Using a Collective Impact Framework to Implement Evidence-Based Strategies for Improving Maternal and Child Health Outcomes

In 2016, the North Carolina Division of Public Health launched the Improving Community Outcomes for Maternal and Child Health program to invest in evidence-based programs to address three aims: improve birth outcomes, reduce infant mortality, and improve health outcomes for children 0 to 5 years old. Five grantees representing 14 counties were awarded 2 years of funding to implement one evidence-based strategy per aim using a collective impact framework, the principles of implementation science, and a health equity approach. Local health departments served as the backbone organization and provided ongoing support to grantees and helped them form community action teams (CATs) comprising implementation team members, community experts, and relevant stakeholders who met regularly. Focus groups with each grantee’s CAT were held during 2017 and 2019 to explore how CATs used a collective impact framework to implement their chosen evidence-based strategies. Results show that grantees made the most progress engaging diverse sectors in implementing a common agenda, continuous communication, and mutually reinforcing activities. Overall, grantees struggled with a shared measurement system but found that a formal tool to assess equity helped use data to drive decision making and program adaptations. Grantees faced logistical challenges holding regular CAT meetings and sustaining community expert engagement. Overtime, CATs cultivated community partnerships and multicounty collaboratives viewed cross-county knowledge sharing as an asset. Future collective impact initiatives should allow grantees more time upfront to form their CAT to plan for sustained community engagement before implementing programs and to incorporate a tool to center equity in their work

Pregnancy-related pelvic girdle pain: an update

A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. This syndrome refers to a musculoskeletal type of persistent pain localised at the anterior and/or posterior aspect of the pelvic ring. The pain may radiate across the hip joint and the thigh bones. The symptoms may begin either during the first trimester of pregnancy, at labour or even during the postpartum period. The physiological processes characterising this clinical entity remain obscure. In this review, the definition and epidemiology, as well as a proposed diagnostic algorithm and treatment options, are presented. Ongoing research is desirable to establish clear management strategies that are based on the pathophysiologic mechanisms responsible for the escalation of the syndrome's symptoms to a fraction of the population of pregnant women

Nutritional and Supplementation Strategies to Prevent and Attenuate Exercise-Induced Muscle Damage: a Brief Review

Exercise-induced muscle damage (EIMD) is typically caused by unaccustomed exercise and results in pain, soreness, inflammation, and reduced muscle function. These negative outcomes may cause discomfort and impair subsequent athletic performance or training quality, particularly in individuals who have limited time to recover between training sessions or competitions. In recent years, a multitude of techniques including massage, cryotherapy, and stretching have been employed to combat the signs and symptoms of EIMD, with mixed results. Likewise, many varied nutritional and supplementation interventions intended to treat EIMD-related outcomes have gained prominence in the literature. To date, several review articles have been published that explore the many recovery strategies purported to minimize indirect markers of muscle damage. However, these articles are very limited from a nutritional standpoint. Thus, the purpose of this review is to briefly and comprehensively summarize many of these strategies that have been shown to positively influence the recovery process after damaging exercise. These strategies have been organized into the following sections based on nutrient source: fruits and fruit-derived supplements, vegetables and plant-derived supplements, herbs and herbal supplements, amino acid and protein supplements, vitamin supplements, and other supplements