Women’s use of Preventive Primary Care in the Late Postpartum Period

The literature has limited data on how women access health care after the traditional postpartum period (postpartum). Modeled after a paper by Bryant (2016), this project assesses the prevalence of primary care visits in the late postpartum period (LPP)(60- 730 days postpartum). Study objectives included (1) Identify demographics of general delivering population at UVMMC compared to patients with UVM-affiliated primary care provider (UVMPCP). (2) Understand how the general delivering population uses the UVMHN LPP (3) Among women with a UVM-affiliated PCP, identify the prevalence of preventive care visits in the LPP. (4) Identify characteristics associated with LPP visit attendance. Hypothesis: Women with an established PCP prior to pregnancy are more likely to attend preventive PCP LPP visits. This was a retrospective cohort study for all women who delivered at UVMMC between 7/1/2015-6/30/2017. Data was extracted from Epic EMR. During the study period, 4169 women had one singleton pregnancy, 3413 (82%) had a known PCP, and 1279 (31%) had UVMPCP. 2535 (61%) of all delivering singleton women and 1112 (87%) of UVMPCP women had at least one clinical visit within UVMHN in the LPP. 959 (75%) of UVMPCP women had a LPP PCP visit, and 382 patients (30%) had preventative PCP LPP visits. Our hypothesis was rejected (OR 0.930), but attending any LPP PCP visit was associated with having a PCP established prior to pregnancy (OR 1.684). Attending preventive PCP visit was associated with having the same delivering provider as PCP (OR 1.742), a pre-pregnancy PCP visit (OR 1.460), a PCP visit during prenatal time (OR 1.459), ED visit early postpartum period (OR 0.402), a fetal or neonatal demise (OR 0.445), being single (0.601), and with public insurance (OR 0.489). Further work in understanding these associations will be important in developing improved transition of care models and increasing overall engagement in women’s preventive medicine

Navigating the Livestock Sector: The Political Economy of Livestock Policy in Burkina Faso

This paper presents a case study of how livestock policies are made and implemented in a national context, and how they can be improved to better serve the interests of the poor. The government estimates that nearly 85 percent of Burkinabè households rely upon livestock for some portion of their income. Furthermore, livestock accounts for approximately 25 percent of the country's exports. Socially, livestock provides a way for young adults to learn the responsibilities of adulthood, a method for family members to fulfill social obligations, and a means for women to support their families. Considering its social and economic significance, livestock must take center stage in efforts to improve Burkinabè livelihoods. The study used the key informant method supplemented with official documents, newspaper sources and recently published research on the livestock sector. Interviews helped reveal policymakers' concerns, whereas field trips allowed the researcher to talk to farmers and learn their perspectives from the bottom. Newspapers and published research analyzed various political, institutional and technical aspects of policymaking in the sector. The author highlights three potential constraints - weak livestock producer organizations, poor animal health service provision, and commercial weaknesses - on the potential contribution of the livestock sector to improving poor people's livelihoods and recommends strategic actions for overcoming each of them.Livestock Production/Industries, Political Economy,

Childhood mental health: an ecological analysis of the effects of neighborhood characteristics

Research on childhood mental illness traditionally examines risk factors most proximal to the child. However, current trends reflect growing interest in how broader contextual factors contribute to psychopathology risk. In this study, we examined neighborhood‐level indicators as potential sources of chronic strain in a sample of 156 mother–child dyads; children were 8 to 12 years old. For most neighborhood indicators, data were collected at the level of census tracts using publicly available data sets. We hypothesized that these indicators would be both associated with greater overall mental health symptoms and specifically predictive of childhood symptoms of depression. We also examined potential mediators (maternal functioning and family cohesion) and moderators (maternal depression). Neighborhood indicators correlated with parents’ ratings of children's overall mental health problems, but did not correlate with children's self‐report of depression symptoms. Maternal functioning mediated neighborhood effects on children's overall mental health problems. Implications and directions for future research are presented.The current work was supported by the following grants from the National Institutes of Health, National Institute of Mental Health MH066077, MH082861, PI: Martha C. Tompson, Ph.D. and MH082861S1, PI: Gail N. Kemp, M.A., M.P.H. (MH066077 - National Institutes of Health, National Institute of Mental Health; MH082861 - National Institutes of Health, National Institute of Mental Health; MH082861S1 - National Institutes of Health, National Institute of Mental Health)Published versio

Preliminary Cultural Resources Investigations for the Pharr-Reynosa International Bridge, Hidalgo County, Texas

Archeological, archival, and geomorphologic investigations were conducted for the proposed Pharr-Reynosa International Bridge Project in Hidalgo County, Texas, by Prewitt and Associates, Inc. from October 12-27, 1992. The purposes of these investigations were to locate and record any cultural resources within the project area, determine their eligibility for listing on the National Register of Historic Places and designation as State Archeological Landmarks, and to provide an overview of the Holocene geomorphic history of the project area. The geomorphic history of the project area suggests that the Rio Grande has experienced continuous channel aggradation from the end of the Pleistocene to ca. 1000 B.P. Climatic changes and diminishing sediment loads led to channel incision around 1000 B.P., forming a low late Holocene terrace and resulting in increased sinuosity and a decreased channel width-to-depth ratio. The investigations included a stratified sample survey of approximately 162 hectares (400 acres) and the excavation of 16 backhoe trenches and 14 shovel tests. A total of 10 sites, consisting of 10 historic and 2 prehistoric components, were documented. Six standing architectural properties, each consisting of a structure or groups of structures, also were documented. Four of the sites (41HG153, 41HG155, 41HG156, and 41HG158) are considered to be potentially eligible for listing on the National Register of Historic Places and for designation as State Archeological Landmarks. Two of the architectural properties - the Carmichael and Sorenson farmsteads - also may be eligible for listing on the National Register. The four potentially eligible sites consist of four historic and two prehistoric components. The historic components date from the Texas Republic period to the early twentieth century, representing the establishment and development of the EI Capote Ranch community. The two prehistoric components (41HG153 and 41HG158), of which only 41HG153 is potentially eligible, represent Late Prehistoric and unknown prehistoric components, respectively

Maternal depression and youth internalizing and externalizing symptomatology: severity and chronicity of past maternal depression and current maternal depressive symptoms

Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58 % male) ages 8 to 12 over a span of 3 years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed.The current work was supported by grants from the National Institutes of Health (MH066077, PI: Martha C. Tompson, PhD; MH082861, PI: Martha C. Tompson, PhD;). (MH066077 - National Institutes of Health; MH082861 - National Institutes of Health)Published versio

Clonal variation in cell surface display of an H-2 protein lacking a cytoplasmic tail

Truncated variants of the gene encoding H-2Ld, an integral membrane protein encoded by the major histocompatibility complex, were constructed by in vitro mutagenesis to elucidate the function of charged amino acids found on the cytoplasmic side of the transmembrane (TM) region. Analysis of cloned L cells transfected with these genes shows that the seven amino acids following the TM segment, four of which are basic, enhance the cell surface expression of H-2Ld protein but are not required for it. However, some clones do not express a tailless H-2Ld protein on the cell surface but express it intracellularly where it has a long half-life. Turnover measurements on cell surface H-2Ld proteins suggest that the basic residues following the TM segment are not a "stop transfer" sequence (Blobel, G., 1980, Proc. Natl. Acad. Sci. USA., 77:1496-1500) which anchors the H-2Ld protein in the membrane. Pulse-chase and endoglycosidase H sensitivity studies show that H-2Ld proteins lacking some or all of the basic residues and H-2Ld proteins which have a full-length cytoplasmic tail are processed with different kinetics. These results suggest an involvement of the membrane-proximal region of the cytoplasmic tail in the intracellular transport of H-2Ld. We further suggest that the L cell clones which do and do not express a tailless H-2Ld protein on the cell surface differ in the ability to transport a tailless integral membrane protein to the cell surface

Shall Be Bright at Last: Reflections on Suffering and Hope in the Letters of Paul

These nine essays on suffering offer exercises in Christian hope. The contributors reveal honest and tender wounds of the many harsh realities of life in a broken world awaiting full redemption. They meditate on Paul\u27s holy words that teach us to pray with expectation and live by faith. They encourage fellow pilgrims to trust the path and stick together. Shall Be Bright at Last is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. CC BY-NC-SAhttps://digitalcommons.georgefox.edu/monographs/1000/thumbnail.jp