Creating New Strategies to Enhance Postpartum Health and Wellness

Over the past 5 years there have been a number of new initiatives focused on improving birth outcomes and reducing infant mortality, including a renewed focus on the complex interactions between motherhood and infancy that influence lifelong health trajectories. Beginning in 2012, the Association of Maternal & Child Health Programs (AMCHP) facilitated a series of meetings to enhance coordination across initiatives. Emerging from these conversations was a shared desire across stakeholders to reimagine the postpartum visit and improve postpartum care and wellness. AMCHP convened a Postpartum Think-Tank Meeting in 2014 to map the system of postpartum care and identify levers for its transformation. The meeting findings are presented in an infographic which frames the challenges and proposed solutions from the woman's perspective. The infographic describes maternal issues and concerns along with a concise summary of the recommended solutions. Strategies include creating integrated services and seamless care transitions from preconception through postpartum and well-baby; business, community, and government support, including paid parental leave, health insurance and spaces for new parents to meet each other; and mother-centered care, including quality visits on her schedule with complete and culturally appropriate information. These solutions catalyze a postpartum system of care that supports women, children, and families by infusing new ideas and capitalizing on existing opportunities and resources

Public Preferences for Investments in Renewable Energy Production and Energy Efficiency

In this paper we investigate the choices citizens make when asked to express willingness to support a proposed energy policy and are then compelled to allocate the program funds to either renewable energy or energy efficiency. In a survey study based on a random sample of residents of the state of Maine, USA, we find that citizens have preferences for specific types of renewable energy but these preferences do not yield significantly different allocation of investment funds between renewable energy and energy efficiency. We find that preferences are generally consistent regardless of presentation of options (i.e. limited ordering effects). Our results also indicate that personal characteristics that are understudied in the energy literature, including promotion/prevention focus and social/fiscal leanings, influence both willingness to support energy policies and also their allocation of fund choices, but in different ways. This suggests the importance of including multiple options in energy policy proposals, and that targeted messages regarding the components of such policies is key for optimal communication

Evaluation of Kentucky\u27s Graduated Driver Licensing System

Kentucky\u27s current GDL program, which applies to drivers up to age 18, was enacted in 1996. The program includes a six-month instruction permit for drivers under age 18 (minimum age 16), a restriction on driving between midnight and 6am and a requirement for adult-supervised driving for permit drivers. In addition, there is a six-point limit on traffic violations with a penalty of license suspension for drivers under age 18, a requirement for a four-hour driving safety education class (or driver education course) and a 0.02 ml/dl limit on blood alcohol concentration (continues up to age 21 ). Objectives: The objectives of this program evaluation were: (a) to examine teen driver motor vehicle crashes, crash-related injuries, and crash-related costs before and after the implementation of the GDL program; (b) to examine the implementation of the program at the local level ; and (c) to recommend actions to enhance the program\u27s effectiveness in addressing the teen crash problem. Methods: Crash and licensing data before ( 1993-1995) and after GDL ( 1997-2000) were analyzed. Data on miles driven were obtained from driving logs of over I ,000 high school students. Estimation of the cost of crashes was derived from analysis of crash data using the Crash Cost computer software program. Information on local implementation of GDL was obtained through interviews and through a questionnaire survey of 700 law enforcement officers and over 40 district judges. Results: Results indicate a 31 percent reduction in crashes for 16 year-old drivers after the GDL program, and a similar reduction in fatal crashes (31 percent) and injury crashes (33 percent), crashes between midnight and 6am (36 percent), and alcohol-related crashes (32 percent). Cost analysis indicates an estimated reduction of $36 million per year in 16 year-old teen driver crash-related expenses. Results indicate that this is due to the 83% reduction in the number of 16 to 16 1/2 year-old drivers involved in crashes. However, the number of crashes has not been reduced for drivers over age 16 1/2, i.e. drivers who may be past the permit level. In addition, the six-point limit on traffic violations and the non-cumulative penalties on 0.02 blood alcohol limit violations have not reduced the number of traffic violations or alcohol-related crashes for teen drivers over age 16 1/2. Recommendations: The six-month permit level has been successful in substantially reducing crash-related injuries and fatalities and should be retained. Additional measures, such as upgrading to an expanded GDL program, are needed to reduce crash-related injuries and fatalities for 16 1/2 to 18 year-old drivers. Specific recommendation are made to increase parental awareness and enforcement of program provisions

Will Offshore Energy Face “Fair Winds and Following Seas”?: Understanding the Factors Influencing Offshore Wind Acceptance

Most offshore energy studies have focused on measuring or explaining people’s perceptions of, and reactions to, specific installations. However, there are two different types of acceptance: one surrounds the siting of projects while the other surrounds a more general acceptance of offshore energy. Understanding what drives this second type of acceptance is important as governments have implemented new financial incentives and policies to support renewable energy development; however, citizens and government officials may be increasingly opposed to some of these support mechanisms. Our paper fills a void in the literature by using regression approaches to better understand how people’s evaluations of the benefits and costs of offshore wind impact their level of general acceptance for offshore wind, while controlling for other factors (e.g., demographics). This analysis should help policy makers, and individuals attempting to educate the general public about renewable energy, to better understand the important factors influencing people’s support or opposition to offshore wind energy initiatives

Developmental interneuron subtype deficits after targeted loss of Arx

Abstract Background Aristaless-related homeobox (ARX) is a paired-like homeodomain transcription factor that functions primarily as a transcriptional repressor and has been implicated in neocortical interneuron specification and migration. Given the role interneurons appear to play in numerous human conditions including those associated with ARX mutations, it is essential to understand the consequences of mutations in this gene on neocortical interneurons. Previous studies have examined the effect of germline loss of Arx, or targeted mutations in Arx, on interneuron development. We now present the effect of conditional loss of Arx on interneuron development. Results To further elucidate the role of Arx in forebrain development we performed a series of anatomical and developmental studies to determine the effect of conditional loss of Arx specifically from developing interneurons in the neocortex and hippocampus. Analysis and cell counts were performed from mouse brains using immunohistochemical and in situ hybridization assays at 4 times points across development. Our data indicate that early in development, instead of a loss of ventral precursors, there is a shift of these precursors to more ventral locations, a deficit that persists in the adult nervous system. The result of this developmental shift is a reduced number of interneurons (all subtypes) at early postnatal and later time periods. In addition, we find that X inactivation is stochastic, and occurs at the level of the neural progenitors. Conclusion These data provide further support that the role of Arx in interneuron development is to direct appropriate migration of ventral neuronal precursors into the dorsal cortex and that the loss of Arx results in a failure of interneurons to reach the cortex and thus a deficiency in interneurons.http://deepblue.lib.umich.edu/bitstream/2027.42/134595/1/12868_2016_Article_265.pd

The Grizzly, November 11, 1996

Ursinus Celebrates Unity Day • Professors Nominated • Ursinus Explores Pass-Fail Option • On Election Day, Ursinus Forged the Atlantic • Opinion: What a Friend; Diversity\u27s Downfall Through Apathy; Intellectual Maturity not Just for Breakfast Any More!; The Outsider Survives; On Our Growing Computer Dependency • Letters from Ireland • Adding Variety to Your Exercise Program • Summer Research in Germany: A Cultural and Educational Experience • A Rose by any Other Name...? • Spotlight: Rocco Iacullo • My Favorite Curses • Previewing the Weekend Game • Men\u27s Soccer Ends Season with Loss • Field Hockey Finishes Season at 2-16 • Centennial Conference Football Standingshttps://digitalcommons.ursinus.edu/grizzlynews/1391/thumbnail.jp

From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa

Background: Adolescent pregnancy has been linked to adverse outcomes. Most studies proposing risk pathways for adolescent pregnancy in South Africa are qualitative, hypothesising links among age-disparate relationships, reduced condom use and higher pregnancy rates. No known South African studies have quantitatively explored pathways to adolescent pregnancy. Objectives: This study aimed to: (i) identify the factors associated with adolescent pregnancy and (ii) explore a pathway of risk by assessing whether condom use mediated the relationship between age-disparate sexual relationships and adolescent pregnancy. Methods: A cross-sectional survey of 447 sexually active girls aged 10–19 years was undertaken in six health districts of South Africa. Multivariate logistic regressions controlled for confounders. Mediation tests used bootstrapping. Results: Consistent condom use (ß = –2.148, odds ratio (OR) = 8.566, P = 0.001) and school enrolment (ß = –1.600, OR = 0.202, P = 0.001) were associated with lower pregnancy rates. Age-disparate sex (ß = 1.093, OR = 2.982, P = 0.001) and long-term school absences (ß = 1.402, OR = 4.061, P = 0.001) were associated with higher pregnancy rates. The indirect effect of age-disparate sex on adolescent pregnancy through condom use was significant, irrespective of age, age at sexual initiation, poverty and residential environment (B = 0.4466, s.d. = 0.1303, confidence interval: 0.2323–0.7428). Conclusion: This survey supports hypotheses that inability to negotiate condom use in age-disparate sexual relationships may drive adolescent pregnancy. Interventions addressing these relationships, facilitating condom use and increasing access to sexual health services among adolescents might avert unwanted pregnancies

The effect of health literacy on knowledge and receipt of colorectal cancer screening: a survey study

BACKGROUND: An estimated one-half of Americans have limited health literacy skills. Low literacy has been associated with less receipt of preventive services, but its impact on colorectal cancer (CRC) screening is unclear. We sought to determine whether low literacy affects patients' knowledge or receipt of CRC screening. METHODS: Pilot survey study of patients aged 50 years and older at a large, university-affiliated internal medicine practice. We assessed patients' knowledge and receipt of CRC screening, basic sociodemographic information, and health literacy level. We defined limited literacy as reading below the ninth grade level as determined by the Rapid Estimate of Adult Literacy in Medicine. Bivariate analyses and exact logistic regression were used to determine the association of limited health literacy with knowledge and receipt of CRC screening. RESULTS: We approached 105 patients to yield our target sample of 50 completing the survey (recruitment rate 48%). Most subjects were female (72%), African-American (58%), and had household incomes less than $25,000 (87%). Overall, 48% of patients had limited literacy skills (95% CI 35% to 61%). Limited literacy patients were less likely than adequate literacy patients to be able to name or describe any CRC screening test (50% vs. 96%, p < 0.01). In the multivariable model, limited literacy patients were 44% less likely to be knowledgeable of CRC screening (RR 0.56, p < 0.01). Self-reported screening rates were similar (54% vs. 58%, p = 0.88). CONCLUSION: Patients with limited literacy skills are less likely to be knowledgeable of CRC screening compared to adequate literacy patients. Primary care providers should ensure patients' understanding of CRC screening when discussing screening options. Further research is needed to determine if educating low literacy patients about CRC screening can increase screening rates