Psychometric properties of the newly translated creole multidimensional scale of perceived social support (MSPSS) and perceived adequacy of resource scale (PARS) and the relationship between perceived social support and resources in Haitian mothers in the US

Background Low income postpartum mothers with little to no social support have increased maternal and infant morbidity and mortality, especially those with limited English proficiency and limited accesses to resources. Haitians, a growing minority in the US are an understudied population excluded from most studies due to the lack of instruments in Creole. The most widely used instruments for measuring social support, the Multidimensional Scale of Perceived Social Support (MSPSS) and Perceived Adequacy of Resource Scale (PARS), are not available in Creole. Currently, there are no published studies on the psychometric properties of the MSPSS or the PARS in Creole. Data from Haitian mothers are needed to identify potential postpartum mothers and infants most at risk of developing adverse maternal and infant outcomes from a lack of social support and perceived resources. The purpose of this study is to test the psychometrics of the newly-translated Creole instruments of the MSPSS and PARS with a sample of bilingual (Creole/English) mothers. Methods The MSPSS and PARS were translated and back translated from English to Creole. The adapted Creole versions of the instruments were tested using a convenience sample. A total of 85 Haitian mothers? completed both instruments in Creole and English 2æweeks apart. Result Internal consistency reliability and stability were strong for both the MSPSS and PARS (.91?.99). The two instruments had strong reliability and validity for the translated Creole versions and similar to the English versions. Conclusion The MSPSS and PARS are a valid measure of perceived social support and resources. Psychometric findings suggest that the newly translated Creole versions are good representations of the English versions indicating the translation process was successful. The newly translated instruments available in Creole provide non-English speaking Haitian mothers the opportunity to participate in studies

Comparing Mothers\u27 Postpartum Concerns in 2 Clinical Trials 18 Years Apart

Background/purpose To determine if US women\u27s postpartum concerns have changed overtime. Methods Mothers\u27 postpartum concerns were compared in 2 clinical trials: 1997 (High Risk Pregnancy); 2015 (First Time Mothers). Advanced Practice Nurses (APNs) provided care through 8 weeks postpartum and recorded interactions in clinical logs. Content analysis of logs was used to identify concerns. Results 95% of 58 1997 mothers were African American; 64% of 62 2015 mothers were Hispanic. Number of infant concerns (129 vs 144) was similar as were 4 of top 5; infant feeding was the top concern for both. 1997 mothers were concerned with body changes, birth control, breastfeeding, maternal health problems and had more concerns about their health (142 vs. 43); 2015 mothers were concerned with not having help, fatigue, finding things hard. Both groups had postpartum pain concerns and problems accessing mother/infant governmental programs. Conclusions Mother\u27s concerns regarding infant care were essentially the same over the 2 time periods with infant feeding as the top concern. Maternal concerns in common were postpartum pain and needing help accessing government programs. Women who had high risk pregnancies had more health concerns. Implications for Practice Results provide guidance for helping minority mothers in the postpartum period

Health Problems and APN Interventions in Pregnant Women with Diabetes

The purpose of this study was to compare health problems and advanced practice nursing (APN) interventions in two types of APN care provided to 41 childbearing women with diabetes. The study’s design involved content analysis of interaction logs containing the process of APN care during two clinical trials: 1) APN care was added to physician care (n = 22); and, 2) half of physician care was substituted with APN care (n = 19). Women’s’ health problems and APN interventions were classified using the Omaha System’s Problem Scheme and Intervention Scheme. The women, in the study, had a mean age of 30, and were predominantly Black, high school graduates, with a low income. The findings identified 61,004 health problems and 60,980 APN interventions from the interaction logs. APNs provided significantly more interventions antenatally to the women in the substitution group than to those in the additive group. However, the overall categories of problems were the same in both groups. Surveillance and health teaching/counseling were the top APN interventions antenatally and postpartum. Case management interventions were third most common for both groups, while treatments and procedures constituted the least number of APN interventions in each group before and after birth. When APNs shared care more equally with physicians, they intervened differently in type and number of interventions. Their broad range of skills and depth of understanding in clinical practice, health systems, family and personal issues allowed them to intervene early and effectively. Correspondenc

Infant and Child Deaths: Parent Concerns about Subsequent Pregnancies

Purpose—examine parents\u27 concerns about subsequent pregnancies after experiencing an infant or child death (newborn to 18 years). Data Sources—39 semi-structured parent (White, Black, Hispanic) interviews 7 and 13 months post infant/child death conducted in English and/or Spanish, audio-recorded, transcribed and content analyzed. Mothers\u27 mean age was 31.8 years, fathers\u27 was 39 years; 11 parents were White, 16 Black, 12 Hispanic. Conclusions—Themes common at 7 and 13 months: wanting more children; fear, anxiety, scared; praying to God/God\u27s will; thinking about/keeping the infant\u27s/child\u27s memory and at 7 months importance of becoming pregnant for family members; and at 13 months happy about a new baby. Parents who lost a child in NICU commented more than those who lost a child in PICU. Black and Hispanic parents commented more on praying to God and subsequent pregnancies being God\u27s will than White parents. Implications for Practice—Loss of an infant/child is a significant stressor on parents with documented negative physical and mental health outcomes. Assessing parents\u27 subsequent pregnancy plans, recognizing the legitimacy of their fears about another pregnancy, discussing a plan should they encounter problems and carefully monitoring the health of all parents who lost an infant/child is an essential practitioner role

Women With High-Risk Pregnancies, Problems, and APN Interventions

Purpose To (a) describe women’s prenatal and postpartum problems and advanced practice nurses (APN) interventions; and (b) determine if problems and APN interventions differed by women’s medical diagnosis (diabetes, hypertension, preterm labor). Design and Methods Content analysis of 85 interaction logs created by APNs during a randomized clinical trial in which half of physician-provided prenatal care was substituted with APN-provided prenatal care in the women’s homes. Patients’ problems and APN interventions were classified with the Omaha Classification System. Findings A total of 212,835 health problems and 212,835 APN interventions were identified. The dominant antenatal problems were physiologic (59.2%) and health-related behaviors (33.3%); postpartum were physiologic (44.0%) and psychosocial problems (31.6%). Antenatally, women with diabetes had significantly more health-related behavior problems; women with preterm labor had more physiologic problems. APN surveillance interventions predominated antenatally (65.6%) and postpartum (66.0%), followed by health teaching, guidance, and counseling both antenatally (25.4%) and postpartum (28.1 %). Women with chronic hypertension required significantly more case-management interventions. Conclusions The categories of women’s problems were largely similar across medical diagnostic groups. Interventions to address women’s problems ranged from assessing maternal and fetal physiologic states to teaching interpersonal relationships and self-care management to assisting with transportation and housing. Data show the range of APN knowledge and skills needed to improve maternal and infant outcomes and ultimately reduce healthcare costs in women with high-risk pregnancies

School functioning and violent behavior among young adolescents: a contextual analysis

This paper examines associations between overall school functioning and the frequency of violent behaviors among young adolescents (ages 10–14). The sample included 16 middle schools participating in an unrelated intervention study (on nutrition) in Minneapolis, Minnesota. A School Functioning Index developed to characterize schools’ overall stability, performance, and demographics was constructed using data from public archives and school administrator surveys. Data on violent behaviors and other variables were collected in student surveys in fall 1998 and spring 1999. We used multilevel modeling to assess the effect of school functioning on violent behavior after adjusting for known individual-level covariates of violent behaviors. We found an interaction between school functioning (group-level variable) and expectations for future education (individual-level variable). Among students who reported expectations of completing a college degree (71% of the sample), positive school functioning was negatively associated with violent behaviors. Among students that reported expectations of completing less than a college degree, no association was found between school functioning and violent behaviors. These results support earlier work suggesting that objectively measured school characteristics are associated with students’ violent behaviors even after accounting for individual-level factors and also identify a subgroup of students for whom school detachment may be an issue

The Causal Approach to Measurement Error in Panel Analysis: Some Further Contingencies

The authors describe and analyze some issues in understanding causality from panel designs. They focus on complications that arise when multivariate panel models are measured with either random or systematic errors. The analysis is illustrated with panel from the U.N. of education and economic data from 96 countries. They conclude that new statistics, to be developed or imported from other disciplines are needed to deal with measurement error in substantive panel data

Anorexia nervosa and nutritional assessment: contribution of body composition measurements

article aims at reviewing present knowledge on these topics in order to determine energy requirements for maintaining a neutral energy balance in ALS patients. Maintaining a neutral energy balance prevents malnutrition and its complications and may improve physical functioning, quality of life and survival. Prevalence of malnutrition varies between 16 and 55% in ALS patients. Energy intakes are below recommended dietary allowances in 70% of ALS patients at least. These elements suggest a chronic negative energy balance with an imbalance between requirements and intakes. While insufficient intakes can be compensated with nutritional support, the energy requirements are unclear. Studies generally report hypermetabolism in ALS patients. Estimation of total energy expenditure and as a corollary energy needs, necessitates taking into account this hypermetabolism, physical activity and possibly mechanical ventilation. The review suggests a flow chart for optimal nutritional follow-up in clinics. Further studies are required to assess whether optimal nutritional follow-up improves outcome

‘Working on a rocky shore’: Micro-moments of positive affect in academic work

Neoliberal ideologies, marketization and performative regimes ssociated with recent reforms in universities have exerted considerable pressure on academic working conditions and subjects in recent years. While analysing these pressures is important, it is also productive to consider the ways in which academics engage in moments of resistance by mobilising resources beyond those of critique. This paper therefore focuses on joy and positive affect in the everyday moments of academic life. It utilises the feminist methodology of collective biography to explore ways of making the restricted spaces of our working day more expansive and finding within them unexpected openings for joy. Our analysis of the stories included in this paper traces the mercurial and ambiguous affective atmospheres of academic work. We suggest that joy is founded upon connections with others, that it arises in different academic spaces and that it can lead to revised knowing of ourselves. We argue that the glimpses of joy evident in this paper provoke affective attunement within the everyday, sensitizing us to other fragments of joy and providing strategies to strengthen that resistance

Seabird Modulations of Isotopic Nitrogen on Islands

The transport of nutrients by migratory animals across ecosystem boundaries can significantly enrich recipient food webs, thereby shaping the ecosystems’ structure and function. To illustrate the potential role of islands in enabling the transfer of matter across ecosystem boundaries to be gauged, we investigated the influence of seabirds on nitrogen input on islands. Basing our study on four widely differing islands in terms of their biogeography and ecological characteristics, sampled at different spatial and temporal intervals, we analyzed the nitrogen isotopic values of the main terrestrial ecosystem compartments (vascular plants, arthropods, lizards and rodents) and their relationship to seabird values. For each island, the isotopic values of the ecosystem were driven by those of seabirds, which ultimately corresponded to changes in their marine prey. First, terrestrial compartments sampled within seabird colonies were the most enriched in δ15N compared with those collected at various distances outside colonies. Second, isotopic values of the whole terrestrial ecosystems changed over time, reflecting the values of seabirds and their prey, showing a fast turnover throughout the ecosystems. Our results demonstrate that seabird-derived nutrients not only spread across the terrestrial ecosystems and trophic webs, but also modulate their isotopic values locally and temporally on these islands. The wealth of experimental possibilities in insular ecosystems justifies greater use of these model systems to further our understanding of the modalities of trans-boundary nutrient transfers