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Chapter 15 - Adrenal Disease in Pregnancy
- from Section II - Hormones and Gestational Disorders
- Edited by Felice Petraglia, Università degli Studi, Florence, Mariarosaria Di Tommaso, Università degli Studi, Florence, Federico Mecacci, Università degli Studi, Florence
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- Book:
- Hormones and Pregnancy
- Published online:
- 09 November 2022
- Print publication:
- 13 October 2022, pp 164-182
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Summary
Through hormonal secretion, the adrenal gland regulates cellular homeostasis, stress, inflammation, metabolism, salt and water balance, and reproductive function amongst other systems. During pregnancy, significant changes occur in adrenal hormonal homeostasis, impacting the usual methods for evaluating adrenal disease. We summarize the changes to adrenal physiology occurring throughout pregnancy. Additionally, we discuss a range of adrenal diseases, their clinical assessment and management in pregnancy: adrenal insufficiency, congenital adrenal hyperplasia, Cushing’s syndrome, primary aldosteronism, pheochromocytoma, and adrenocortical carcinoma.
19 - Policy drivers for peatland conservation
- from Part III - Socio-economic and political solutions to managing natural capital and peatland ecosystem services
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- By Rob Stoneman, Yorkshire Wildlife Trust UK, Clifton Bain, IUCN UK Peatland Programme, Scottish Wildlife Trust, UK, David Locky, Grant MacEwan University, Canada, Nick Mawdsley, Euroconsult Mott MacDonald, The Netherlands, Michael McLaughlan, Saskatchewan Ministry of Environment, Canada, Shashi Kumaran-Prentice, Charles Darwin University, Mark Reed, Newcastle University, UK, Vicki Swales, Royal Society for the Protection of Birds (RSPB), UK
- Edited by Aletta Bonn, Tim Allott, University of Manchester, Martin Evans, University of Manchester, Hans Joosten, Rob Stoneman
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- Book:
- Peatland Restoration and Ecosystem Services
- Published online:
- 05 June 2016
- Print publication:
- 23 June 2016, pp 375-401
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Summary
Introduction
Peatlands have long been recognised as a high priority for protection under international and national wildlife laws and agreements. Over the last half century this protection has essentially been reactionary in the face of more widespread land management policy and market forces, which have encouraged damage to peatlands. This damage has been mainly to support the delivery of provisioning services, such as food, timber and pulp, or the widespread extraction of peat and oil. Across the world, peatlands of different types face a variety of pressures from land use and land-use change as well as pollution (e.g. atmospheric pollution on British blanket bogs), making them more susceptible to impacts of climate change. Within the general framework of international agreements on peatland conservation, each country has developed its own approach to tackling the threats with varying degrees of success. While established wildlife conservation policy has helped limit the extent of damage to peatlands in some countries, there is a need and opportunity for a stronger and more urgent public policy response to address the significant ongoing losses of peatland biodiversity and ecosystem services. The recognition of the multiple benefits that peatlands provide has presented new avenues to support sustainably managed peatlands, in addition to reducing peatland loss through active restoration (e.g. Bain et al. 2011; Joosten, Tapio-Biström and Tol 2012). This chapter presents an overview of the principal international and national policy drivers, with examples from selected countries across the world to highlight how new resources could be directed at wise use and conservation of peatlands.
Global overview of policy drivers for peatland conservation
While peatlands have been regarded as wastelands, and areas to be ‘improved’ for agriculture and forestry since the late eighteenth century (Chapter 2), they are now recognised for their wildlife and increasingly for their ecosystem services. Peatlands, therefore, feature in some of the world's highest-level environmental policies.
One of the earliest global agreements to recognise the importance of peatlands for protection was the Ramsar Convention (1971) that promoted the establishment and management of a network of protected wetlands. In 1996, it was reported that though peatlands represented 50% of the world's freshwater and terrestrial wetlands, less than 10% of the designated Ramsar sites had peatland as their dominant habitat (Chapter 15). Given continuing peatland loss and degradation, Contracting Parties set out guidelines to improve peatland protection (Ramsar 2003).
Asthma control in pregnancy is associated with pre-conception dietary patterns
- Jessica A Grieger, Luke E Grzeskowiak, Lisa G Wood, Vicki L Clifton
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- Journal:
- Public Health Nutrition / Volume 19 / Issue 2 / February 2016
- Published online by Cambridge University Press:
- 24 April 2015, pp. 332-338
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Objective
To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during pregnancy.
DesignCross-sectional study. Pre-conception food frequency data were collected retrospectively. Asthma control was assessed using the Global Initiative for Asthma guidelines. Dietary patterns were derived using factor analysis. Binary logistic regression analyses were used to test the association between uncontrolled asthma and each dietary pattern (Z-score), with values presented as odds ratio and 95 % confidence interval.
SettingAntenatal clinic in a tertiary hospital, Adelaide, Australia, May 2009–July 2013.
SubjectsOne hundred and fifty-eight asthmatic pregnant women.
ResultsThree dietary patterns were identified: (i) ‘high protein/fruit’ (strong food group loadings for fish, meat, chicken, fruit); (ii) ‘high fat/sugar/takeaway’ (takeaway foods, crisps, refined grains); and (iii) ‘vegetarian-type’ (vegetables, fruit, soya milk, whole grains). A 1 sd increase in score on the high fat/sugar/takeaway pattern was associated with increased likelihood of uncontrolled asthma (adjusted OR=1·54; 95 % CI 1·07, 2·23; P=0·022). Women with uncontrolled asthma (n 115) had higher energy-adjusted intakes of saturated fat, monounsaturated fat, carbohydrate, sugar and fibre compared with women with controlled asthma (n 43, all P≤0·05).
ConclusionsPre-pregnancy dietary patterns may influence maternal asthma control. Our work highlights the importance of achieving a healthy diet before pregnancy that is low in saturated fat, sugar and takeaway foods, and therefore higher in lean meats, poultry and fish, as well as fruits, vegetables and whole grains. A healthy dietary pattern should be encouraged in all asthmatic women who are of childbearing age, and should additionally be promoted before pregnancy and beyond.
2 - The regulation of human parturition
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- By Roger Smith, Sam Mesiano, Richard Nicholson, Vicki Clifton, Tamas Zakar, Eng-Cheng Chan, Andrew Bisits, Warwick Giles, Mothers and Babies Research Centre, John Hunter Hospital, Newcastle, Australia
- Edited by Michael L. Power, American College of Obstetricians and Gynecologists, Washington DC, Jay Schulkin, American College of Obstetricians and Gynecologists, Washington DC
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- Book:
- Birth, Distress and Disease
- Published online:
- 16 October 2009
- Print publication:
- 28 July 2005, pp 74-87
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Summary
Preterm birth accounts for 70% of neonatal mortality and is a common cause for intellectual handicap among survivors. Approximately 50% of cases of cerebral palsy are associated with preterm birth, in turn preterm birth increases the risk of cerebral palsy by 40 times! (Goldenberg, 2002). Preterm labor thus afflicts individuals at the very beginning of their lives, depriving them of opportunities and increasing health and educational costs for families and society in general. Unfortunately the rates of preterm birth have not changed for over 30 years due to an inability to predict the event and lack of effective therapies.
This clinical problem has driven research into the mechanisms that regulate the timing of human birth and the disorders which cause preterm birth.
For reasons of ethics most research in the past has focused on animal work, especially in the sheep. Unfortunately studies have revealed substantial differences between parturition in humans and that in other animals. Thus animal studies provide us with clues as to how systems operate to regulate delivery in mammals but frustrate us with uncertainty as to whether particular mechanisms operate in the human. Experimental in vivo studies provide the strongest evidence for cause and effect, yet the closer we come to the human state in our near relatives the apes, the larger the ethical constraints on experimental studies become.