Relationships as Key to Recovery for Perinatal Women Living with Depression

Findings from a study of women with lived experience of depression during and after pregnancy, specific to what is helpful, what are barriers and how to affect change

Barriers and Facilitators to Addressing Perinatal Depression in Obstetric Settings

Background: Perinatal depression is common and can cause suffering for mother, fetus/child and family. The perinatal period is an ideal time to detect and treat depression due to regular contact between mothers and health professionals. Despite the opportune time and setting, depression is under-diagnosed and under-treated in the obstetric setting. Caring and committed providers are frustrated and confused, and mothers do not feel heard or understood by their providers. Objectives: (1) Identify postpartum women’s perspective on how perinatal depression is addressed in obstetric settings; (2) Identify strategies for improvement of the delivery of depression care in OB/Gyn settings; and, (3) Inform the development of interventions aimed to improve the delivery of perinatal depression care in obstetric settings. Methods: Four, two hour focus groups were conducted women 3 months – 3 years postpartum (n=27), who identified experiencing symptoms of perinatal depression. Focus group data were analyzed using a grounded theory approach. Results: Participants reported individual, provider and systems-level barriers and facilitators to seeking perinatal depression treatment. Women reported feeling stigmatized, afraid of losing parental rights, and described negative experiences with medical providers, including feeling dismissed by providers and uncomfortable discussing mental health concerns. A lack of provider knowledge and skill sets to address depression was noted by participants. Participants recommended an integrated approach, including psycho-education, peer-support, and provider education/training to improve perinatal depression care in the obstetric setting. Conclusion: Individual, provider and systems-level barriers hinder women from addressing issues of perinatal depression and receiving appropriate care. These data suggest strategies that integrate depression and obstetric care to support OB/Gyns providers and staff in their roles as front line providers to perinatal women. Future efforts could focus on the development of multidisciplinary treatment strategies that utilize patient psychoeducation and provider training and education to overcome barriers and engage women in depression treatment

Clinical inertia in the management of low-density lipoprotein abnormalities in an HIV clinic

A retrospective cohort study evaluating the frequency of and factors related to clinical inertia in low-density lipoprotein (LDL) management was performed. Subjects were 90 patients that were not meeting National Cholesterol Education Program Adult Treatment Panel III LDL goals at the University of Alabama at Birmingham 1917 HIV/AIDS Clinic between 1 August 2004 and 1 August 2005. Clinical inertia was observed in 44% of cases. Patients with higher baseline LDL levels were less likely to experience inertia, whereas women and those in the highest coronary heart disease risk category were more likely to be affected

Utility of Direct Pancreatic Function Testing in Children

OBJECTIVES: Exocrine pancreatic insufficiency (EPI) can have a significant impact on a child's growth and nutrition. Our aim was to evaluate the utility of direct endoscopic pancreatic function testing (ePFT) in pediatrics. METHODS: A single-center retrospective chart review was performed of children who underwent ePFT from December 2007 through February 2015. Endoscopic pancreatic function testings were performed by 1 of 2 methods: (1) intravenous cholecystokinin, followed by the collection of a single duodenal aspirate at 10 minutes, or (2) intravenous cholecystokinin or secretin, followed by the collection of 3 duodenal aspirates at a 5, 10, and 15 minutes. Samples were tested for pH and enzyme activities. RESULTS: A total of 508 ePFTs were performed (481 single-sample tests, 27 multiple-sample tests). Based on the multiple-sample group, enzyme levels for chymotrypsin, amylase, and lipase peaked at 5 minutes, followed by a decrease in activity over time. Exocrine pancreatic sufficiency was identified in 373 (73.4%) and EPI in 93 (18.3%). Exocrine pancreatic sufficiency analysis found all pancreatic enzyme activities significantly increase with age: trypsin, chymotrypsin, amylase, and lipase, (P < 0.05). CONCLUSIONS: Endoscopic pancreatic function testing can be used in the evaluation of EPI in children. Normative data suggest that pancreatic enzyme activities mature with age

Antigenic diversity is generated by distinct evolutionary mechanisms in African trypanosome species

Antigenic variation enables pathogens to avoid the host immune response by continual switching of surface proteins. The protozoan blood parasite Trypanosoma brucei causes human African trypanosomiasis ("sleeping sickness") across sub-Saharan Africa and is a model system for antigenic variation, surviving by periodically replacing a monolayer of variant surface glycoproteins (VSG) that covers its cell surface. We compared the genome of Trypanosoma brucei with two closely related parasites Trypanosoma congolense and Trypanosoma vivax, to reveal how the variant antigen repertoire has evolved and how it might affect contemporary antigenic diversity. We reconstruct VSG diversification showing that Trypanosoma congolense uses variant antigens derived from multiple ancestral VSG lineages, whereas in Trypanosoma brucei VSG have recent origins, and ancestral gene lineages have been repeatedly co-opted to novel functions. These historical differences are reflected in fundamental differences between species in the scale and mechanism of recombination. Using phylogenetic incompatibility as a metric for genetic exchange, we show that the frequency of recombination is comparable between Trypanosoma congolense and Trypanosoma brucei but is much lower in Trypanosoma vivax. Furthermore, in showing that the C-terminal domain of Trypanosoma brucei VSG plays a crucial role in facilitating exchange, we reveal substantial species differences in the mechanism of VSG diversification. Our results demonstrate how past VSG evolution indirectly determines the ability of contemporary parasites to generate novel variant antigens through recombination and suggest that the current model for antigenic variation in Trypanosoma brucei is only one means by which these parasites maintain chronic infections

Neural correlates of enhanced visual short-term memory for angry faces: An fMRI study

Copyright: © 2008 Jackson et al.Background: Fluid and effective social communication requires that both face identity and emotional expression information are encoded and maintained in visual short-term memory (VSTM) to enable a coherent, ongoing picture of the world and its players. This appears to be of particular evolutionary importance when confronted with potentially threatening displays of emotion - previous research has shown better VSTM for angry versus happy or neutral face identities.Methodology/Principal Findings: Using functional magnetic resonance imaging, here we investigated the neural correlates of this angry face benefit in VSTM. Participants were shown between one and four to-be-remembered angry, happy, or neutral faces, and after a short retention delay they stated whether a single probe face had been present or not in the previous display. All faces in any one display expressed the same emotion, and the task required memory for face identity. We find enhanced VSTM for angry face identities and describe the right hemisphere brain network underpinning this effect, which involves the globus pallidus, superior temporal sulcus, and frontal lobe. Increased activity in the globus pallidus was significantly correlated with the angry benefit in VSTM. Areas modulated by emotion were distinct from those modulated by memory load.Conclusions/Significance: Our results provide evidence for a key role of the basal ganglia as an interface between emotion and cognition, supported by a frontal, temporal, and occipital network.The authors were supported by a Wellcome Trust grant (grant number 077185/Z/05/Z) and by BBSRC (UK) grant BBS/B/16178

Observation of Ultra-high-energy Cosmic Rays with the ANITA Balloon-borne Radio Interferometer

We report the observation of sixteen cosmic ray events of mean energy of 1.5 x 10^{19} eV, via radio pulses originating from the interaction of the cosmic ray air shower with the Antarctic geomagnetic field, a process known as geosynchrotron emission. We present the first ultra-wideband, far-field measurements of the radio spectral density of geosynchrotron emission in the range from 300-1000 MHz. The emission is 100% linearly polarized in the plane perpendicular to the projected geomagnetic field. Fourteen of our observed events are seen to have a phase-inversion due to reflection of the radio beam off the ice surface, and two additional events are seen directly from above the horizon.Comment: 5 pages, 5 figures, new figure adde

Ultra-Relativistic Magnetic Monopole Search with the ANITA-II Balloon-borne Radio Interferometer

We have conducted a search for extended energy deposition trails left by ultra-relativistic magnetic monopoles interacting in Antarctic ice. The non-observation of any satisfactory candidates in the 31 days of accumulated ANITA-II flight data results in an upper limit on the diffuse flux of relativistic monopoles. We obtain a 90% C.L. limit of order 10^{-19}/(cm^2-s-sr) for values of Lorentz boost factor 10^{10}<gamma at the anticipated energy E=10^{16} GeV. This bound is stronger than all previously published experimental limits for this kinematic range.Comment: updated to version accepted by Phys. Rev.

A study of patent thickets

Report analysing whether entry of UK enterprises into patenting in a technology area is affected by patent thickets in the technology area

Expanding the Diversity of Mycobacteriophages: Insights into Genome Architecture and Evolution

Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists