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Gestational diabetes mellitus (GDM) is associated with excessive fetal growth in later gestation. Recent data suggest accelerated growth may begin before 28 weeks' gestation when GDM is typically diagnosed. The identification of pregnancies at risk of early fetal growth would enable early intervention. We assessed the use of early pregnancy HbA1c in predicting excessive fetal growth.Women were recruited at antenatal booking from a major maternity unit in the UK. HbA1c was measured at14 weeks gestation in 1243 women at risk of GDM as defined by UK NICE risk factors of whom 1115 underwent OGTT. Women with previous GDM were excluded. Comprehensive fetal ultrasound was performed at 28 weeks' gestation alongside 75 g OGTT in 976 of these women. GDM was defined using WHO criteria. Pregnancy outcomes were extracted from the regional maternity care database.Two hundred and thirty-six women screened positive for GDM. At diagnosis, GDM pregnancies demonstrated higher adjusted fetal weight percentile than non-GDM pregnancies: (51.8 vs. 46.3, p = 0.008). This was driven by increases in the fetal abdominal circumference percentile in GDM compared with non-GDM pregnancies (55.3 vs. 46.2, p = 0.001). Early pregnancy HbA1c was higher in the GDM versus non-GDM group: (35.7 mmol/mol vs. 32.9 mmol/mol p = 0.01). A threshold for predicting excessive fetal growth was not identified in this cohort.Accelerated fetal growth is evident prior to the diagnosis of GDM. There remains a need for suitable methods of early identification of pregnancies at high risk for early accelerated fetal growth due to GDM. First-trimester HbA1c was not useful in identifying these pregnancies.WHAT IS ALREADY KNOWN?: Recent research suggests excessive growth associated with GDM may begin prior to 28 weeks' gestation, when GDM is typically tested for WHAT THIS STUDY HAS FOUND?: Pregnancies affected by GDM are already subject to accelerated fetal growth in comparison to non-GDM pregnancies by way of higher estimated fetal weight and fetal abdominal circumference Neither first-trimester HbA1c nor plasma glucose was useful predictors of these outcomes WHAT ARE THE IMPLICATIONS OF THIS STUDY?: Highlights the emergence of excessive growth prior to detection of GDM Reinforces need for suitable methods of identifying such pregnancies in earlier gestation.

Background The first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland. Methods A qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children ( Results Twelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house. Conclusions The restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents.

By 2015, an estimated 2.3–4.8 million children will be orphaned due to AIDS-related illness. Limited information is available on the emotional and behavioral problems that AIDS-orphaned children experience. This qualitative study explores 49 orphaned children who were observed in a non-governmental organization group setting in a small, rural village located in Eastern Cape, South Africa. Of the children in this study, 20 were orphaned due to AIDS. However, 19 children were orphaned due to parental death with an undeclared cause, but the deaths are believed to have resulted from AIDS.

This article examines the ways that plebeian women confessed to concubinary relationships in seventeenth-century Lima. Part One reviews complaints brought by casta and enslaved concubines to enforce matrimonial promises. Part Two analyzes the imprecise laws and policies of the canonists on concubinage. Part Three considers the Church’s inquisitorial function in policing interethnic intimacies, given the virtual synonymity of illegitimacy and concubinage. The article assesses the marriage–concubinage dichotomy from the perspective of women who, given their ethnic and social position in colonial society enjoyed limited legal standing vis-à-vis elite women, but conversely exercised greater sexual freedom in forming and dissolving partnerships.

In 1629, Gaspar Zape sought a preliminary injunction in Lima's ecclesias tical court against Geronimo Vosmediano de Leon to prevent him from shipping Juliana Bran off to Chile. Gaspar learned that Vosmediano de Leon, his wife's owner, planned to send Juliana off to Chile as a wet nurse for his newborn granddaughter. Acting quickly, Gaspar sought court intervention basing his injunction on his right to marital unity and cohabitation that was the prerogative of enslaved married couples granted by the Siete Partidas} Vosmediano de Leon responded by invoking his

Este artículo explora las relaciones de intercambio entre las comunidades indígenas de la Amazonia peruana y los patrones locales, centrándose en el caso de cuatro comunidades Urarina, relacionadas entre sí y ubicadas en la cuenca del río Chambira, en el departamento de Loreto (en el nororicnte peruano). De manera particular, el artículo presenta el caso de la disputa entre 5 jóvenes Urarina y su patrón. Si bien es cierto que la mayoría de las comunidades indígenas solucionan sus conflictos sin recurrir al sistema legal del Estado, muchos individuos, particularmente jóvenes que aspiran a convertirse en autoridades comienzan a utilizar sus conocimientos jurídico-legales como prueba de su autoridad y su habilidad para asumir posiciones de liderazgo al interior de sus comunidades. Sin embargo, la ausencia del Estado en zonas remotas de la Amazonia termina socavando los esfuerzos de estos litigantes Urarina en el uso del sistema legal para solucionar las asimetrías estructurales que determinan sus relaciones de intercambio con los no indígenas. Este artículo explora las razones que motivan a los jóvenes Urarina a consultar a las autoridades civiles en lugar de terminar simplemente sus desiguales relaciones de trabajo.

This article examines the ways in which globally driven population policies are experienced by rural indigenous women in Amazonian communities on the periphery of formal political power. As with other global development processes population programs are actively resisted accepted and modified by the women who are their intended “targets.” Through a nuanced exploration of the interface of indigenous identity with the discourse of empowerment and reproductive rights this article traces the impact of internationally funded population and development programs on local identity politics in the Peruvian Amazon. (authors)

Baseline survey data are integrated into an ethnographic understanding of locally situated knowledge to evaluate how radio entertainment—education regarding reproductive health is socially constructed in the riverine communities of the Peruvian Amazon. Focus group interviews, sustained participant observation, in—depth interviews, letters from radio listeners, and input from trained peer promoters complement the survey data. Employment of culturally sensitive, multiple methods makes findings more intelligible and coherent, provides practical wisdom for action, and heightens awareness of the joint ownership of ethical responsibilities on the part of the researcher and the researched.

Starting in the early 1980s, media coverage of customary African genital surgeries for females has been problematic and overly reliant on sources from within a global activist and advocacy movement ...

[R]eproductive rights ... rest on the recognition of the basic right of couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health . .. [taking] into account the needs of their living and future children and their responsibilities towards the community. The promotion of the responsible exercise of these rights for all people should be the fundamental basis for ... community-supported policies and programmes in the area of reproductive health.... Programme of Action adopted at the International Conference on Population and Development, Cairo, 1994, Paragraph 7.3