Spontaneous Pushing vs Directed Valsalva Pushing

The purpose of this study is to determine if spontaneous pushing during the second stage of labor produces better maternal outcomes than the more commonly used directed Valsalva pushing. A literature review of the recent studies has been performed to determine if Valsalva pushing is simply archaic or absolutely necessary for healthier mother/baby outcomes. To recommend that women go against their primal urges to push in the man­ner that their own bodies are directing them, indicates that there must be research-based evidence to intervene in the natural order of things and use Valsalva pushing instead. When in fact, there are several study results proving that women using spontaneous pushing experienced less pain, fatigue, and appreciated an overall more positive experience over directed Valsalva pushing. Another study revealed decreased bladder capacity and problems with the first urge to void three months postpartum after use of the Valsalva pushing technique. The only current evidence to support directed Valsalva pushing is due to a shorter second stage of labor, although, despite the shorter duration, the maternal and fetal outcomes were the same using both techniques. At this point in time there does not seem to be enough research-based evidence to recommend one pushing technique over the other, therefore the only recommendation should be to allow birthing mothers to push naturally and sponta­neously, when their bodies instinctively tell them it is time to push

Ibuprofen Blunts Ventilatory Acclimatization to Sustained Hypoxia in Humans.

Ventilatory acclimatization to hypoxia is a time-dependent increase in ventilation and the hypoxic ventilatory response (HVR) that involves neural plasticity in both carotid body chemoreceptors and brainstem respiratory centers. The mechanisms of such plasticity are not completely understood but recent animal studies show it can be blocked by administering ibuprofen, a nonsteroidal anti-inflammatory drug, during chronic hypoxia. We tested the hypothesis that ibuprofen would also block the increase in HVR with chronic hypoxia in humans in 15 healthy men and women using a double-blind, placebo controlled, cross-over trial. The isocapnic HVR was measured with standard methods in subjects treated with ibuprofen (400 mg every 8 hrs) or placebo for 48 hours at sea level and 48 hours at high altitude (3,800 m). Subjects returned to sea level for at least 30 days prior to repeating the protocol with the opposite treatment. Ibuprofen significantly decreased the HVR after acclimatization to high altitude compared to placebo but it did not affect ventilation or arterial O2 saturation breathing ambient air at high altitude. Hence, compensatory responses prevent hypoventilation with decreased isocapnic ventilatory O2-sensitivity from ibuprofen at this altitude. The effect of ibuprofen to decrease the HVR in humans provides the first experimental evidence that a signaling mechanism described for ventilatory acclimatization to hypoxia in animal models also occurs in people. This establishes a foundation for the future experiments to test the potential role of different mechanisms for neural plasticity and ventilatory acclimatization in humans with chronic hypoxemia from lung disease

Culturally Relevant Health Education: A Foundation for Building Cultural Competence of Health Professionals

Background: Professionals educating ethnic minority populations should employ a cultural focus during development, training, refinement and implementation stages of an intervention. Purpose: This manuscript posits that the skill of developing a culturally relevant curriculum supports the increase of cultural competence proficiency of professionals, while promoting health equity. Methods: A community-based participatory research-trained staff, recruited 378 families with 2 to 8-year-old children. Eight intergenerational focus groups were conducted at neighborhood facilities. Graduate fellows conducted reviews of literature and health directives to conceptualize the curriculum. Spanish-speaking students and promotoras (community health workers) having participants’ confidence, presented healthy lifestyle information and taught practical skills to each group of 12-16 low-income Latino families from Long Beach, CA. With attention to participants’ preferred language, educational level, cultural beliefs, practices and food preferences, the intervention demonstrates a culturally relevant curriculum. Hands-on activities and motivational interviewing questions enriched the 4-hour intervention delivered in Spanish. Results: Graduate fellows’ cultural competence increased. More than 97% of participants reported sessions beneficial to their families’ health with 84% attending all sessions/assessments. Participants found the content easy to understand and helpful to eat healthier and be more active. Conclusion: Sanos y Fuertes is a model for developing a culturally relevant, family-based healthy lifestyle educational curriculum and building culturally competent health professionals

Primary Outcomes of a Healthy Lifestyle Interventions for Latino Families

Latinos, especially children, are disproportionately affected by obesity. Sanos y Fuertes is a community-based, participatory research project that created a culturally resonant, bilingual, healthy lifestyle intervention for Latinos in California. Results of the program for families are presented. Methods: The sample consisted of 390 Latino families with at least one 2 to 8-year-old child. Confidential, self-report, paper-and-pencil surveys and objective anthropometrics were assessed. Paired sample t-tests evaluated changes between baseline-to-follow-up assessments. Results: A significant decrease was observed in children’s percent body fat, but not in adults. Improvements were found in adult knowledge, frequency of food label use and serving MyPlate portions. Adult frequency of breakfast, fruit, and vegetable intake increased, while frequency of sugary beverage intake decreased. Concomitant increases in parent-reported frequencies of children’s intake of breakfast, fruits, and vegetables were observed along with a less frequent intake of sugary beverage. Conclusion: Sanos y Fuertes is a promising, short-term healthy lifestyle education program which may lower obesity risk among Latino families. Replication in a randomized controlled trial is needed to establish its effectiveness among diverse Latino populations

Teaching Culture Indicators: Enhancing Quality Teaching

Canadian postsecondary institutions are committed to providing students with high quality teaching and learning experiences. In recent years, provincial and institutional stakeholders have shifted their focus toward better supporting this effort and enhancing an evolving, teaching- and learning-centred institutional culture. As Cox, McIntosh, Reason, and Terenzini (2011) note, a culture with improved teaching quality is likely to lead to improved student engagement and learning. Researchers in the United States, Europe, and Australia have investigated institutional culture and its relationship to high quality teaching over the last 20 years (Aitken & Sorcinelli, 1994; Cox et al., 2011; Hodge, Nadler, Shore, & Taylor, 2011; Gosling, 2013; Harvey & Stensaker, 2008; Kallioinen, 2013; Hunt, 2013, Prosser, 2013); however, to date, there is little, if any, research done in this area in the Canadian context.https://scholar.uwindsor.ca/ctlreports/1004/thumbnail.jp

Comet C/2004 Q2 (MACHHOLZ): Parent Volatiles, a Search for Deuterated Methane, and Constraint on the CH4 Spin Temperature

High-dispersion (l/dl ~ 25,000) infrared spectra of Comet C/2004 Q2 (Machholz) were acquired on Nov. 28-29, 2004, and Jan. 19, 2005 (UT dates) with NIRSPEC at the Keck-2 telescope on Mauna Kea. We detected H2O, CH4, C2H2, C2H6, CO, H2CO, CH3OH, HCN, and NH3 and we conducted a sensitive search for CH3D. We report rotational temperatures, production rates, and mixing ratios (with respect to H2O) at heliocentric distances of 1.49 AU (Nov. 2004) and 1.21 AU (Jan. 2005). We highlight three principal results: (1) The mixing ratios of parent volatiles measured at 1.49 AU and 1.21 AU agree within confidence limits, consistent with homogeneous composition in the mean volatile release from the nucleus of C/2004 Q2. Notably, the relative abundance of C2H6/C2H2 is substantially higher than those measured in other comets, while the mixing ratios C2H6/H2O, CH3OH/H2O, and HCN/H2O are similar to those observed in comets, referred to as "organics-normal". (2) The spin temperature of CH4 is > 35-38 K, an estimate consistent with the more robust spin temperature found for H2O. (3) We obtained a 3s upper limit of CH3D/CH4 < 0.020 (D/H < 0.005). This limit suggests that methane released from the nucleus of C/2004 Q2 is not dominated by a component formed in extremely cold (near 10 K) environments. Formation pathways of both interstellar and nebular origin consistent with the measured D/H in methane are discussed. Evaluating the relative contributions of these pathways requires further modeling of chemistry including both gas-phase and gas-grain processes in the natal interstellar cloud and in the protoplanetary disk.Comment: Accepted by The Astrophysical Journa

Teaching Culture Perception: Documenting and Transforming Institutional Teaching Cultures

An institutional culture that values teaching is likely to lead to improved student learning. The main focus of this study was to determine faculty, graduate and undergraduate students’ perception of the teaching culture at their institution and identify indicators of that teaching culture. Themes included support for teaching development; support for best practices, innovative practices and specific effective behaviours; recognition of teaching; infrastructure; evaluation of teaching and implementing the student feedback received from teaching evaluations. The study contributes to a larger project examining the quality of institutional teaching culture

Discovery of Soft-Drug Topical Tool Modulators of Sphingosine-1-phosphate Receptor 1 (S1PR1)

In order to study the role of S1PRs in inflammatory skin disease, S1PR modulators are dosed orally and topically in animal models of disease. The topical application of S1PR modulators in these models may, however, lead to systemic drug concentrations, which can complicate interpretation of the observed effects. We set out to design soft drug S1PR modulators as topical tool compounds to overcome this limitation. A fast follower approach starting from the drug ponesimod allowed the rapid development of an active phenolic series of soft drugs. The phenols were, however, chemically unstable. Protecting the phenol as an ester removed the instability and provided a compound that is converted by enzymatic hydrolysis in the skin to the phenolic soft drug species. In simple formulations, topical dosing of these S1PR modulators to mice led to micromolar skin concentrations but no detectable blood concentrations. These topical tools will allow researchers to investigate the role of S1PR in skin, without involvement of systemic S1PR biology

"Women's rights, the European Court and Supranational Constitutionalism"

This analysis examines supranational constitutionalism in the European Union. In particular, the study focuses on the role of the European Court of Justice in the creation of women’s rights. I examine the interaction between the Court and member state governments in legal integration, and also the integral role that women’s advocates – both individual activists and groups – have played in the development of EU social provisions. The findings suggest that this litigation dynamic can have the effect of fueling the integration process by creating new rights that may empower social actors and EU organizations, with the ultimate effect of diminishing member state government control over the scope and direction of EU law. This study focuses specifically on gender equality law, yet provides a general framework for examining the case law in subsequent legal domains, with the purpose of providing a more nuanced understanding of supranational governance and constitutionalism

Morphine paradoxically prolongs neuropathic pain in rats by amplifying spinal NLRP3 inflammasome activation

Pain after disease/damage of the nervous system is predominantly treated with opioids, but without exploration of the long-term consequences. We demonstrate that a short course of morphine after nerve injury doubles the duration of neuropathic pain. Using genetic and pharmacological interventions, and innovative Designer Receptor Exclusively Activated by Designer Drugs disruption of microglia reactivity, we demonstrate that opioid-prolonged neuropathic pain arises from spinal microglia and NOD-like receptor protein 3 inflammasome formation/activation. Inhibiting these processes permanently resets amplified pain to basal levels, an effect not previously reported. These data support the “two-hit hypothesis” of amplification of microglial activation—nerve injury being the first “hit,” morphine the second. The implications of such potent microglial “priming” has fundamental clinical implications for pain and may extend to many chronic neurological disorders