(caseload midwifery):a cost analysis using results from the COSMOS randomised controlled trial

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Gynecology and Obstetrics Clinical Medicine 2024年第2期4卷 94-101页

作者： emily j callander Hannah jackson Helen L McLachlan Mary-Ann Davey Della A Forster University of Technology Sydney SydneyNew South WalesAustralia The Royal Women's Hospital MelbourneVictoriaAustralia Faculty of Health University of Technology SydneyBroadwayNew South WalesAustralia judith Lumley Centre La Trobe UniversityMelbourneVictoriaAustralia School of Nursing and Midwifery a Trobe UniversityMelbourneVictoriaAustralia Department of Obstetrics and Gynaecology Monash UniversityClaytonVictoriaAustralia

Introduction Caseload midwifery(continuity of midwifery carer)offers benefits including lower caesarean section rates,lower risks of preterm birth and stilbirth,and improved maternal satisfaction of *** these advantages,concerns about additional costs hinder widespread *** study examinesthecost of caseload midwifery compared with standard maternity care from the perspective of both public hospitals and public *** A cost analysis was conducted using data from a randomised controlled trial of 2314 low-risk pregnant women in Melbourne,*** randomised to caseload care received antenatal,intrapartum and postpartum care from a primary midwife,with some care provided by a‘back-up'*** in standard care received midwifery-led care with varying levels of continuity,junior obstetric care or community-based medical *** cost analysis compared differences in mean costs of health resources to public hospitals and to public ***,a budget impact analysis estimated total costs to the health system between 2023 and *** For public hospitals,there was no significant difference in overall costs between women receiving caseload midwifery(n=1146)versus standard care(n=1151)($SA12363(SD:$A4967)vs$A12323(SD:$A7404);p=0.85).Conversely,public funders incurred lower expenditures for women receiving caseload midwifery($A20330(SD:$A8312))versus standard care($A21637(SD:$A11818);p<0.001).The budget impact analysis estimated savings of sA625million to the health system over the next 5 years with expanded access to caseloadmidwifery *** Caseloadmidwifery in low-risk women is cost-neutral to public hospitals and cost-saving to public *** abstract Continuity of midwifery for low-risk women reduces costs to public funders,with no additional costs to hospitals.

关键词： random continuity Continuity

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A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

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journal of Sport and Health Science 2024年第4期13卷 472-483,F0003页

作者： Kelly R.Evenson Wendy j.Brown Alison K.Brinson emily Budzynski-Seymour Melanie Hayman Department of Epidemiology Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599-8050USA Faculty of Health Sciences and Medicine Bond UniversityGold CoastQLD 4226Australia School of Human Movement and Nutrition Sciences The University of QueenslandBrisbaneQLD 4072Australia Department of Anthropology University of North Carolina at Chapel HillChapel HillNC 27599-3115USA Carolina Population Center University of North Carolina at Chapel HillChapel HillNC 27599-8120USA Faculty of Sport Health and Social SciencesSolent UniversitySouthamptonSO140YNUK Appleton Institute School of HealthMedical and Applied SciencesCentral Queensland UniversityRockhamptonQLD 4701Australia

Background:The period following pregnancy is a critical time window when future habits with respect to physical activity(PA) and sedentary behavior(SB) are established;therefore,it warrants *** purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines ***:To identity guidelines published since 2010,we performed a(a) systematic search of 4 databases(CINAHL,Global Health,PubMed,and SPORTDiscus),(b) structured repeatable web-based search separately for 194 countries,and(c) separate web-based *** the most recent guideline was included for each ***:We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB *** continents with guidelines included Europe(n=12),Asia(n=5),Oceania(n=2),Africa(n=1),North America(n=1),and South America(n=1).The most common benefits recorded for PA included weight control/management(n=10),reducing the risk of postpartum depression or depressive symptoms(n=9),and improving mood/well-being(n=8).Postpartum guidelines specified exercises to engage in,including pelvic floor exercises(n=17);muscle strengthening,weight training,or resistance exercises(n=13);aerobics/general aerobic activity(n=13);walking(n=11);cycling(n=9);and swimming(n=9).Eleven guidelines remarked on the interaction between PA and breastfeeding;several guidelines stated that PA did not impact breast milk quantity(n=7),breast milk quality(n=6),or infant growth(n=3).For SB,suggestions included limiting long-term sitting and interrupting sitting with ***:Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.

关键词： Breastfeeding Caesarean section Guidelines Postnatal Recommendations

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Neuroprotection by resveratrol-glucuronide and quercetin-glucuronide via binding to polyphenol-and glycosaminoglycan-binding sites in the laminin receptor

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Neural Regeneration Research 2025年第3期20卷 819-820页

作者： Rayudu Gopalakrishna jennifer Aguilar emily Lee William j.Mack Department of Integrative Anatomical Sciences Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA Department of Neurological Surgery Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA

The dietary polyphenolic compounds resveratrol and quercetin prevent neurodegenerative diseases in experimental models;however, they reach the brain only in nanomolar concentrations in the glucuronidated and sulfated ... 详细信息

关键词： resveratrol molar dated

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Oxidative Stress in Collegiate Cross Country Skiers in Mid- and Post-Seasons

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journal of Biosciences and Medicines 2024年第5期12卷 99-110页

作者： Scott P. jerome Kriya L. Dunlap Ava M. Parrish Matthew L. Lowman emily M. Shipman Lawrence K. Duffy Arleigh j. Reynolds Department of Chemistry & Biochemistry University of Alaska Fairbanks Fairbanks AK USA Institute of Arctic Biology University of Alaska Fairbanks Fairbanks AK USA Department of Biology & Wildlife University of Alaska Fairbanks Fairbanks AK USA Department of Veterinary Medicine University of Alaska Fairbanks Fairbanks AK USA

Purpose: The oxidative stress (OS) hypothesis of overtraining syndrome argues that increased production of free radicals through exercise cause muscle fatigue and damage resulting in lower athletic performance. Several studies have investigated OS immediately before and after exercise bouts in a training macrocycle. Our study aimed to compare OS of endurance athletes between a competition macrocycle and the immediate post-season recovery macrocycle. In addition, we aimed to identify athletes who experienced an unexplainable drop in athletic performance during the competition season in order to compare their OS to those who experienced no drop in performance. Methods: Fifteen members of the University of Alaska Fairbanks cross country ski team volunteered for this study. Blood samples were taken in early February (“mid-season”) and late April (“post-season”). Participants completed questionnaires regarding physical activity and athletic performance at the time of the blood draws. Plasma was analyzed for 4-hydroxynonenal (HNE), nitrotyrosine, nitric oxide (NOX), and superoxide dismutase (SOD). Significance was determined by Wilcoxon and Mann-Whitney tests. Results: Participants displayed significantly higher (p Conclusion: Signs of oxidative stress and mitigation during the post-season recovery macrocycle were higher in athletes who reported experiencing a drop in athletic performance during the competition season macrocycle.

关键词： Oxidative Stress 4-Hydroxynonenal Superoxide Dismutase Athletic Performance Training Macrocycle

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Using self-determination theory to identify organizational interventions to support coal mineworkers’ dust-reducing practices

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International journal of Mining Science and Technology 2019年第3期29卷 371-378页

作者： emily j.Haas Centers for Disease Control and Prevention National Institute for Occupational Safety and Health

Advancing the application of safety and health(S&H)technologies is likely to remain a value in the mining ***,any information that technologies generate must be translated from the organization to the workforce in a targeted way to result in sustainable *** a case study approach with continuous personal dust monitors(CPDMs),this paper argues for an organizational focus on technology *** CPDMs provide mineworkers with near real-time feedback about their respirable coal dust exposure,they do not ensure that workers or the organization will continuously use the information to learn about and reduce exposure *** study used self-determination theory(SDT)to help three mines manage and communicate about information learned from the CPDM ***,35 mineworkers participated in two mixed-method data collection efforts to discuss why they do or do not use CPDMs to engage in dust-reducing ***,the data was analyzed to better understand how organizations can improve the integration of technology through their management *** indicate that using the CPDM to reduce sources of dust exposure is consistent with mineworkers’self-values to protect their health and not necessarily because of compliance to a manager or mine.

关键词： Autonomous organization Continuous personal dust monitor Respirable coal mine dust Safety and health management system Self-determination theory

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Endogenous testosterone and mortality risk

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Asian journal of Andrology 2018年第2期20卷 115-119页

作者： emily j Meye Gary Wittert Endocrine Diabetes and Metabolic Unit Royal Adelaide Hospital Port Road SA 5000 Australia Discipline of Medicine University of Adelaide Adelaide SA 5000 Australia Discipline of Medicine and Freemasons Foundation Centre for Men's Health University of Adelaide SA 5000 Australia

In men, obesity and metabolic complications are associated with lower serum testosterone （T） and dihydrotestosterone （DHT） and an increased risk of, and mortality from, multiple chronic diseases in addition to cardiovascular disease （CVD）. The causal interrelationships between these factors remain a matter of debate. In men with untreated congenital and lifelong forms of hypogonadotropic hypogonadism, there appears to be no increased risk. Men with Klinefelter＇s syndrome have an increased risk of various types of cancers, as well as CVD, which persist despite T therapy. In the absence of pathology of the hypothalamic-pituitary- gonadal axis, the effect of modest reductions in serum T in aging men is unclear. The prevalence of low serum T concentrations is high in men with cancer, renal disease, and respiratory disease and is likely to be an indicator of severity of systemic disease, not hypogonadism. Some population-based studies have found low serum T to be associated with a higher risk of deaths attributed to cancer, renal disease, and respiratory disease, while others have not. Although a meta-analysis of longitudinal studies has shown an association between low serum T and all-cause mortality, marked heterogeneity between studies limited a firm conclusion. Therefore, while a decrease in T particularly occurring later in life may be associated with an increase in all-cause and specific types of mortality in men, the differential effects, if any, of T and other sex steroids as compared to health and lifestyle factors are unknown at the current time.

关键词： hypogonadism mortality testosterone

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Inhibition of tumor autophagy: a strategy to improve antitumorimmunity?

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Signal Transduction and Targeted Therapy 2021年第1期6卷 3-4页

作者： Andrew jFreeman emily jLelliott jane Oliaro Cancer Immunology Program Peter MacCallum Cancer CentreMelbourneVIC 3000Australia Sir Peter MacCallum Department of Oncology The University of MelbourneParkvilleVIC 3010Australia Department of Immunology and Pathology Monash UniversityMelbourneVIC 3004Australia

In a study recently published in Nature,Lawson et *** several pathways previously implicated in tumor cell sensitivity to cytotoxic T lymphocytes(CTLs),and identify autophagy as an additional pathway involved in mediating tumor immune evasion.1 Autophagy is a regulated and conserved multistep process that enables cells to degrade and recycle intracellular components and is critical for cellular *** has recently been associated with tumor immune evasion in pancreatic ductal adenocarcinoma,2 whereby this process selectively targeted the degradation of major histocompatibility complex I(MHC-I),limiting recognition,and anti-tumor responses by ***,Lawson et *** an additional role for autophagy in tumor immune evasion,by mediating resistance to cytokine-mediated cell death.

关键词： immunity homeostasis limiting

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Differential effects of short term winter thermal stress on diapausing tiger swallowtail butterflies （Papilio spp.）

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Insect Science 2012年第3期19卷 277-285页

作者： j. Mark Scriber emily Maher Matthew L. Aardema Department of Entomology Michigan State University East Lansing MI McGuire Center for Lepidoptera and Biodiversity Florida Museum of Natural History University of Florida Gainesville FL Department of Ecology and Evolutionary Biology Princeton University Princeton N J USA

It is generally thought that insects inhabiting lower latitudes are more severely impacted by changes in their thermal environment than are high latitude species. This is attributed to the wider range of temperatures to which high-latitude species are exposed. By contrast, low-latitude species have typically evolved in more thermally stable environments with a narrower range of temperature variation. However, deviation from this pattern can occur and here we report that under variable winter conditions a higher latitude species may be more sensitive to thermal variation than its lower latitude sister species. Using split broods, we examined the survival and adult emergence success of diapausing pupae of Papilio canadensis and P. glaucus, as well as a unique, recombinant hybrid population （＂late-flight＂） to short periods of mid-winter cold and heat stress. Our results indicate that the higher latitude, univoltine populations （P. canadensis and late-flights） exhibit lower pupal survival than the lower latitude, facultative diapauser （P. glaucus） for all mid-winter thermal stress treatments, both high and low. Size differences alone do not appear to account for the observed differences in survival or metabolic costs in these three pheno- types, as late-flight individuals are similar in size to R glaucus. We attribute the observed differences in survival and weight loss to potential metabolic differences and variation in the intensity of diapause, in addition to divergent adaptation to winter precipitation levels （e.g. snow cover） and the influences this may have on microhabitat temperature moderation.

关键词： climate change developmental threshold incipient hybrid species metabolic cost Papilionidae post-diapause delays thermal stress

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South Asian dairy smallholders: A scoping review of practices and zoonoses

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Asian Pacific journal of Tropical Medicine 2023年第10期16卷 446-452页

作者： emily Schembri Angus j D Campbell juan Pablo Villanueva-Cabezas Melbourne School of Population and Global Health The University of MelbourneVictoriaAustralia The Nossal Institute for Global Health The University of MelbourneVictoriaAustralia The Peter Doherty Institute for Infection and Immunity The University of Melbourne and the Royal Melbourne HospitalVictoriaAustralia

Objective: To identify and discuss on-farm management practices linked to bacterial zoonosis risk in smallholder dairy farmers in South Asia. Methods: This scoping review was conducted as per the PRISMA-ScR guidelines. Five hundred and two publications were retrieved from five online databases using a comprehensive search strategy. Studies were selected if they discussed a farm management practice which impacted human health within a South Asian country. Results: Twenty-two studies were included. Seven management practices relevant to farmers, livestock and their shared environment were identified including raw milk consumption, farm hygiene management, personal protective equipment uses, animal vaccination, cleaning udders, hand washing and disposal of afterbirth materials. Preventive practices were found to be utilized at lower frequencies compared to risk increasing practices. Awareness of bacterial zoonoses is particularly low within the region. Conclusions: Based on the results of this review, it was determined that improving farmer awareness of bacterial zoonotic diseases may favor several of the presented leverage points within the South Asian smallholder dairy system. Relying on formal school education to improve this awareness may not solve this problem, instead, more focus on accessible and affordable zoonoses education and farming programs is required.

关键词： Management practices Zoonoses Dairy Smallholder system

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Advances in immuno-oncology biomarkers for gastroesophageal cancer:programmed death ligand 1,microsatellite instability,and beyond

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World journal of Gastroenterology 2018年第25期24卷 2686-2697页

作者： emily M Lin jun Gong Samuel j Klempner joseph Chao Department of Internal Medicine Harbor-UCLA Medical CenterTorranceCA 90509United States Department of Medical Oncology and Developmental Therapeutics City of Hope Comprehensive Cancer CenterDuarteCA 91010United States The Angeles Clinic and Research Institute Los AngelesCA 90404United States Samuel Oschin Comprehensive Cancer Institute Cedars-Sinai Medical CenterLos AngelesCA 90048United States

Blockade of the programmed death ligand 1(PD-L1) and programmed cell death 1(PD-1) receptor axis represents an effective form of cancer immunotherapy. Preclinical evidence initially suggested that gastric and gastroesophageal junction(GEj) cancers are potentially immunotherapy-sensitive tumors. Early phase clinical trials have demonstrated promising antitumor activity with PD-1/PD-L1 blockade in advanced or metastatic gastric/GEj cancer. Microsatellite instability(MSI) and PD-L1 expression have been shown to predict higher response to PD-1 inhibitors as highlighted by the recent approvals of pembrolizumab in treatmentrefractory solid tumors with MSI status and the thirdline or greater treatment of PD-L1 positive advanced gastric/GEj cancers. However, predictive and prognostic biomarkers remain an ongoing need. In this review, we detail the preclinical evidence and early tissue biomarker analyses illustrating potential predictive biomarkers to PD-1/PD-L1 blockade in gastric/GEj cancer. We also review the clinical development of PD-1/PD-L1 inhibitors in gastric/GEj cancer and highlight several areas in need of future investigation in order to optimize the efficacy of PD-1/PD-L1 blockade in gastric/GEj cancer.

关键词： Immunotherapy programmed cell death 1 programmed death ligand 1 microsatellite instablility Gastric cancer

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