Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain

Abstract

Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340?kcal?d^?1 and 452?kcal?d^?1 needed for the second and third trimesters. Energy intake depends on pre-gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300?kcal?d^?1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500?kcal?d^?1 and obese women an increase of 0, 450 and 350?kcal?day^?1. The recommendations for carbohydrate and protein intake are 175?g?d^?1 and 0.88–1.1?g?kgBM?d^?1, with no change to fat intake. The number of pre-gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8–11.3?kg and obese women 5.0–9.1?kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5–16.0?kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.     

The effect of 14 weeks of vitamin D3 supplementation on antimicrobial peptides and proteins in athletes

Heavy training is associated with increased respiratory infection risk and antimicrobial proteins are important in defence against oral and respiratory tract infections. We examined the effect of 14 weeks of vitamin D₃ supplementation (5000 IU/day) on the resting plasma cathelicidin concentration and the salivary secretion rates of secretory immunoglobulin A (SIgA), cathelicidin, lactoferrin and lysozyme in athletes during a winter training period. Blood and saliva were obtained at the start of the study from 39 healthy men who were randomly allocated to vitamin D₃ supplement or placebo. Blood samples were also collected at the end of the study; saliva samples were collected after 7 and 14 weeks. Plasma total 25(OH)D concentration increased by 130% in the vitamin D₃ group and decreased by 43% in the placebo group (both P = 0.001). The percentage change of plasma cathelicidin concentration in the vitamin D₃ group was higher than in the placebo group (P = 0.025). Only in the vitamin D₃ group, the saliva SIgA and cathelicidin secretion rates increased over time (both P = 0.03). A daily 5000 IU vitamin D₃ supplement has a beneficial effect in up-regulating the expression of SIgA and cathelicidin in athletes during a winter training period, which could improve resistance to respiratory infections.     

Steps Toward Transformation: One College’s Achieving The Dream Story

Tarrant County College’s Achieving the Dream transformation has not only changed the college but all who engaged in the initiative. In four years, through ATD TCC became a college with one purpose, one goal, and one focus—student success through data informed decision making. From TCC Chancellor Dr. Erma Johnson Hadley to campus administrators, faculty, and staff, the college embraced the call for systemic change and fully engaged in the step by step process. Personnel throughout the college reported widespread satisfaction with senior leadership and viewed collaborations with colleagues across the district as beneficial and personally rewarding. Tireless endeavors to wholly engage stakeholders, build a culture of evidence, and employ effective student success interventions through ATD not only transformed TCC but ushered the college onto the national stage with Leader College recognition. The college’s next steps include keeping that momentum going and building on what it has accomplished.     

The Roles of Parental Support and Family Stress in Adolescent Sleep

The current study examines the association between parental support and adolescent sleep under varying levels of family stress. Participants included 316 adolescents (M_age = 16.40 years, 43% male) and their parents (M_age = 45.67 years, 91% mothers) from diverse ethnic backgrounds. Both adolescents and parents completed questionnaires and adolescents wore wrist actigraphs and completed self‐reports on their sleep for 7 consecutive days. Results indicated that under contexts of family stress, more parental support was linked to longer sleep duration, less sleep variability, and less time spent awake during the night. Findings suggest that under contexts of family stress, cohesive family relationships may provide a sense of stability and security that is necessary for healthful sleep.     

Short-term heat acclimation prior to a multi-day desert ultra-marathon improves physiological and psychological responses without compromising immune status

Multistage, ultra-endurance events in hot, humid conditions necessitate thermal adaptation, often achieved through short term heat acclimation (STHA), to improve performance by reducing thermoregulatory strain and perceptions of heat stress. This study investigated the physiological, perceptual and immunological responses to STHA prior to the Marathon des Sables. Eight athletes (age 42 ± 4 years and body mass 81.9 ± 15.0 kg) completed 4 days of controlled hyperthermia STHA (60 min·day^?1, 45°C and 30% relative humidity). Pre, during and post sessions, physiological and perceptual measures were recorded. Immunological measures were recorded pre-post sessions 1 and 4. STHA improved thermal comfort (P = 0.02), sensation (P = 0.03) and perceived exertion (P = 0.04). A dissociated relationship between perceptual fatigue and T_re was evident after STHA, with reductions in perceived Physical (P = 0.04) and General (P = 0.04) fatigue. Exercising T_re and HR did not change (P > 0.05) however, sweat rate increased 14% (P = 0.02). No changes were found in white blood cell counts or content (P > 0.05). Four days of STHA facilitates effective perceptual adaptations, without compromising immune status prior to an ultra-endurance race in heat stress. A greater physiological strain is required to confer optimal physiological adaptations.     

Enabling integrated knowledge acquisition and management in health care teams

Basing treatment, policy and planning decisions on the best available research knowledge remains a central principle in modern health care around the world, yet many health professionals find acquiring and managing published research knowledge challenging. In this paper, we report on a Soft Systems Methodology-based collaborative action research initiative with a specialist mental health service from the United Kingdom's National Health Service. Our objective was to design and implement improvements to their knowledge acquisition and management activities in order to facilitate sustained and effective evidence-based practices. We report on both the factors found to impede effective research knowledge acquisition and management and the development of more integrated knowledge management processes designed to improve the situation.