Area-level poverty and preterm birth risk: A population-based multilevel analysis

<p>Abstract</p> <p>Background</p> <p>Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate.</p> <p>Methods</p> <p>Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group.</p> <p>Results</p> <p>PTB < 35 weeks occurred in 24,490 pregnancies (3.9%). The rate of PTB < 35 weeks was 2.8% in counties within the lowest quartile of poverty and increased through the 4^thquartile (4.9%), p < 0.0001. High county-level poverty was significantly associated with PTB risk. PTB risk (< 35 weeks) was increased for women who resided in counties within the highest quartile of poverty, adjusted odds ratio (_adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (< 32 weeks), _adjOR 1.27 (95% CI 1.06, 1.52).</p> <p>Conclusion</p> <p>Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.</p

Integrative Medicine Insights 2007: 2 15-23 Effect of Tai Chi Exercise on Type 2 Diabetes: A Feasibility Study

Abstract: This feasibility study investigated the effects of Tai Chi, a mind-body exercise, on management of Type 2 diabetes mellitus. A total of 25 subjects (20-70 years) were recruited to participate in two 60-minute instructed Tai Chi exercise sessions each week for 12 weeks. The primary outcome measures (physiological variables) were hemoglobin A 1 C (HbA1c) taken at baseline and after 12 weeks of intervention, and self-reported fasting blood glucose level measured at baseline, 3, 6, 9, and 12 weeks of intervention. The secondary outcome measures (psychosocial variables) were Diabetes Quality of Life Questionnaire (Diabetes-39) and Exercise Self-Effi cacy administered at baseline and 12 weeks. A semi-structured interview was conducted at the end of the study (week 12). Paired t-tests was employed to determine all pre-and postintervention measurement changes, while individual growth curves were generated to show changes in fasting blood glucose levels during the study period. A rather high attrition rate of 48% was observed among the participants. The data showed no signifi cant effect of Tai Chi on HbA1c and self-reported fasting blood glucose, although there seemed to be a trend of lowered HbA1c. Analysis of subjects&apos; response suggested a positive experience for those who completed the intervention

Effect of Tai Chi Exercise on Type 2 Diabetes: A Feasibility Study

This feasibility study investigated the effects of Tai Chi, a mind-body exercise, on management of Type 2 diabetes mellitus. A total of 25 subjects (20–70 years) were recruited to participate in two 60-minute instructed Tai Chi exercise sessions each week for 12 weeks. The primary outcome measures (physiological variables) were hemoglobin A 1 C (HbA1c) taken at baseline and after 12 weeks of intervention, and self-reported fasting blood glucose level measured at baseline, 3, 6, 9, and 12 weeks of intervention. The secondary outcome measures (psychosocial variables) were Diabetes Quality of Life Questionnaire (Diabetes-39) and Exercise Self-Efficacy administered at baseline and 12 weeks. A semi-structured interview was conducted at the end of the study (week 12). Paired t -tests was employed to determine all pre- and post-intervention measurement changes, while individual growth curves were generated to show changes in fasting blood glucose levels during the study period. A rather high attrition rate of 48% was observed among the participants. The data showed no significant effect of Tai Chi on HbA1c and self-reported fasting blood glucose, although there seemed to be a trend of lowered HbA1c. Analysis of subjects’ response suggested a positive experience for those who completed the intervention

“You Hear my Funny Accent?!”: Problematizing Assumptions about Afro-Caribbean “Teachers turned Educators”

Increasingly, teacher educators are required to prepare teachers for students in mainstream classrooms who are more culturally and linguistically diverse than ever before. Yet, calls for teacher educators to model enactments of curriculum and instruction concerning diversity expected of prospective teachers in U.S. K-12 classrooms have resulted in few efforts that attempt to understand and to document the personal predispositions, attitudes, beliefs, and experiences of culturally and linguistically diverse teacher educators. This study examines the learning of five vernacular-speaking Afro-Caribbean “teachers turned educators” (TTEs) about their multilingual and multicultural awareness after they migrated across cultures from their home countries to the United States. Findings indicated that the TTEs demonstrated learning about their awareness by modifying their intonation, message content, facial expressions, deciding to speak or to be silent, and identifying previously overlooked concerns about language in their home countries. Reflexivity was critical to learning about their multilingual awareness and specific sources for navigating cultural incongruence were useful for learning about their multicultural awareness. The TTEs developed “transnational linguistic fluidity” in their demonstration of awareness through learning, raising questions about the inadvertent assumption that immigrant, multilingual, and Black educators naturally reflect an awareness of language and culture