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This review focuses on the nutritional needs and reality of women while pregnant. In addition the physiology of the pregnant woman is discussed including the weight gain associated with pregnancy the energy and nutritional requirements of pregnancy and the changes is basic metabolism and homeostasis. Pregnant women are considered a nutritionally vulnerable group; however if women were so vulnerable why is there a massive overpopulation problem? That is to say that obviously many women living in nutritionally poor environments sustain healthy pregnancies. To investigate this paradox clinical and epidemiological studies are reviewed and it was found that: 1) in communities where dietary standards are not grossly defective the improved feeding of pregnant women produce only a marginal but by no means unimportant increase of reproductive efficiency; and 2) maternal stature has a considerable influence on reproductive efficiency possibly as a result of the influence of nutritional status during growth i.e. preceding pregnancy. This review compares recorded dietary intakes of pregnant women with recommended dietary allowances but such a comparison fails to produce cogent evidence of serious deficiencies. Nor was evidence found to indicate that many clinical abnormalities can be unequivocally attributed to dietary defects. Maternal weight gain and its implication for nutritional requirements are discussed. And alterations of maternal metabolism and homeostasis are now thought to favor transfer of nutrients to the fetus over uptake of nutrients by the maternal tissues; before these alterations had been viewed as signs of nutritional depletion.

Background\ud \ud Recent trials demonstrate the acceptability and short term efficacy of primary care referral to a commercial weight loss provider for weight management. Commissioners now need information on the optimal duration of intervention and the longer term outcomes and cost effectiveness of such treatment to give best value for money.\ud \ud \ud \ud Methods/Design\ud \ud This multicentre, randomised controlled trial with a parallel design will recruit 1200 overweight adults (BMI ≥28 kg/m2) through their primary care provider. They will be randomised in a 2:5:5 allocation to: Brief Intervention, Commercial Programme for 12 weeks, or Commercial Programme for 52 weeks. Participants will be followed up for two years, with assessments at 0, 3, 12 and 24 months. The sequential primary research questions are whether the CP interventions achieve significantly greater weight loss from baseline to 12 months than BI, and whether CP52 achieves significantly greater weight loss from baseline to 12 months than CP12. The primary outcomes will be an intention to treat analysis of between treatment differences in body weight at 12 months. Clinical effectiveness will be also be assessed by measures of weight, fat mass, and blood pressure at each time point and biochemical risk factors at 12 months. Self-report questionnaires will collect data on psychosocial factors associated with adherence, weight-loss and weight-loss maintenance. A within-trial and long-term cost-effectiveness analysis will be conducted from an NHS perspective. Qualitative methods will be used to examine the participant experience.\ud \ud \ud \ud Discussion\ud \ud The current trial compares the clinical and cost effectiveness of referral to a commercial provider with a brief intervention. This trial will specifically examine whether providing longer weight-loss treatment without altering content or intensity (12 months commercial referral vs. 12 weeks) leads to greater weight loss at one year and is sustained at 2 years. It will also evaluate the relative cost-effectiveness of the three interventions. This study has direct implications for primary care practice in the UK and will provide important information to inform the decisions of practitioners and commissioners about service provision.\ud \ud \ud \ud Trial Registration\ud \ud Current Controlled Trials ISRCTN82857232. Date registered: 15/10/2012.

As an N-methylaspartate antagonist on cat and frog spinal neurones, (−) cyclazocine was twice as potent as (+) cyclazocine. This stereoselectivity is similar to that of cyclazocine at sigma rather than at mu or kappa opiate receptors. Cyclazocine also reduced synaptic excitation in rat cortex.

These experiments were an attempt to study the possible interactions between cells of the supraoptic nucleus. In isolated brain slices pairs of supraoptic neurones were recorded simultaneously either with a single electrode or with two electrodes and cross-correlograms produced. Correlations were demonstrated in 22 of the 82 pairs studied and were found to be more common between closely neighbouring pairs of cells. Ten of the correlations indicated that the spikes of one cell followed spikes in the other cell. The correlations of another 10 pairs indicated that the cells were coactivated. In only 2 pairs was there a correlation indicative of an inhibitory connexion. That these correlations could result either from synaptic connexions within the nucleus, or from coactivation of cells from an extranuclear site is discussed.

$\textit{Background}$ Evidence exist that primary care referral to an open-group behavioural programme is an effective strategy for management of obesity, but little evidence on optimal intervention duration is available. We aimed to establish whether 52-week referral to an open-group weight-management programme would achieve greater weight loss and improvements in a range of health outcomes and be more cost-effective than the current practice of 12-week referrals. $\textit{Methods}$ In this non-blinded, parallel-group, randomised controlled trial, we recruited participants who were aged 18 years or older and had body-mass index (BMI) of 28 kg/m² or higher from 23 primary care practices in England. Participants were randomly assigned (2:5:5) to brief advice and self-help materials, a weight-management programme (Weight Watchers) for 12 weeks, or the same weight-management programme for 52 weeks. We followed-up participants over 2 years. The primary outcome was weight at 1 year of follow-up, analysed with mixed-effects models according to intention-to-treat principles and adjusted for centre and baseline weight. In a hierarchical closed-testing procedure, we compared combined behavioural programme arms with brief intervention, then compared the 12-week programme and 52-week programme. We did a within-trial cost-effectiveness analysis using person-level data and modelled outcomes over a 25-year time horizon using microsimulation. This study is registered with Current Controlled Trials, number ISRCTN82857232. $\textit{Findings}$ Between Oct 18, 2012, and Feb 10, 2014, we enrolled 1269 participants. 1267 eligible participants were randomly assigned to the brief intervention (n=211), the 12-week programme (n=528), and the 52-week programme (n=528). Two participants in the 12-week programme had been found to be ineligible shortly after randomisation and were excluded from the analysis. 823 (65%) of 1267 participants completed an assessment at 1 year and 856 (68%) participants at 2 years. All eligible participants were included in the analyses. At 1 year, mean weight changes in the groups were –3·26 kg (brief intervention), –4·75 kg (12-week programme), and –6·76 kg (52-week programme). Participants in the behavioural programme lost more weight than those in the brief intervention (adjusted difference –2·71 kg, 95% CI –3·86 to –1·55; p, This trial was funded by the National Prevention Research Initiative grant MR/J000493/1. The cost of the Weight Watchers® programme and the costs of blood sampling and analysis were funded by Weight Watchers International as part of an MRC Industrial Collaboration Award.