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Interventions to improve vitamin D status in at-risk ethnic groups during pregnancy and early childhood: a systematic review
- Nuttan K Tanna, Emma C Alexander, Charlotte Lee, Monica Lakhanpaul, Rickin M Popat, Pamela Almeida-Meza, Alice Tuck, Logan Manikam, Mitch Blair
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- Journal:
- Public Health Nutrition / Volume 24 / Issue 11 / August 2021
- Published online by Cambridge University Press:
- 17 February 2021, pp. 3498-3519
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- Article
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Objective:
To systematically review the literature with the primary aim of identifying behavioural interventions to improve vitamin D stores in children from at-risk ethnic groups.
Design:Review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PROSPERO registration number: CRD42017080932. Health Behaviour Model and Behaviour Change Wheel framework constructs used to underpin evaluation of interventions. Methodological quality evaluated using Cochrane Risk of Bias, Cochrane ROBINS-I and NHLBI tools.
Setting:Databases Cochrane Library, MEDLINE, EMBASE, CINAHL with secondary search of Google Scholar. No country limits set. Papers between January 1990 and February 2018, published in English included. Anticipating study heterogeneity, outcome measures not pre-specified and identified from individual full papers. Updated literature search November 2020.
Participants:Patient or population including pregnant women, newborns and children aged under 18 years, from Asian or African ethnic groups.
Results:Of 10 690 articles screened, 298 underwent full-text review, with 24 ultimately included for data extraction. All identified studies conducted a vitamin D pharmacological supplementation intervention, with two also incorporating a behavioural intervention strategy. No study explicitly defined a primary aim of evaluating a behavioural intervention, undertaken to study its effect on vitamin D supplement uptake.
Conclusions:There is a need to address the paucity of data in ethnic at-risk children on how behavioural interventions ideally developed and co-produced with the community under study, affect and help improve vitamin D uptake, within the antenatal and pregnancy phase as well as during childhood.
Foreword
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- By Mitch Blair
- Jenny Reynolds, Catherine Houlston, Lester Coleman, Gordon Harold, University of Sussex
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- Book:
- Parental Conflict
- Published by:
- Bristol University Press
- Published online:
- 04 February 2022
- Print publication:
- 31 January 2014, pp vii-viii
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Summary
All happy families resemble one another, but each unhappy family is unhappy in its own way. (Anna Karenina, Leo Tolstoy, part 1, chapter 1)
When I first saw Mark, he was 8 years old and had severe abdominal pains and headaches which had been troubling him for several weeks. His GP and his parents were both concerned that there was an underlying disease process. After a number of basic investigations, it was clear to me that his parents, whom he brought with him for the appointment, were clearly not getting along well and I could sense that this was the source of his distress, as I had done with so many other families I had seen over the years. Up until recently I have felt very much unprepared to deal with such cases.
Four out of 10 marriages end in divorce now compared with around a third in 1979. The circumstances are frequently conflictual and the children often suffer and come to the attention of various adults who care for them. Practitioners like myself, need to be aware of the different forms of parental conflict and how this affects children's health and wellbeing at different ages and stages of their lives and most importantly how we can support and signpost parents to appropriate help.
This authoritative resource reviews the evidence and skilfully takes the reader though the distinctions between ‘constructive’ and ‘destructive’ forms of parental conflict, its effects on sleep, immune system, hormonal systems, and emotional health of the child and the theoretical basis on which children process such conflict in their daily lives. We read how children react in different ways depending on their gender, age, temperament and genetic make-up as well as the effects of peers and others who interface with their lives. This review looks critically at the components of what works in parenting programmes, both universal and targeted, and the additional effectiveness of those which specifically address parental conflict in their design.
Most importantly, by the end one realises oneself that, with appropriate training, there is help which we can provide to families within our spheres of influence and high quality programmes which one can signpost parents to.