Using the March of Dimes "Becoming a Mom" Prenatal Program to Improve Maternal Attitudes and Knowledge

BACKGROUND: Premature birth, low birth weight, birth defects, and Sudden Infant Death Syndrome were identified as issues contributing to infant mortality in Kansas by the state’s Blue Ribbon Panel. The March of Dimes Becoming a Mom (BAM) prenatal program was implemented in four counties identified with high infant mortality rates and significant birth numbers (Geary, Saline, Sedgwick, and Shawnee) by the Kansas Blue Ribbon Panel. The purpose of this study was to identify the changes in prenatal attitudes, knowledge, and health outcomes among BAM program participants. METHODS: A collaborative community-based model incorporating multidisciplinary teams was created to address the health disparity gap in birth outcomes. Patients participated in multiple prenatal education sessions using a curriculum developed by the March of Dimes. A pre-/post-test design was implemented for the prenatal sessions. Changes in attitudes were assessed using descriptive statistics. Paired t-tests were used to assess the difference in knowledge questions from pre- and post-tests. Health outcomes were analyzed using descriptive statistics. RESULTS: Participants were 69% White, 87% spoke English, 64% were under age 26, 41% were employed full time, 45% had some high school or had a diploma, 39% had Medicaid, and 49% were enrolled in WIC (N=114). Participants demonstrated a statistically significant increase in knowledge among 14 out of 32 questions including: identifying signs of preterm labor, what to do during preterm labor, postpartum symptoms, and baby sleep position. There were also changes in prenatal attitudes including: need for prenatal care as soon as possible, continuing prenatal care when feeling healthy and not smoking during pregnancy. Relative frequencies were tabulated for week of delivery, infant birth weight, type of delivery, and presence of maternal and infant medical conditions. CONCLUSION: The March of Dimes BAM program participants reported improvements in prenatal knowledge. The BAM program can improve maternal knowledge through a community-based collaborative model of care. The combined prenatal education program with quality prenatal care can result in better maternal and child health outcomes

Biological processing of dinuclear ruthenium complexes in eukaryotic cells

The biological processing - mechanism of cellular uptake, effects on the cytoplasmic and mitochondrial membranes, intracellular sites of localisation and induction of reactive oxygen species - of two dinuclear polypyridylruthenium(ii) complexes has been examined in three eukaryotic cells lines. Flow cytometry was used to determine the uptake of [{Ru(phen)2}2{μ-bb12}](4+) (Rubb12) and [Ru(phen)2(μ-bb7)Ru(tpy)Cl](3+) {Rubb7-Cl, where phen = 1,10-phenanthroline, tpy = 2,2':6',2''-terpyridine and bbn = bis[4(4'-methyl-2,2'-bipyridyl)]-1,n-alkane} in baby hamster kidney (BHK), human embryonic kidney (HEK-293) and liver carcinoma (HepG2) cell lines. The results demonstrated that the major uptake mechanism for Rubb12 and Rubb7-Cl was active transport, although with a significant contribution from carrier-assisted diffusion for Rubb12 and passive diffusion for Rubb7-Cl. Flow cytometry coupled with Annexin V/TO-PRO-3 double-staining was used to compare cell death by membrane damage or apoptosis. Rubb12 induced significant direct membrane damage, particularly with HepG2 cells, while Rubb7-Cl caused considerably less membrane damage but induced greater levels of apoptosis. Confocal microscopy, coupled with JC-1 assays, demonstrated that Rubb12 depolarises the mitochondrial membrane, whereas Rubb7-Cl had a much smaller affect. Cellular localisation experiments indicated that Rubb12 did not accumulate in the mitochondria, whereas significant mitochondrial accumulation was observed for Rubb7-Cl. The effect of Rubb12 and Rubb7-Cl on intracellular superoxide dismutase activity showed that the ruthenium complexes could induce cell death via a reactive oxygen species-mediated pathway. The results of this study demonstrate that Rubb12 predominantly kills eukaryotic cells by damaging the cytoplasmic membrane. As this dinuclear ruthenium complex has been previously shown to exhibit greater toxicity towards bacteria than eukaryotic cells, the results of the present study suggest that metal-based cationic oligomers can achieve selective toxicity against bacteria, despite exhibiting a non-specific membrane damage mechanism of action.Xin Li, Kirsten Heimann, Xuyen Thi Dinh, F. Richard Keene and J. Grant Collin

Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.

IntroductionExposure to secondhand smoke (SHS) is associated with occult obstructive lung disease as evident by abnormal airflow indices representing small airway disease despite having preserved spirometry (normal forced expiratory volume in 1 s-to-forced vital capacity ratio, FEV1/FVC). The significance of lung volumes that reflect air trapping in the presence of preserved spirometry is unclear.MethodsTo investigate whether lung volumes representing air trapping could determine susceptibility to respiratory morbidity in people with SHS exposure but without spirometric chronic obstructive pulmonary disease, we examined a cohort of 256 subjects with prolonged occupational SHS exposure and preserved spirometry. We elicited symptom prevalence by structured questionnaires, examined functional capacity (maximum oxygen uptake, VO2max) by exercise testing, and estimated associations of those outcomes with air trapping (plethysmography-measured residual volume-to-total lung capacity ratio, RV/TLC), and progressive air trapping with exertion (increase in fraction of tidal breathing that is flow limited on expiration during exercise (per cent of expiratory flow limitation, %EFL)).ResultsRV/TLC was within the predicted normal limits, but was highly variable spanning 22%±13% and 16%±8% across the increments of FEV1/FVC and FEV1, respectively. Respiratory complaints were prevalent (50.4%) with the most common symptom being ≥2 episodes of cough per year (44.5%). Higher RV/TLC was associated with higher OR of reporting respiratory symptoms (n=256; r2=0.03; p=0.011) and lower VO2max (n=179; r2=0.47; p=0.013), and %EFL was negatively associated with VO2max (n=32; r2=0.40; p=0.017).ConclusionsIn those at risk for obstruction due to SHS exposure but with preserved spirometry, higher RV/TLC identifies a subgroup with increased respiratory symptoms and lower exercise capacity

Nanoparticle growth following photochemical α‐ and β‐pinene oxidation at Appledore Island during International Consortium for Research on Transport and Transformation/Chemistry of Halogens at the Isles of Shoals 2004

Nanoparticle events were observed 48 times in particle size distributions at Appledore Island during the International Consortium for Atmospheric Research on Transport and Transformation/Chemistry of Halogens on the Isles of Shoals (ICARTT/CHAiOS) field campaign from 2 July to 12 August of 2004. Eighteen of the nanoparticle events showed particle growth and occurred during mornings when peaks in mixing ratios of α‐ and β‐pinene and ozone made production of condensable products from photochemical oxidation probable. Many pollutants and other potential precursors for aerosol formation were also at elevated mixing ratios during these events, including NO, HNO3, NH3, HCl, propane, and several other volatile organic carbon compounds. There were no consistent changes in particle composition, although both submicron and supermicron particles included high maximum concentrations of methane sulfonate, sulfate, iodide, nitrate, and ammonium during these events. Nanoparticle growth continued over several hours with a nearly linear rate of increase of diameter with time. The observed nanoparticle growth rates varied from 3 to 13 nm h−1. Apparent nanoparticle aerosol mass fractions (yields) were estimated to range from less than 0.0005 to almost 1 using α‐ and β‐pinene as the presumed particle source. These apparent high aerosol mass fractions (yields) at low changes in aerosol mass are up to two orders of magnitude greater than predictions from extrapolated laboratory parameterizations and may provide a more accurate assessment of secondary organic aerosol formation for estimating the growth of nanoparticles in global models

Observations on the Behavioral Responses of Bowhead Whales (Balaena mysticetus) to Active Geophysical Vessels in the Alaskan Beaufort Sea

The responses of bowhead whales to controlled approaches by geophysical vessels producing airgun blasts were observed during the course of four field experiments conducted in the Alaskan Beaufort Sea in September 1984. Behavioral responses included shorter surfacing and dive times, fewer blows per surfacing, longer blow intervals and subtle to overt changes in surface behaviors. Subtle behavioral responses occurred at 3.5 and 8.2 km with received airgun noise levels of 142 and 157 dB respectively (all levels in dB re 1 micro Pa). Partial avoidance (i.e., some whales leaving the observation area while others remained) occurred at ranges of 3.5 and 7.6 km, with sound levels of 142 and 158 dB respectively. Total avoidance (i.e., all whales leaving the observation area) occurred at 1.3, 7.2, 3.5 and 2.9 km, with corresponding sound levels of 152, 165, 178 and 165 dB. The similarities among experiments reported here support the conclusion that short-term behavioral changes occur when bowhead whales are exposed to airgum blasts from approaching geophysical vessels at ranges <10 km. These disturbance efforts wane within one hour after a disturbance; long-term effects on social, behavioral or physiologic parameters are not known at this time.Key words: bowhead whale, Balaena mysticerus, geophysical vessel, bioacoustics, airgunsMots clés: baleine franche, Balaena mysticetus, navire de prospection géophysique, bioacoustique, canons à ai

Wind Symphony

Bone Swdent Center Ballroom Thursday Evening February 18, 1993 8:00p.m

Molecular excitation in the Eagle nebula's fingers

Context: The M16 nebula is a relatively nearby Hii region, powered by O stars from the open cluster NGC 6611, which borders to a Giant Molecular Cloud. Radiation from these hot stars has sculpted columns of dense obscuring material on a few arcmin scales. The interface between these pillars and the hot ionised medium provides a textbook example of a Photodissociation Region (PDR). Aims: To constrain the physical conditions of the atomic and molecular material with submillimeter spectroscopic observations. Methods: We used the APEX submillimeter telescope to map a ~3'x3' region in the CO J=3-2, 4-3 and 7-6 rotational lines, and a subregion in atomic carbon lines. We also observed C18O(3-2) and CO(7-6) with longer integrations on five peaks found in the CO(3-2) map. The large scale structure of the pillars is derived from the molecular lines' emission distribution. We estimate the magnitude of the velocity gradient at the tips of the pillars and use LVG modelling to constrain their densities and temperatures. Excitation temperatures and carbon column densities are derived from the atomic carbon lines. Results: The atomic carbon lines are optically thin and excitation temperatures are of order 60 K to 100 K, well consistent with observations of other Hii region-molecular cloud interfaces. We derive somewhat lower temperatures from the CO line ratios, of order 40 K. The Ci/CO ratio is around 0.1 at the fingers tips.Comment: 4 pages, APEX A&A special issue, accepte

Quality of life in elderly ICU survivors before the COVID-19 pandemic: a systematic review and meta-analysis of cohort studies

Objectives The influence of age on intensive care unit (ICU) decision-making is complex, and it is unclear if it is based on expected subjective or objective patient outcomes. To address recent concerns over age-based ICU decision-making, we explored patient-assessed quality of life (QoL) in ICU survivors before the COVID-19 pandemic. Design A systematic review and meta-analysis of cohort studies published between January 2000 and April 2020, of elderly patients admitted to ICUs. Primary and secondary outcome measures We extracted data on self-reported QoL (EQ-5D composite score), demographic and clinical variables. Using a random-effect meta-analysis, we then compared QoL scores at follow-up to scores either before admission, age-matched population controls or younger ICU survivors. We conducted sensitivity analyses to study heterogeneity and bias and a qualitative synthesis of subscores. Results We identified 2536 studies and included 22 for qualitative synthesis and 18 for meta-analysis (n=2326 elderly survivors). Elderly survivors’ QoL was significantly worse than younger ICU survivors, with a small-to- medium effect size (d=0.35 (−0.53 and −0.16)). Elderly survivors’ QoL was also significantly greater when measured slightly before ICU, compared with follow-up, with a small effect size (d=0.26 (−0.44 and −0.08)). Finally, their QoL was also marginally significantly worse than age-matched community controls, also with a small effect size (d=0.21 (−0.43 and 0.00)). Mortality rates and length of follow-up partly explained heterogeneity. Reductions in QoL seemed primarily due to physical health, rather than mental health items. Conclusions The results suggest that the proportionality of age as a determinant of ICU resource allocation should be kept under close review and that subjective QoL outcomes should inform person-centred decision -aking in elderly ICU patients. PROSPERO registration number CRD42020181181

Focused laser Doppler velocimeter

A system for remotely measuring velocities present in discrete volumes of air is described. A CO2 laser beam is focused by a telescope at such a volume, a focal volume, and within the focusable range, near field, of the telescope. The back scatter, or reflected light, principally from the focal volume, passes back through the telescope and is frequency compared with the original frequency of the laser, and the difference frequency or frequencies represent particle velocities in that focal volume