The impact of endometrial injury to the risk of preeclampsia

Thesis (Ph.D.)--Boston UniversityPreeclampsia is associated with disproportionately high rates of neonatal mortality and morbidity. Both therapeutic and prophylactic interventions have been lacking and delivery of the placenta remains the only effective cure for this obstetrical complication. In study 1 we examined the association between prior induced abortion and preeclampsia among nulliparous women in the Medical Birth Register (MBR) of Finland from 1996-2010. Preeclampsia cases (n=12,650) and frequency matched controls (n=50,600) were linked with the Finnish Registry of Induced Abortions to collect data on any prior induced abortions (IA), method of IA, and gestational age at the time of IA. History ofiA was associated with a decreased risk ofpreeclampsia (OR 0.89, 95% CI 0.84, 0.95). The risk of preeclampsia decreased further with an increasing number of prior IA with decreased risks of 8%, 23%, and 26% for 1, 2, and 2:3 lAs, respectively. These associations become more protective after restricting the analysis to women with no history of spontaneous abmtion (SAB). Surgical abortions at 2:12 weeks were associated with the greatest reduction in risk of preeclampsia (OR 0.81 95% CI 0.61, 1.06). Our study confirms previous findings of a protective effect of IA on risk of preeclampsia and provides new information regarding method and gestational age of abortion in relation to preeclampsia risk. In study 2 we investigated the potential for a differential effect of placental abruption on preeclampsia, based on the gestational age at the time of abruption among parous women in the MBR of Finland from 1996-2010. Cases of preeclampsia (n=6,487) and frequency matched controls (n=25,948) were linked to the Hospital Discharge Registry (HDR) and MBR to ascertain data on prior placental abruption. Placental abruption was categorized as preterm (<37 weeks) or term (2:37 weeks). Preterm abruptions were associated with a two-fold increase in risk of preeclampsia (OR 2.18 95% CI 1.45, 3.30). In contrast term placental abruption was not associated with preeclampsia. The association between preterm placental abruption and preeclampsia was further elevated among women with a history of preeclampsia. Associations with preterm abruption were also strengthened when the outcome was defined as early-onset preeclampsia (<34 weeks). Placental abruption in a prior pregnancy conferred a different risk of preeclampsia based on the gestational age of the abruption affected pregnancy. Lastly, in study 3 we examined the association between intrauterine device (IUD) use and preeclampsia among women in the United Kingdom's Clinical Practice Research Database from 1993-2010. Data on IUD use was obtained from patient records for 2,837 cases and 11 ,221 matched controls. Any prior IUD use was associated with a reduced risk of preeclampsia (OR 0.77 95% CI 0.61 , 0.98). Timing of removal in relation to the start of pregnancy showed an inverse association, with shorter intervals associated with the largest decreases in risk of preeclampsia. IUD removal within a year prior to pregnancy had an OR of 0.66 (95% CI 0.46, 0.96). Associations were most notable for women with a BMI <25kg/m and for women with no prior births. IUD use prior to pregnancy was associated with a reduced risk of preeclampsia, which was most apparent for those using an IUD within a year prior to pregnancy

Enhancing Active Collaborative Classroom Learning with Tablet PC Technology

This research study had two aims: Aim 1: Describe graduate student and faculty perceptions of using tablet laptop technology to enhance active collaborative classroom learning. Aim 2: Identify supporting structures and processes for using tablet laptop technology to enhance active collaborative classroom learning. This peer-reviewed poster was presented as a series of mounted/laminated Microsoft PowerPoint slides at the UMass Instructional Technology Conference, April 2008

Canine Genomics and Genetics: Running with the Pack

The domestication of the dog from its wolf ancestors is perhaps the most complex genetic experiment in history, and certainly the most extensive. Beginning with the wolf, man has created dog breeds that are hunters or herders, big or small, lean or squat, and independent or loyal. Most breeds were established in the 1800s by dog fanciers, using a small number of founders that featured traits of particular interest. Popular sire effects, population bottlenecks, and strict breeding programs designed to expand populations with desirable traits led to the development of what are now closed breeding populations, with limited phenotypic and genetic heterogeneity, but which are ideal for genetic dissection of complex traits. In this review, we first discuss the advances in mapping and sequencing that accelerated the field in recent years. We then highlight findings of interest related to disease gene mapping and population structure. Finally, we summarize novel results on the genetics of morphologic variation

Increasing Flexibility for Adult Learners: Merging a Hybrid Course with a Fully Online Course

The objectives of this presentation are to: 1. Examine the processes and outcomes of a project aimed at increasing enrollment into two nurse educator courses at the Graduate School of Nursing at the University of Massachusetts Worcester. 2. Discuss the pros and cons of the strategy selected for the project. This peer-reviewed slide presentation was presented at the 15th Sloan-C International Conference on Online Learning, on October 30, 2009, in Orlando, Florida

Redesigning Web-Based Courses for Nurse Educators. Fully Online? Hybrid?

Background: Schools of nursing are experiencing faculty shortages which limit student admissions. The additional time and effort needed to gain competency as an academic nurse educator is one reason for this shortage. Nurse educator web-based courses offer increased flexibility in time management as well as reduced commuting time, however not all nurses embrace the online learning environment. Aim: Expand access to two web-based nurse educator courses at the University of Massachusetts Worcester by offering nurses the choice, within a single course, of completing either a hybrid or fully online course. N620: Teaching and Curriculum DevelopmentN623: Identifying and Measuring Outcomes Research Design: Exploratory prospective design. Qualitative data gathered from student focus groups and interviews. Quantitative data gathered through initial, formative and end of course surveys, student assignments, grades. Findings: 1. 50% of the students completed the hybrid course because face to face interaction was highly valued. 2. Students with prior satisfactory online learning experiences and who knew each other from other courses completed the fully online course. 3. Students with no previous experience taking online courses did not anticipate the time commitment. 4. Even a hybrid course format can increase access to graduate courses for busy students with jobs and families. The online format reduced the burden of commuting and allowed for flexibility. Enrollment in N 620 more than doubled from the previous year (four versus nine students). Recommendations: 1. Potential students should complete a self-assessment to determine if they are motivated to be self-directed learners and learn basic computer skills, Powerpoint© and Blackboard Vista© technology prior to beginning a hybrid or fully online course. 2. To facilitate communication in a hybrid or fully online course, course syllabi should contain detailed descriptions of all assignments, grading criteria and due dates. (U Wisconsin Milwaukee Learning Technology Center)

Small business and information systems

We are pleased to present this AJIS featured theme on Small Business and Information Systems, which is the result of a merger between AJIS and the Journal of Information Systems and Small Business. The co-editors of both journals felt that the merger would help raise the profile of small business research in Australia (since AJIS is more highly recognised than JISSB) and that it would increase the number of publications in AJIS. It is also a global featured theme, with papers from Australia, New Zealand, the United Kingdom and Ireland

Viral-immune cell interactions at the maternal-fetal interface in human pregnancy

The human decidua and placenta form a distinct environment distinguished for its promotion of immunotolerance to infiltrating semiallogeneic trophoblast cells to enable successful pregnancy. The maternal-fetal interface also successfully precludes transmission of most pathogens. This barrier function occurs in conjunction with a diverse influx of decidual immune cells including natural killer cells, macrophages and T cells. However, several viruses, among other microorganisms, manage to escape destruction by the host adaptive and innate immune system, leading to congenital infection and adverse pregnancy outcomes. In this review, we describe mechanisms of pathogenicity of two such viral pathogens, Human cytomegalovirus (HCMV) and Zika virus (ZIKV) at the maternal-fetal interface. Host decidual immune cell responses to these specific pathogens will be considered, along with their interactions with other cell types and the ways in which these immune cells may both facilitate and limit infection at different stages of pregnancy. Neither HCMV nor ZIKV naturally infect commonly used animal models [e.g., mice] which makes it challenging to understand disease pathogenesis. Here, we will highlight new approaches using placenta-on-a-chip and organoids models that are providing functional and physiologically relevant ways to study viral-host interaction at the maternal-fetal interface

Telehealth Group Interactions in the Hospice Setting: Assessing Technical Quality Across Platforms

Objective: This study aims to examine the technical quality of videoconferencing used in hospice to engage caregivers as “virtual” members of interdisciplinary team meetings and their impressions of telehealth. Furthermore, it aims to compare the quality of plain old telephone service (POTS) and Web-based videoconferencing and provide recommendations for assessing video quality for telehealth group interactions. Materials and Methods: Data were obtained from an ongoing randomized clinical trial exploring Web-based videoconferencing and a completed prospective study of POTS-based videoconferencing in hospice. For the assessment of the technical quality, an observation form was used. Exit interviews with caregivers assessed impressions with the use of telehealth. A retrospective analysis of video-recorded team meetings was conducted rating attributes essential for the quality of videoconferencing (e.g., video artifacts, sharpness). Results: In total, 200 hospice team meetings were analyzed, including 114 video-recorded team meetings using Web-based videoconferencing and 86 meetings using POTS videophones. A direct comparison between the two modalities indicates the superiority of Web-based video in image quality but less so in audio quality. Transcripts of 19 caregiver interviews were analyzed. Caregivers found the use of videoconferencing to be a positive experience and a useful and essential tool to communicating with the hospice team. Conclusions: This study highlights the potential of telehealth to improve communication in hospice and the need for new tools that capture the quality of video-mediated communication among multiple stakeholders and strategies to improve the ongoing documentation of telehealth group sessions\u27 technical quality

Education day for new graduates

Describes an orientation program for new graduate nurses where new nurses are matched with preceptors