Abstract Objective: To disrupt cycles of health inequity, traceable to dietary inequities in the earliest stages of life, public health interventions should target improving nutritional wellbeing in preconception/pregnancy environments. This requires a deep engagement with pregnant/postpartum people (PPP) and their communities (including their health and social care providers, HSCP). We sought to understand the factors that influence diet during pregnancy from the perspectives of PPP and HSCP, and to outline intervention priorities. Design: We carried out thematic network analyses of transcripts from ten focus group discussions (FGD) and one stakeholder engagement meeting with PPP and HSCP in a Canadian city. Identified themes were developed into conceptual maps, highlighting local priorities for pregnancy nutrition and intervention development. Setting: FGD and the stakeholder meeting were run in predominantly lower socioeconomic position (SEP) neighbourhoods in the sociodemographically diverse city of Hamilton, Canada. Participants: All local, comprising twenty-two lower SEP PPP and forty-three HSCP. Results: Salient themes were resilience, resources, relationships and the embodied experience of pregnancy. Both PPP and HSCP underscored that socioeconomic-political forces operating at multiple levels largely determined the availability of individual and relational resources constraining diet during pregnancy. Intervention proposals focused on cultivating individual and community resilience to improve early-life nutritional environments. Participants called for better-integrated services, greater income supports and strengthened support programmes. Conclusions: Hamilton stakeholders foregrounded social determinants of inequity as main factors influencing pregnancy diet. They further indicated a need to develop interventions that build resilience and redistribute resources at multiple levels, from the household to the state.
Abstract Evidence supporting the Developmental Origins of Health and Disease (DOHaD) hypothesis indicates that improving early life environments can reduce non-communicable disease risks and improve health over the lifecourse. A widespread understanding of this evidence may help to reshape structures, guidelines and individual behaviors to better the developmental conditions for the next generations. Yet, few efforts have yet been made to translate the DOHaD concept beyond the research community. To understand why, and to identify priorities for DOHaD Knowledge Translation (KT) programs, we review here a portion of published descriptions of DOHaD KT efforts and critiques thereof. We focus on KT targeting people equipped to apply DOHaD knowledge to their everyday home or work lives. We identified 17 reports of direct-to-public DOHaD KT that met our inclusion criteria. Relevant KT programs have been or are being initiated in nine countries, most focusing on secondary school students or care-workers-in-training; few target parents-to-be. Early indicators suggest that such programs can empower participants. Main critiques of DOHaD KT suggest it may overburden mothers with responsibility for children’s health and health environments, minimizing the roles of other people and institutions. Simultaneously, though, many mothers-to-be seek reliable guidance on prenatal health and nutrition, and would likely benefit from engagement with DOHaD KT. We thus recommend emphasizing solidarity, and bringing together people likely to one day become parents (youth), people planning pregnancies, expecting couples, care workers and policymakers into empowering conversation about DOHaD and about the importance and complexity of early life environments.
To date, research into reconfigurable mobile communications has predominantly focussed on the software radio concept, and specifically on the hardware technologies required to move physical layer processing into a programmable environment [1][2][3]. Although an interesting and necessary challenge, this only represents a fraction of the overall support and technology required to realise the potential of the concept. Other necessary developments include network/terminal cooperation for seamless inter-standard handoff, QoS management, a secure software download mechanism, terminal software architecture supporting reconfiguration, configuration management, capability negotiation, etc.. Summarising results from early ISTTRUST (Transparently Reconfigurable UbiquitouS terminal) [4] project deliverables, this paper describes the likely overall system environment and the key technical challenges to be researched in TRUST for realising a reconfigurable terminal to meet the needs of users within that environment. Future wireless systems As we move towards the 4 Generation of Mobile Communications, we can perceive the convergence towards an IP-based core network and ubiquitous, seamless access between 2G, 3G, broadband and broadcast wireless access schemes, augmented by self-organising network schemes and short-range connectivity between intelligent communicating appliances (Figure 1) [5]. In general, vertical handover takes place between different access systems (cellular layer down to personal network layer, e.g. Bluetooth). Vertical handover is combined with service negotiations to ensure seamless service, because different access systems support different user data rates and other bearer and service parameters. The interworking, mobility management and roaming will be handled via the medium access systems and the IP based core network. Reconfigurable radio terminals and new appliances are key components of such a seamless network. Figure 1: Seamless future network including a variety of access technologies [5] Services and
To date, research into reconfigurable mobile communications has predominantly focussed on the software radio concept, and specifically on the hardware technologies required to move physical layer processing into a programmable environment. Although an interesting and necessary challenge, this only represents a fraction of the overall support and technology required to realise the potential of the concept. Other necessary developments include network/terminal cooperation for seamless inter-standard handoff, QoS management, a secure software download mechanism, terminal software architecture supporting reconfiguration, configuration management, capability negotiation. Summarising results from early IST-TRUST (Transparently Reconfigurable Ubiquitous terminal) project deliverables, this paper describes the likely overall system environment, and the key technical challenges to be researched in TRUST for realising a reconfigurable terminal to meet the needs of users within that environment.
