Quality of Prenatal Care and Pregnancy Outcomes: Centering Pregnancy Versus Traditional Prenatal Care

Prenatal care provides a unique opportunity for healthcare providers to improve outcomes for women and their families and by extension community health. Therefore, prenatal care has the opportunity to become the cornerstone of healthcare in our nation. It can influence the health of the mother, newborn, and family unit long beyond the course of a 9-month pregnancy. However, evidence supporting positive outcomes from current tradition based models of prenatal care is lacking. The current United States prenatal system limits the patient-provider relationship, does not empower the patient, lacks emphasis on education, and is not woman-centered. The aim of the study was to compare an alternative prenatal care model, Centering Pregnancy, to individual prenatal care. An initial comparative concept analysis of power and empowerment focused on the nurse’s role in cultivating empowerment in the pregnant woman. Subsequently, a study exploring the differences in outcomes for women in two different prenatal care groups was conducted. Differences examined included quality of prenatal care and pregnancy-related empowerment from the patient’s perspective. Also comparison of birth weight and gestational age at time of birth for a sample size of 51 pregnant patients (n =14 in Centering Pregnancy, n=37 in individual prenatal care). Findings from this feasibility study revealed no statistical significance between the two independent groups in quality of prenatal care and gestational age. Differences in pregnancy-related empowerment (p = 0.083) and birth weight (p = 0.088) were noted to be approaching significance. Participants receiving individual prenatal care demonstrated higher post pregnancy-related empowerment. Centering Pregnancy participants had higher birth weights. The results call for further research into the effect of Centering Pregnancy on empowerment and birth weight with a larger sample size to determine if true significance exists

Evaluating the Reliability of Field Identification and Morphometric Classifications for Carnivore Scats Confirmed with Genetic Analysis

Scat surveys are commonly used to monitor carnivore populations. Scats of sympatric carnivores can be difficult to differentiate and field-based identification can be misleading. We evaluated the success of field-based species identification for scats of 2 sympatric carnivores—coyotes (Canis latrans) and kit foxes (Vulpes macrotis). We conducted scat surveys in the Great Basin desert of Utah, USA, during the winter and summer of 2013, and we detected 1,680 carnivore scats. We classified scats based on field identification, recorded morphometricmeasurements, and collected fecalDNA samples for molecular species identification. We subsequently evaluated the classification success of field identification and the predictive power of 2 nonparametric classification techniques—k-nearest neighbors and classification trees—based on scat measurements. Overall, 12.2% of scats were misclassified by field identification, but misclassifications were not equitable between species. Only 7.1% of the scats identified as coyote with field identification were misclassified, compared with 22.9% of scats identified as kit fox. Results from both k-nearest neighbor and classification-tree analyses suggest that morphometric measurements provided an objective alternative to field identification that improved classification of rarer species. Overall misclassification rates for k-nearest neighbor and classification-tree analyses were 11.7% and 7.5%, respectively. Using classification trees, misclassification was reduced for kit foxes (8.5%) and remained similar for coyotes (7.2%), relative to field identification. Although molecular techniques provide unambiguous species identification, classification approaches may offer a cost-effective alternative. We recommend that monitoring programs employing scat surveys utilize molecular species identification to develop training data sets and evaluate the accuracy of field based and statistical classification approaches

Emerging La Niña conditions in the equatorial Pacific : notes for the health community

This report provides information to assist monitoring of vulnerable communities and provide time sensitive information for interventions to reduce negative health impacts. It is prudent for health decision makers to follow the situation for any developments and monitor climate/weather forecasts as part of an early warning-early action approach. Resources and recommendations for monitoring the situation are presented

Evaluating the Reliability of Field Identification and Morphometric Classifications for Carnivore Scats Confirmed with Genetic Analysis

Scat surveys are commonly used to monitor carnivore populations. Scats of sympatric carnivores can be difficult to differentiate and field-based identification can be misleading. We evaluated the success of field-based species identification for scats of 2 sympatric carnivores—coyotes (Canis latrans) and kit foxes (Vulpes macrotis). We conducted scat surveys in the Great Basin desert of Utah, USA, during the winter and summer of 2013, and we detected 1,680 carnivore scats. We classified scats based on field identification, recorded morphometricmeasurements, and collected fecalDNA samples for molecular species identification. We subsequently evaluated the classification success of field identification and the predictive power of 2 nonparametric classification techniques—k-nearest neighbors and classification trees—based on scat measurements. Overall, 12.2% of scats were misclassified by field identification, but misclassifications were not equitable between species. Only 7.1% of the scats identified as coyote with field identification were misclassified, compared with 22.9% of scats identified as kit fox. Results from both k-nearest neighbor and classification-tree analyses suggest that morphometric measurements provided an objective alternative to field identification that improved classification of rarer species. Overall misclassification rates for k-nearest neighbor and classification-tree analyses were 11.7% and 7.5%, respectively. Using classification trees, misclassification was reduced for kit foxes (8.5%) and remained similar for coyotes (7.2%), relative to field identification. Although molecular techniques provide unambiguous species identification, classification approaches may offer a cost-effective alternative. We recommend that monitoring programs employing scat surveys utilize molecular species identification to develop training data sets and evaluate the accuracy of field based and statistical classification approaches

Assessment tools and phenotype classification for hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a heterogeneous chronic relapsing skin disease. Several assessment tools are used to assess disease severity and to classify disease phenotype; however, no consensus exists. This review evaluates the various assessment tools and phenotypes, assessing their validity and reliability. Numerous assessment tools and phenotype classifications have been proposed for identifying various subtypes within the hidradenitis suppurativa disease spectrum. Each has a different purpose, such as use in daily practice or in clinical trial settings. Several assessment tools and phenotype classifications have been validated but not always with satisfactory results and often with studies showing divergent intra-rater reliability results. A consensus is needed for a validated, easy-to-use, and timesaving assessment tool for routine daily practice. For clinical trials, a validated and extensive assessment tool that also measures response to treatment is also needed.</p

Genetic and spatial structure within a swift fox population

1. We incorporated spatial data on swift foxes (Vulpes velox) with genetic analysis to assess the influence of relatedness between individuals on their social and spatial ecology. We recorded the space use patterns of 188 radio-collared swift foxes in southeastern Colorado from January 1997 to December 2000. One hundred and sixty-seven foxes were also genotyped at 11 microsatellite DNA loci and the degree of relatedness between individuals was estimated. 2. We described the genetic structure of the population by examining the relatedness of neighbors and the relationship between the spatial and genetic distance of all individuals. We found that close kin appeared to cluster within the population. Neighbors were significantly more related (mean R= 0.089 ± 0.01) than non-neighbors (mean R = 0.003 ± 0.01; randomization test, P \u3c 0.0002). Female clusters were more extensive than male clusters. 3. The degree of genetic relatedness among foxes was useful in explaining why foxes tolerated encroachment of their home ranges by neighbors; the more closely related neighbors were, the more home-range overlap they tolerated (Mantel test, P = 0.0004). Foxes did not appear to orientate their home ranges to avoid neighbors and home ranges overlapped by as much as 54.77% (x = 14.13% ± 0.41). Neighbors also occasionally engaged in concurrent den sharing. 4. Relatedness influenced the likelihood that an individual would inherit a newly vacated home range, with a mean relatedness of range inheritors to previous owners of 0.333 ±&#;0.074. Thus, the genetic structure of the population and interactions between kin were interrelated to space-use patterns and social ecology of the swift fox

Evaluating Otter Reintroduction Outcomes Using Genetic Spatial Capture-Recapture Modified for Dendritic Networks

Monitoring the demographics and genetics of reintroduced populations is critical to evaluating reintroduction success, but species ecology and the landscapes that they inhabit often present challenges for accurate assessments. If suitable habitats are restricted to hierarchical dendritic networks, such as river systems, animal movements are typically constrained and may violate assumptions of methods commonly used to estimate demographic parameters. Using genetic detection data collected via fecal sampling at latrines, we demonstrate applicability of the spatial capture–recapture (SCR) network distance function for estimating the size and density of a recently reintroduced North American river otter (Lontra canadensis) population in the Upper Rio Grande River dendritic network in the southwestern United States, and we also evaluated the genetic outcomes of using a small founder group (n = 33 otters) for reintroduction. Estimated population density was 0.23–0.28 otter/km, or 1 otter/3.57–4.35 km, with weak evidence of density increasing with northerly latitude (β = 0.33). Estimated population size was 83–104 total otters in 359 km of riverine dendritic network, which corresponded to average annual exponential population growth of 1.12–1.15/year since reintroduction. Growth was ≥40% lower than most reintroduced river otter populations and strong evidence of a founder effect existed 8–10 years post-reintroduction, including 13–21% genetic diversity loss, 84%–87% genetic effective population size decline, and rapid divergence from the source population (FST accumulation = 0.06/generation). Consequently, genetic restoration via translocation of additional otters from other populations may be necessary to mitigate deleterious genetic effects in this small, isolated population. Combined with non-invasive genetic sampling, the SCR network distance approach is likely widely applicable to demogenetic assessments of both reintroduced and established populations of multiple mustelid species that inhabit aquatic dendritic networks, many of which are regionally or globally imperiled and may warrant reintroduction or augmentation efforts