Scaling Up Group Prenatal Care: Analysis Of The Current Situation And Recommendations For Future Research And Policy Actions

The United States consistently spends more on healthcare than other developed nations, but continues to suffer from inferior outcomes in maternal and infant morbidity and mortality. Innovation is needed within maternal and child healthcare to address these adverse outcomes. One identified innovative approach to tackle these issues is group prenatal care (GPNC). Women who participate in GPNC experience individual clinical care checks to monitor weight, blood pressure, and gestational age in addition to interactive learning and community-building activities and discussions. When compared to those who receive individual prenatal care, GPNC recipients have lower rates of preterm birth, fewer small for gestational age infants, less incident of sexually transmitted infections, and fewer depressive symptoms as well as increased patient satisfaction with care. GPNC has also shown to be cost-saving and is well received by patients and providers. Despite these positive outcomes, GPNC has yet to be widely adapted and utilized. This manuscript describes the challenges that are acting as barriers to a large-scale acceptance of GPNC, including logistical challenges, unsustainable financing mechanisms, and a mixed evidence-base and presents recommendations for future research and policy actions that could help overcome these challenges

Do clinicians perceive a connection between their personal and professional habits of self-disclosure? : a study exploring self-disclosure on social networking sites and in therapy

This qualitative, exploratory study used an interview method to understand if clinicians believed there was any connection between their online self-disclosure on social networking sites (SNS) and offline self-disclosure with clients. Twelve clinicians were asked a myriad of questions to address the perceptions of their disclosures in each arena and any potential relationship between their comfort and frequency to self-disclose online and in therapy. Using a relational theory lens to understand therapeutic self-disclosure, this research adds a new component to current clinical literature on the topic by comparing it to self-disclosure on social networking sites like Facebook. As a whole, clinicians in the study did not perceive a connection between their personal use of social networking sites and how often they self-disclosed with clients. Half the participants believed that their comfort to disclose in both places was related based on being limited and cautious with disclosures while the other half did not see the two categories as related. No one in this study indicated that increased comfort or frequency to selfdisclose online led to increased self-disclosures with clients. These results suggest that clinicians perceive online SNS self-disclosure in a different light than therapeutic self-disclosure and that they can engage in online social networking habits and professional roles simultaneously without blurring therapeutic boundaries. Participant demographics are addressed and discussion is offered in terms of the strengths and weaknesses of this research, the study\u27s implications, and suggestions for future exploration on this topic

Generating statistical distributions without maximizing the entropy

We show here how to use pieces of thermodynamics' first law to generate probability distributions for generalized ensembles when only level-population changes are involved. Such microstate occupation modifications, if properly constrained via first law ingredients, can be associated not exclusively to heat and acquire a more general meaning.Comment: 6 pages, no figures, Conferenc

Parameter-free ansatz for inferring ground state wave functions of even potentials

Schr\"odinger's equation (SE) and the information-optimizing principle based on Fisher's information measure (FIM) are intimately linked, which entails the existence of a Legendre transform structure underlying the SE. In this comunication we show that the existence of such an structure allows, via the virial theorem, for the formulation of a parameter-free ground state's SE-ansatz for a rather large family of potentials. The parameter-free nature of the ansatz derives from the structural information it incorporates through its Legendre properties

The role of recovered envelope cues in the identification of temporal-fine-structure speech for hearing-impaired listeners

Narrowband speech can be separated into fast temporal cues [temporal fine structure (TFS)], and slow amplitude modulations (envelope). Speech processed to contain only TFS leads to envelope recovery through cochlear filtering, which has been suggested to account for TFS-speech intelligibility for normal-hearing listeners. Hearing-impaired listeners have deficits with TFS-speech identification, but the contribution of recovered-envelope cues to these deficits is unknown. This was assessed for hearing-impaired listeners by measuring identification of disyllables processed to contain TFS or recovered-envelope cues. Hearing-impaired listeners performed worse than normal-hearing listeners, but TFS-speech intelligibility was accounted for by recovered-envelope cues for both groups.National Institutes of Health (U.S.) (Grant R43 DC013006)National Institutes of Health (U.S.) (Grant R01 DC00117

Thermodynamics' 0-th-Law in a nonextensive scenario

Tsallis' thermostatistics is by now recognized as a new paradigm for statistical mechanical considerations. However, it is still affected by a serious hindrance: the generalization of thermodynamics' zero-th law to a nonextensive scenario is plagued by difficulties. Here we show how to overcome this problem.Comment: 4 pages, latex; added references for section

Acceleration-extended Newton-Hooke symmetry and its dynamical realization

Newton-Hooke group is the nonrelativistic limit of de Sitter (anti-de Sitter) group, which can be enlarged with transformations that describe constant acceleration, as well as central charges. We consider a higher order Lagrangian that is quasi-invariant under the acceleration-extended Newton-Hooke symmetry, and obtain the Schr\"{o}dinger equation quantizing the Hamiltonian corresponding to its first order form. We show that the Schr\"{o}dinger equation is invariant under the acceleration-extended Newton-Hooke transformations. We also discuss briefly the exotic conformal Newton-Hooke symmetry in 2+1 dimension.Comment: 14 pages, revtex4; refs added, misleading statements revised, version to appear in Phys. Lett.

The clock paradox in a static homogeneous gravitational field

The gedanken experiment of the clock paradox is solved exactly using the general relativistic equations for a static homogeneous gravitational field. We demonstrate that the general and special relativistic clock paradox solutions are identical and in particular that they are identical for finite acceleration. Practical expressions are obtained for proper time and coordinate time by using the destination distance as the key observable parameter. This solution provides a formal demonstration of the identity between the special and general relativistic clock paradox with finite acceleration and where proper time is assumed to be the same in both formalisms. By solving the equations of motion for a freely falling clock in a static homogeneous field elapsed times are calculated for realistic journeys to the stars.Comment: Revision: Posted with the caption included with the figure

Masking Release for Igbo and English

In this research, we explored the effect of noise interruption rate on speech intelligibility. Specifically, we used the Hearing In Noise Test (HINT) procedure with the original HINT stimuli (English) and Igbo stimuli to assess speech reception ability in interrupted noise. For a given noise level, the HINT test provides an estimate of the signal-to-noise ratio (SNR) required for 50%-correct speech intelligibility. The SNR for 50%-correct intelligibility changes depending upon the interruption rate of the noise. This phenomenon (called Masking Release) has been studied extensively in English but not for Igbo – which is an African tonal language spoken predominantly in South Eastern Nigeria. This experiment explored and compared the phenomenon of Masking Release for (i) native English speakers listening to English, (ii) native Igbo speakers listening to English, and (iii) native Igbo speakers listening to Igbo. Since Igbo is a tonal language and English is a non-tonal language, this allowed us to compare Masking Release patterns on native speakers of tonal and non-tonal languages. Our results for native English speakers listening to English HINT show that the SNR and the masking release are orderly and consistent with other English HINT data for English speakers. Our result for Igbo speakers listening to English HINT sentences show that there is greater variability in results across the different Igbo listeners than across the English listeners. This result likely reflects different levels of ability in the English language across the Igbo listeners. The masking release values in dB are less than for English listeners. Our results for Igbo speakers listening to Igbo show that in general, the SNRs for Igbo sentences are lower than for English/English and Igbo/English. This means that the Igbo listeners could understand 50% of the Igbo sentences at SNRs less than those required for English sentences by either native or non-native listeners. This result can be explained by the fact that the perception of Igbo utterances by Igbo subjects may have been aided by the prediction of tonal and vowel harmony features existent in the Igbo language. In agreement with other studies, our results also show that in a noisy environment listeners are able to perceive their native language better than a second language. The ability of native language speakers to perceive their language better than a second language in a noisy environment may be attributed to the fact that: a) Native speakers are more familiar with the sounds of their language than second language speakers. b) One of the features of language is that it is predictable hence even in noise a native speaker may be able to predict a succeeding word that is scarcely audible. These contextual effects are facilitated by familiarity.National Institutes of Health (U.S.) (Grant R01 DC00117