Sleep and Diet in Urban Pregnant African American Women

ABSTRACT Objective: Sleep disturbances during pregnancy are associated with gestational diabetes and excessive weight gain. Diet could potentially play a role in these relationships, yet examinations of sleep and diet in African American pregnant populations are scarce. Methods: The study population includes pregnant African American women from Detroit, MI (n=53). At the baseline study visit during late pregnancy, women were surveyed about typical bed and wake times, as well as usual food intake via a dietary screener. Sleep measures examined included time in bed and sleep midpoint (median of going to bed and wake time). Composite dietary measures included estimated fruit and vegetable (FV), dairy, and added sugar intake. Linear regression models were used to evaluate associations between sleep and dietary measures, adjusting for potential confounders. Results: On average, women with shorter time in bed (\u3c8 hours compared to ≥8 hours) had one cup/day higher intake of fruits and vegetables (95% CI 0.10 to 1.83), driven by the individual items tomato sauce, salsa, and fruit juice. Delayed sleep timing (a midpoint\u3e2:45 AM compared to midpoint≤2:45 AM) was associated with 0.78 cup/day lower fruit and vegetable intake (95% CI -1.67 to 0.12), mostly driven by whole fruit and vegetables (e.g. string beans, peas, corn rather than salad or cooked dried beans). Later midpoint was also associated with lower dairy intake (0.41 fewer servings/day; 95% CI -0.78 to -0.04), particularly milk. Shorter time in bed was associated with higher pastry intake, and delayed sleep timing was associated with lower pastry intake. Conclusions: Sleep characteristics were uniquely associated with diet in pregnant women

Teaching Matters: Essays by UMF Faculty

Essays by faculty at the University of Maine at Farmington.https://scholarworks.umf.maine.edu/publications/1086/thumbnail.jp

\u3ci\u3eNebraska Symposium on Motivation, 1997, Volume 45: Gender and Motivation\u3c/i\u3e

Chapter: Childhood aggression and gender: A new look at an old problem, co-authored by Juan Casas, UNO faculty member. Does knowing a person’s gender give us a reliable sense of how aggressive, competitive, or emotional he or she is? In this volume leading scholars examine different aspects of this issue. Carol Tavris discusses the state of gender research and the reasons for the continuing popularity of essentialist theories of gender opposition. Nicki Crick and a team of researchers reassess stereotyped assumptions about gender and aggression, employing a more comprehensive definition of aggression as damaging relations rather than only bodies. Diane Gill looks at the relationship between gender and sports competition, explicating how the unique social context of sports affects gender perceptions and performances. Reed Larson and Joseph Pleck question the popular conception of men as less emotional than women, studying gender differences in “felt” rather than “expressed” emotions in daily life. Leonore Tiefer considers the ways in which gender roles in sexuality are socially rather than biologically constructed.https://digitalcommons.unomaha.edu/facultybooks/1189/thumbnail.jp

Assessing what matters: A milestone focused on justice, equity, diversity, & inclusion (JEDI)

Objective or purpose of innovation: To develop an ACGME-like milestone that concurrently serves as a curriculum blueprint across the continuum of medical education. Background and/or theoretical framework and importance to the field: In 2019, Milwaukee County became one of the first municipalities to declare racism a public health crisis.(1) Motivated by racial injustice and COVID-19 disparities medical education (2-4) are accelerating efforts to address racism and eliminate health disparities (AAMC’s DEI Cross-Continuum Competencies). Yet, the 2019 ACGME Common Program Requirements six core competencies fails to include the key terms (disparities, inequities, justice, community, underserved) and requires a new structural competency domain with assessments.(5) Design: To match our existing assessment framework, an ACGME like milestone, applicable across the continuum of medical education was developed by an interprofessional team (eg, MedEd, Ethics, DE&I). A literature review was completed to identify key milestone elements. Milestone was framed by ACGME core competencies (eg, MK, PC, SBP) and progression delineated across five levels. The 8-page milestone was iteratively revised by multiple stakeholders to 1-page suitable for inclusion as the end of each GME program’s required milestone assessment form. Outcomes: Enthusiastic and pervasive support for the structural fluency milestone was achieved across the continuum. It was approved by GME Council for inclusion as a required formative milestone in every program. GME milestone data informs curriculum/instruction across the continuum (UME, GME, CME) using an expanded 2-page milestone for use as a blueprint at it retained each of the competency domains and references. Innovation\u27s strengths and limitations: Our milestone innovation recognizes need for data: to monitor our ability to learn/teach and ultimately eliminate racism (and other isms) and health disparities. Its strength is its limitation as we recognize it’s a journey and it will evolve as we do. Feasibility and transferability for adoption: Formatted like existing ACGME milestones implementation within the assessment system was seamless enhancing its feasibility and transferability

Safety Issues in Cell-Based Intervention Trials

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established

Breast Cancer Screening Among Childhood Cancer Survivors Treated Without Chest Radiation: Clinical Benefits and Cost-Effectiveness

BACKGROUND: Early initiation of breast cancer screening is recommended for high-risk women, including survivors of childhood cancer treated with chest radiation. Recent studies suggest that female survivors of childhood leukemia or sarcoma treated without chest radiation are also at elevated early onset breast cancer risk. However, the potential clinical benefits and cost-effectiveness of early breast cancer screening among these women are uncertain. METHODS: Using data from the Childhood Cancer Survivor Study, we adapted 2 Cancer Intervention and Surveillance Modeling Network simulation models to reflect the elevated risks of breast cancer and competing mortality among leukemia and sarcoma survivors. Costs and utility weights were based on published studies and databases. Outcomes included breast cancer deaths averted, false-positive screening results, benign biopsies, and incremental cost-effectiveness ratios. RESULTS: In the absence of screening, the lifetime risk of dying from breast cancer among survivors was 6.8% to 7.0% across models. Early initiation of annual mammography with breast magnetic resonance imaging screening between ages 25 and 40 years would avert 52.6% to 64.3% of breast cancer deaths. When costs and quality-of-life impacts were considered, screening starting at age 40 years was the only strategy with an incremental cost-effectiveness ratio below the $100 000 per quality-adjusted life-year (QALY) gained cost-effectiveness threshold ($27 680 to $44 380 per QALY gained across models). CONCLUSIONS: Among survivors of childhood leukemia or sarcoma, early initiation of breast cancer screening at age 40 years may reduce breast cancer deaths by half and is cost-effective. These findings could help inform screening guidelines for survivors treated without chest radiation

Public Stem Cell Banks: Considerations of Justice in Stem Cell Research and Therapy

Faden et al discuss the forthcoming transition of stem cell research from basic science to the development of therapies, which raises important questions of justice. They argue that they have great therapies and only a limited assortment of patients to give them to: the therapies would work only for patients whose immune systems are compatible with the stem cell lines from which the therapies are derived. If they develop therapies from cell lines that are compatible with the largest possible segments of the population, they will tend to benefit primarily whites

I dug a ditch I dug a ditch and struck it rich in Wichita [first line of chorus]

Performers: Judy Garland, Kathryn Grayson, Jose Iturbi, M-G-M Recording Orchestra, Eleanor Powell, Red Skelton, Lucille Ball, Mickey Rooney, Ann Sothern, Gene Kelly, Mary Astor, Marsha Hunt, Margaret O\u27Brien, John Boles, Virginia O\u27Brien, Frank Morgan, Lena Horne, Ben Blue, Frances Rafferty, Frank Jenks, John Conte, Dick Simmons, Don Loper, Maxine Barrat, Mary Elliott, Marilyn Maxwell, Frank Sully, Sara Haden, Ben Lessy, June Allyson, M-G-M Dancing Girls, Gloria DeHaven, Benny Carter and his band, Bob Crosby and his Orchestra, Kay Kyser and his Orchestra, Donna ReedPiano, Voice and Chord

You won\u27t believe it, you\u27ll think it\u27s a dream to hear them [first line of chorus]

Performers: Judy Garland, Kathryn Grayson, Eleanor Powell, Red Skelton, Lucille Ball, Mickey Rooney, Ann Sothern, Gene Kelly, Mary Astor, Marsha Hunt, Margaret O\u27Brien, John Boles, Virginia O\u27Brien, Frank Morgan, Lena Horne, Ben Blue, Frances Rafferty, Frank Jenks, John Conte, Dick Simmons, Don Loper, Maxine Barrat, Mary Elliott, Marilyn Maxell, Frank Sully, Sara Haden, Ben Lessy, June Allyson, M-G-M Dancing Girls, Gloria DeHaven, Benny Carter and his band, Bob Crosby and his Orchestra, Kay Kyser and his Orchestra, Donna Reed, Jose Iturbi, M-G-M Recording OrchestraPiano, Voice and Chord