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Background: Low birth weight (LBW) and low infant lung capacity among others are risk factors for childhood and adulthood chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma. These respiratory diseases are among the leading causes of death and disability worldwide. The aetiology of these respiratory diseases and other inflammatory conditions has recently been linked to maternal diet during pregnancy. As such it has been important to study the role of maternal diet during pregnancy to find any association with maternal and infant outcomes. Highly diverse diets have been thought to be a proxy to maternal nutrient adequacy as well as healthy diet. Diverse diets may offer protection from inflammatory airway diseases and other inflammatory diseases by evening out inflammatory and anti-inflammatory food components. Purpose: To investigate the effect of Dietary diversity (DD) and Dietary inflammatory index (DII), on infant birth outcomes particularly birth weight and lung function and to determine if there is any association. Methods: In this study we analysed data obtained from 564 women who attended antenatal care facilities in Kalungu district of rural Uganda. These women were recruited by convenience sampling as they walked into the facilities for antenatal care. Those who gave consent were asked about their diets and socioeconomic statuses by means of questionnaires. Infant outcomes were measured by healthcare professionals at presentation for postnatal care at 6 weeks ofage. Dietary scores were created as the number of unique food groups obtained from the data collected. The scores ranged from 0-14, with 14 representing those who consumed all 14 unique food groups identified in the study. Dietary inflammatory index was also calculated from the data obtained. The methods for calculating the DII will be explained in detail under methods. The data collection for this purpose was based on 24hr recall. Results: The mean Dietary Diversity score was 4.61 +/- 1.79 SD. In the previous 24 h, 84.8% of the participating women had consumed tubers such as cassava, 57.1% reported consuming grains or cereal, 12.6% vegetables, 19.3% Fruits, 1.2% meat and 7.4% eggs. There were statistically significant differences in dietary practices of the women according to their level of education, with 81% of those who attained tertiary education having adequate dietary diversity. Starches were the most consumed food group with an average of 16 servings per week while meat, processed starches (samosas, etc), fruits and vegetables were consumed at=<2 serving per week, with meat the least consumed at an average of less than 1 serving per week. Although marginal, the diets of the participants were mostly anti-inflammatory with an average dietary inflammatory score of -1.2. Those with the lowest inflammatory score were associated with more servings of legumes, green leafy vegetables, fish and less servings of processed starches and animal oil. There was no association observed between dietary diversity and infant birth outcomes, birth weight and lung function. No association was also observed between Dietary inflammatory scores and infant lung function.

Menorrhagia--menstrual periods lasting longer than 7 days and totaling blood losses greater than 80mL--affects 9%-14% of otherwise healthy women, and it can signal cancer, an endocrinologic disorder, or gynecologic disease. Blood loss can be high enough to result in anemia, fatigue, and syncope. Most often, abnormal uterine bleeding such as menorrhagia involves a disruption in the hypothalamic-pituitary axis, the ovary, and/or the uterus. Other identified causes include medications (especially psychotropics) that cross the blood-brain barrier; chronic diseases such as cancer, diabetes, and liver and kidney dysfunction; endocrine disorders, perimenopausal anovulation, polycystic ovary disease, pituitary tumors, and abnormal estrogen cycling caused by morbid obesity; and anatomic abnormalities of the uterus. Routine tests include hematocrit or hemoglobin to detect and evaluate anemia, thyroid stimulating hormone (TSH) level to evaluate thyroid function as a possible cause, and a pregnancy test to rule out an incomplete, spontaneous abortion as a cause. A Pap test is recommended to screen for dysplasia that can suggest a gynecologic cancer cause. Additional screening for endocrine disorders that may be causing menorrhagia include tests of thyroid, liver, and kidney function, and tests of follicle stimulating hormone (FSH), prolactin, and cortisol levels. Treatment can be medical or surgical. Medical treatment includes prostaglandin inhibitors, specifically nonsteroidal antiinflammatory drugs (NSAIDs), and hormonal therapy with estrogen, progesterone, gonadotropin-releasing hormone agonists, or oral contraceptives such as medroxyprogesterone (Depo-Provera). Surgical treatment includes hysteroscopic endometrial ablation by physical agents, laser electrodiathermy, and "roller ball," or surgical, resection. Hysterectomy is the treatment of last resort.

During the last 30 years it has become clearly evident that oxidative stress and free radical biology play key roles in carcinogenesis, cancer progression, cancer therapy, and normal tissue damage that limits treatment efficacy during cancer therapy. These mechanistic observations have led to the realization that free radical biology and cancer biology are two integrally related fields of investigation that can greatly benefit from cross fertilization of theoretical constructs. The current volume of scientific papers was assembled under the heading of Oxidative Stress in Cancer Biology and Therapy in order to stimulate the discussion of how the knowledge gained in the emerging field of oxidative stress in cancer biology can be utilized to more effectively design interventions to enhance therapeutic responses while causing fewer treatment limiting complications. The chapters contained in this volume provide highly informative emerging perspectives on how that selective enhancement of oxidative stress in cancerous tissues can be used as a target for enhancing therapeutic outcomes as well as how selective inhibition of oxidative stress could spare normal tissue damage and inhibit carcinogenesis. In this regard, the book represents an outstanding resource for both basic and translational scientists as well as clinicians interested in the field of oxidative stress and cancer therapy. / https://dc.etsu.edu/etsu_books/1245/thumbnail.jpg

In this editorial we describe the clinician/administrator/researcher experience of frustration or confusion around how to effectively advocate for policy change in health care. By the end of the piece the reader will (a) understand the importance of health professionals’ ad-vocacy; (b) know how to use policy papers to advocate; and (c) understand how policy organizations use policy papers. We also discuss the National Academies of Medicine, Science, & Engineering High Quality Primary Care report as an example of a policy pa-per, introduce our new coeditors for the Policy and Management Department, and describe the Collaborative Family Health Care Association’s new policy principles.

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