Dacron-containing heart valve repair devices trigger chronic inflammation characterized by the presence of activated macrophages, foreign body giant cells, and capsule formation. Upon blood contact, proinflammatory proteins adsorb to the material and provide a substrate for monocyte binding and differentiation. Various heparin-coated polymers have been shown to reduce adsorption of proinflammatory proteins in vitro and in vivo. In this study, the effect of knitted, heparin-coated Dacron on the foreign body reaction was tested subcutaneously in rats. We hypothesized that the anti-inflammatory effect of heparin would reduce monocyte recruitment and differentiation and therefore limit the inflammatory reaction. An ongoing foreign body reaction, characterized by the presence of foreign body giant cells and high vascularization, was observed in uncoated as well as (heparin-)coated Dacron at up to 180 days of implantation. Also, a thin capsule was formed around each material up to this time. In conclusion, although heparin coatings might have an effect on the acute inflammatory response, we were not able to show a difference between heparin-coated and uncoated Dacron after 180 days' implantation in rats. Further research needs to be conducted to assess the difference in proinflammatory protein adsorption between the tested materials and the effect this has on the long-term foreign body reaction.
Background: Programmes offering carboard baby boxes to parents in England began in some NHS Trusts in 2016. This study aimed to examine the strengths and weaknesses of English baby-box schemes as experienced by healthcare providers and parents. Methods: An independent mixed-methods evaluation was conducted via telephone interviews and online surveys with healthcare providers and parents in all 7/9 NHS regions of England where baby-box schemes were established 2016-2019. Participants responded to requests circulated electronically by NHS Research & Design Departments, and infant health organisations in England. The objectives were to identify how parents and healthcare providers understood and experienced baby-box schemes implemented in England to date, and to produce recommendations for organisations considering involvement in future schemes.Results: Baby-box schemes changed over time, and were complex to run and monitor. Both parents and practitioners were misinformed about their purpose and origins. Partnerships with a commercial box-provider reduced the investment needed to run a baby-box scheme, and offered potential benefits to staff regarding engagement with families via online education and face-to-face contact around handover of boxes, but carried unforeseen costs. Of particular concern was the box-provider's access to parent personal details being promoted by NHS staff and parents' lack of awareness; the hidden costs incurred by NHS facilities of running a box-scheme; and the costs incurred by parents in accessing their 'free' box. Sixteen recommendations are proposed for healthcare providers and organisations considering commercial -health-provider baby-box partnerships in future. Conclusions: Many assumptions exist about the origins and purpose of baby-boxes; this misinformation needs correcting, especially as it relates to infant death reduction and safe infant sleep. Baby-box schemes take multiple forms from those motivated by social welfare to those motivated by commercial profit. The English experience of partnership schemes between healthcare facilities and commercial box-providers reveals some success stories, along with multiple points of ambiguity, unanticipated difficulty, and concerns for infant safety.
Objectives: The goals of this study were to describe and interpret two new fossil assemblages of cercopithecin monkeys (n = 328), one from the Faro Daba beds (ca. 100,000 years) and the other one from the Chai Baro beds (>158,000 years old), in the Afar Rift of Ethiopia. Materials and Methods:We describe the two assemblages and compare them to extant cercopithecin species and the smaller fossil assemblage from Asbole, Ethiopia (ca. 600 ka). We use a population-based approach to the taxonomy given the unusually large number of specimens. Craniodental and postcranial anatomy are presented.Evidence of locomotor habitus is described and evaluated in a framework of hybridization and postcranial plasticity. Results:We attribute all cercopithecin specimens from both beds to cf. Chlorocebus and conclude that the Faro Daba and Chai Baro assemblages likely sample single species at each time horizon. Subtle differences between the two assemblages, mostly in postcranial morphology, are insufficient to justify separation at the species level.Discussion: The large sample sizes and unique preservational aspects of these two assemblages open a new window into the recent evolution of guenons. Our data indicate that these fossil populations may be ancestral to the cercopithecins currently living in the Afar region of Ethiopia.
Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Previous research indicates that UK parents would value an approach that facilitates meeting their infants' needs while supporting their own sleep-related well-being throughout their infant's first year. Six initial stakeholder meetings were held with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The Possums Sleep Program developed and delivered in Brisbane, Australia in a GP clinic setting, was chosen as an appropriate approach. Working collaboratively with a stakeholder group, we translated the Possums Sleep Program into an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Parent and practitioner views of the initial materials were obtained via feedback questionnaires and the tool was revised. The intervention was then field-tested by 164 practitioners who delivered it to at least 535 new parents and babies over 5 UK locations, to capture anonymous parent and practitioner views of the intervention concept, the materials, and their experiences with both. The intervention helps parents recalibrate their expectations of infant sleep development, encourages responsive parenting and experimentation to meet their infant's needs, offers parents strategies for supporting the development of their babies' biological sleep regulators and promote their own well-being, and teaches parents to manage negative thinking and anxiety that can impede sleep using the principles of Acceptance and Commitment Therapy. The 'Sleep, Baby & You' discussion tool, a 14 page illustrated booklet for parents, was field-tested and evaluated by practitioners and parents who offered enthusiastic feedback. Practitioners reported the 'Sleep, Baby & You' materials were easy for them to explain and for parents to understand, and were a good fit with the responsive parenting approaches they employed in other areas of their work. Parents who received the intervention postnatally understood the material and found the suggestions easy to follow. All parents who provided feedback had implemented one or
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