Evaluation of the Volunteer Doula Program at Brookings Health System

The 12-month research project included interviews and focus groups with key stakeholders, as well as an evaluation of promotional materials. An interdisciplinary team of researchers from South Dakota State University (SDSU) partnered with OB and PR/Marketing staff at Brookings Health System (BHS) to evaluate the volunteer doula program. The team collaboratively recruited participants and developed interview questions for key stakeholders, including: OB nurses and doctors, volunteer doulas, expectant parents, and mothers. Promotional materials were also evaluated by a persuasion expert. Our findings are drawn from interviews with 15 BHS staff, 9 doulas

Epidemiology of gastroschisis: A population-based study in California from 1995 to 2012.

BackgroundAlthough the incidence of gastroschisis is increasing, risk factors are not clearly identified.MethodsUsing the Linked Birth Database from the California Office of Statewide Health Planning and Development from 1995 to 2012, patients with gastroschisis were identified by ICD-9 diagnosis/procedure code or birth certificate designation. Logistic regressions examined demographics, birth factors, and maternal exposures on risk of gastroschisis.ResultsThe prevalence of gastroschisis was 2.7 cases per 10,000 live births. Patients with gastroschisis had no difference in fetal exposure to alcohol (p = 0.609), narcotics (p = 0.072), hallucinogenics (p = 0.239), or cocaine (p = 0.777), but had higher exposure to unspecified/other noxious substances (OR 3.27, p = 0.040; OR 2.02, p = 0.002). Gastroschisis was associated with low/very low birthweight (OR 5.08-16.21, p < 0.001) and preterm birth (OR 3.26-10.0, p < 0.001). Multivariable analysis showed lower risk in black (OR 0.44, p < 0.001), Asian/Pacific Islander (OR 0.76, p = 0.003), and Hispanic patients (OR 0.72, p < 0.001) compared to white patients. Risk was higher in rural areas (OR 1.24-1.76, p = 0.001). Compared to women age < 20, risk decreased with advancing maternal age (OR 0.49-OR 0.03, p < 0.001). Patients with gastroschisis had increased total charges ($336,270 vs.$9012, p < 0.001) and length of stay (38.1 vs. 2.9 days, p < 0.001). Mortality was 4.6%.ConclusionsThis is the largest population-based study summarizing current epidemiology of gastroschisis in California.Type of studyRetrospective comparative cohort study.Level of evidenceIII

Blending Qualitative, Quantitative, and Rhetorical Methods to Engage Citizens in Public Deliberation to Improve Workplace Breastfeeding Support

To improve breastfeeding support in local businesses in Brookings, SD, researchers from South Dakota State University partnered with Brookings Health System, the Brookings Area Chamber of Commerce, local breastfeeding advocates, and an expert public deliberation moderator to conduct community-based participatory research leading to a public deliberation event. The collaborative team took a mixed-methods approach, using qualitative, quantitative, and rhetorical methods to collect and analyze data across two phases of the project: formative research (Phase I) and implementation (Phase II). During Phase I, the team conducted focus groups and marketed the project. Results from Phase I shaped the conversations at the public deliberation event in Phase II. At the event, community members deliberated about the issue of breastfeeding support in Brookings businesses, and they identified action steps. Following that event, the community members delegated actions and the collaborative team disseminated results from the project. This case study emphasizes the collaborative nature of communitybased participatory research and the importance of clear communication throughout the process. In each stage of the project, every team member was meaningfully involved with the research process and had ownership of the products we produced. This level of collaboration was made possible through clear communication between team members that came from very different backgrounds, for example, education, health, or business. Team members respectfully listened to each other’s diverse perspectives and provided unique expertise; the team then modeled those same communication skills with the community as it sought community input and led a public deliberation event

Report on the Community Conversation on Breastfeeding in Brookings Businesses

The Brookings Supports Breastfeeding (BSB) team hosted a Community Conversation on Breast feeding in Brookings Businesses, a public deliberation event on November 1, 2014. The deliberation focused on the question, “How can our community support the breastfeeding experience in Brookings businesses?” The event was held from 10am-2pm at the McCrory Gardens Education &Visitor Center in Brookings, SD. Background The BSB project is a community effort to promote dialogue and deliberation about supporting breastfeeding in Brookings businesses. It is funded through a Community Innovation grant from the Bush Foundation, and is a partnership between South Dakota State University (SDSU), the Brookings Area Chamber of Commerce, Brookings Health System, community breastfeeding advocates, and a public deliberation expert from Wabash College (IN). Focus Groups To prepare for the event, the BSB team conducted 6focusgroups:3with breastfeeding mothers and 3 with business representatives. From the focus groups, the team learned that: 1) support for breastfeeding in Brookings is growing, 2) some businesses already provide breast feeding support, and 3) breastfeeding support in Brookings can be improved. Based on these findings, the BSB team created a deliberation guide for the Community Conversation event. The guide and event focused on 3different approaches to improving breastfeeding support in Brookings businesses. Event On November 1, 2014, more than 70 community members attended the Community Conversation. At 10 tables, community members participated in directed discussions led by trained facilitators (community members and SDSU students). At each table, facilitators and note takers recorded key aspects of the conversation; the conversations were also audio recorded. Each participant had a copy of the Community Conversation guide and was encouraged to complete pre-and post-event surveys. Report This report presents a summary of the conversations and the preferred actions generated by participants at the event; it is not a portrayal of the opinions of the entire Brookings community. The report is an accurate and complete portrayal of the most frequent themes and supporting arguments, while also identifying less dominant butt still significant topics. It is based on table notes, facilitator post-event worksheets, and participant surveys from the event. The report includes an overview of the procedures from the event, an analysis of participants’ perceptions of the problem and conversations about each approach, and a summary of the preferred actions from the tables and from individuals

A preliminary investigation into worry about mental health: Development of the mental health anxiety inventory

Background: Worry about physical health is broadly referred to as health anxiety and can range from mild concern to severe or persistent anxiety such as that found in DSM-IV hypochondriasis. While much is known about anxiety regarding physical health, little is known about anxiety regarding mental health. However, recent conceptualizations of health anxiety propose that individuals can experience severe and problematic worry about mental health in similar ways to how people experience extreme worry about physical health. Aims: Given the paucity of research in this area, the aim of the current study was to explore anxiety regarding mental health through validation of the Mental Health Anxiety Inventory (MHAI), a modified version of the Short Health Anxiety Inventory. Method: The MHAI, and measures of state anxiety (Depression, Anxiety and Stress Scales-21), trait worry (Penn State Worry Questionnaire), and health anxiety (Short Health Anxiety Inventory) were administered to 104 adult volunteers from the general community. Results: The MHAI demonstrated high internal consistency, acceptable test-retest reliability, and good construct validity when correlated with other measures of anxiety. Results also indicated that participants worried about their mental health and physical health equally, and that almost 9% of participants reported levels of mental health anxiety that were potentially problematic. Conclusion: Preliminary results suggest that a small proportion of adults in the community may experience high levels of mental health anxiety requiring treatment, and that the MHAI, if validated further, could be a useful tool for assessing this form of anxiet

Racial Disparities in Caesarean Delivery Among Nulliparous Women that Delivered at Term: Cross-Sectional Decomposition Analysis of Nebraska Birth Records

Background: Access to medically indicated caesarean sections is an essential strategy for reducing maternal and infant mortality rates worldwide. However, overuse of medically unnecessary caesarean sections is associated with excess maternal-child morbidity. Previous studies suggest higher rates of caesarean section among women who identify as racial/ethnic minorities. Significance of Problem: Despite national efforts to prioritize the reduction of medically unnecessary caesarean sections, caesareans rates in the United States have remained stable over the last decade. Women who identify as racial or ethnic minorities experience disproportionally higher rates of caesarean, even when controlling for demographic, behavioral, medical, and institutional level factors. However, detailed analysis of factors contributing to racial/ethnic disparities in caesarean section rates remains largely unexplored. Identifying these factors and assessing their relative importance is critical for the development of interventions specifically tailored to reduce racial and ethnic disparities in caesarean use. Question: The objective of this study was to understand underlying social and demographic factors that contribute to differences in caesarean rates across racial and ethnic groups. Experimental Design: Data was collected from 2005-2014 Nebraska birth records on singleton births occurring on or after 37 weeks gestation (n=87,908). Risk ratios (RR) and 95% confidence intervals (CI) for caesarean were calculated for different racial and ethnic categories. Fairlie decomposition technique was utilized to quantify the contribution of individual variables to the observed differences in caesarean. Results: In the adjusted analysis, relative to non-Hispanic (NH) White race, both Asian-NH (RR 1.21, 95% CI 1.14, 1.28) and Black-NH races (RR 1.13, 95% CI 1.08, 1.19) were associated with a significantly higher risk for caesarean. The decomposition analysis showed that among the variables assessed, maternal age, education, and pre-pregnancy BMI contributed the most to the observed differences in caesarean rates across racial/ethnic groups. Conclusion: This analysis quantified the effect of social and demographic factors on racial differences in caesarean delivery, which may guide public health interventions aimed towards reducing racial disparities in caesarean rates. Interventions targeted towards modifying maternal characteristics, such as reducing pre-pregnancy BMI or increasing maternal education, may narrow the gap in caesarean rates across racial and ethnic groups. Future studies should determine the contribution of physician characteristics, hospital characteristics, and structural determinants of health towards racial disparities in caesarean rates.https://digitalcommons.unmc.edu/chri_forum/1064/thumbnail.jp

Differential Requirements for COPI Coats in Formation of Replication Complexes among Three Genera of Picornaviridae

Picornavirus RNA replication requires the formation of replication complexes (RCs) consisting of virus-induced vesicles associated with viral nonstructural proteins and RNA. Brefeldin A (BFA) has been shown to strongly inhibit RNA replication of poliovirus but not of encephalomyocarditis virus (EMCV). Here, we demonstrate that the replication of parechovirus 1 (ParV1) is partly resistant to BFA, whereas echovirus 11 (EV11) replication is strongly inhibited. Since BFA inhibits COPI-dependent steps in endoplasmic reticulum (ER)-Golgi transport, we tested a hypothesis that different picornaviruses may have differential requirements for COPI in the formation of their RCs. Using immunofluorescence and cryo-immunoelectron microscopy we examined the association of a COPI component, ß-COP, with the RCs of EMCV, ParV1, and EV11. EMCV RCs did not contain ß-COP. In contrast, ß-COP appeared to be specifically distributed to the RCs of EV11. In ParV1-infected cells ß-COP was largely dispersed throughout the cytoplasm, with some being present in the RCs. These results suggest that there are differences in the involvement of COPI in the formation of the RCs of various picornaviruses, corresponding to their differential sensitivity to BFA. EMCV RCs are likely to be formed immediately after vesicle budding from the ER, prior to COPI association with membranes. ParV1 RCs are formed from COPI-containing membranes but COPI is unlikely to be directly involved in their formation, whereas formation of EV11 RCs appears to be dependent on COPI association with membranes

On the magnetic structure of the solar transition region

We examine the hypothesis that ``cool loops'' dominate emission from solar transition region plasma below temperatures of $2\times10^5$K. We compare published VAULT images of H L$\alpha$, a lower transition region line, with near-contemporaneous magnetograms from Kitt Peak, obtained during the second flight (VAULT-2) on 14 June 2002. The measured surface fields and potential extrapolations suggest that there are too few short loops, and that L$\alpha$ emission is associated with the base regions of longer, coronal loops. VAULT-2 data of network boundaries have an asymmetry on scales larger than supergranules, also indicating an association with long loops. We complement the Kitt Peak data with very sensitive vector polarimetric data from the Spectro-Polarimeter on board Hinode, to determine the influence of very small magnetic concentrations on our analysis. From these data two classes of behavior are found: within the cores of strong magnetic flux concentrations ($> 5\times10^{18}$ Mx) associated with active network and plage, small-scale mixed fields are absent and any short loops can connect just the peripheries of the flux to cell interiors. Core fields return to the surface via longer, most likely coronal, loops. In weaker concentrations, short loops can connect between concentrations and produce mixed fields within network boundaries as suggested by Dowdy and colleagues. The VAULT-2 data which we examined are associated with strong concentrations. We conclude that the cool loop model applies only to a small fraction of the VAULT-2 emission, but we cannot discount a significant role for cool loops in quieter regions. We suggest a physical picture for how network L$\alpha$ emission may occur through the cross-field diffusion of neutral atoms from chromospheric into coronal plasma.Comment: Accepted by ApJ, 9 May 200

A two-species continuum model for aeolian sand ripples

We formulate a continuum model for aeolian sand ripples consisting of two species of grains: a lower layer of relatively immobile clusters, with an upper layer of highly mobile grains moving on top. We predict analytically the ripple wavelength, initial ripple growth rate and threshold saltation flux for ripple formation. Numerical simulations show the evolution of realistic ripple profiles from initial surface roughness via ripple growth and merger.Comment: 9 pages, 3 figure