Expanding Use of Magnesium Sulfate for Treatment of Pre-eclampsia and Eclampsia

Pre-eclampsia/eclampsia is a serious condition that can develop during pregnancy, even in women with no risk factors. Although there is little understanding of what causes pre-eclampsia/eclampsia, there is an effective treatment for this condition which, if left untreated, can progress to coma and death. In 1994, the World Health Organization (WHO) recommended magnesium sulfate as the standard treatment for pre-eclampsia and eclampsia and within two years it was placed on WHO's Essential Medicines List. Despite its known efficacy, this inexpensive drug is often underutilized, in part because the diffusion of innovation takes time but also because of the service delivery challenges inherent to the use of magnesium sulfate—it requires a strong and effective referral system, often a challenge in under-resourced health systems. The underutilization of magnesium sulfate has been a recognized problem in Nigeria for some time; prior to 2007 there was almost no magnesium sulfate in the country.The significant contribution of pre-eclampsia/eclampsia to maternal mortality in Nigeria—along with the promise of magnesium sulfate as a solution—caught the attention of the John D. and Catherine T. MacArthur Foundation in 2005 when a program officer overheard a conversation between two Nigerian doctors who were lamenting the failure of a piece of equipment in their hospital laboratory that was used for manufacturing magnesium sulfate. Without it, one was saying to the other, they would have no supply of the drug to treat pre-eclampsia/eclampsia and no way to save women's lives. The Foundation decided to fund a series of grants to expand the use of magnesium sulfate for pre-eclampsia/eclampsia in Nigeria and, in 2014, commissioned an evaluation of that work. This case study describes the findings of the evaluation, including the challenges encountered while implementing the projects, the successes achieved, and existing opportunities for future scaling up of the services across the country

Project SustAIn: Sustainable Agriculture Initiative

In partnership with Outside In, Pacific University School of Occupational Therapy and two students as a part of their Innovative Practice Project (IPP) began Project SustAIn a program in 2008. Project SustAIn was a renewed effort to continue a gardening program initiated at Outside In’s Education Resource Center by one of the Urban Education teachers (see Figure 1 for an illustration of Project SustAIn: Program Development and Partnership). Project SustAIn was initially designed to create vocational job opportunities and attain educational credits for the homeless youth while collaborating with occupational therapy to develop work and vocational skills through the therapeutic process of gardening; these skills included personal goal development and planning, time management, professional behavior and interview skills training. Through continued partnership on the behalf of the original 2008 occupational therapy students (currently practicing occupational therapists), Pacific University, and Outside In’s Urban Ed program, Project SustAIn was expanded in the Winter of 2010 by two additional occupational therapy students as a part of their IPP to encompass a new tract for independent living and transitional skill development as well as grow in areas of professional and organizational collaboration to more fully meet the needs of Portland’s homeless youth population. This document describes the expansion and growth of Project SustAIn including: a background and literature search of adolescent development in addition to theory and the implications for transition into adulthood for the homeless youth at Outside In; an account of actions and methodologies of Project SustAIn 2010; and a discussion and summary of outcomes, perceived benefits and suggestions for future program development and collaboration

Population assessment of the vermilion snapper, Rhomboplites aurorubens, from the Southeastern United States

Changes in the age structure and population size of vermilion snapper, Rhornboplites aurorubens, from North Carolina through the Florida Keys were examined using records of landings and size frequencies of fish from commercial, recreational, and headboat fisheries from 1986-1996. Population size in numbers at age was estimated for each year by applying separable virtual population analysis (SVPA) to the landings in numbers at age. SVPA was used to estimate annual, age-specific fishing mortality (F) for four levels of natural mortality (M = 0.20, 0.25, 0.30, and 0.35). Although landings of vermilion snapper for the three fisheries have declined, minimum fish size regulations have resulted in an increase in the mean size of fish landed. Age at entry and age at full recruitment were age-1 andage-3 fDr 1986-1991, compared with age-1 and age-4, respectively, for 1992-1996. Levels of mortality from fishing (F) ranged from 0.38 - 0.61 for the entire period. Current spawning potential ratio (SPR) is 21% or 27% depending on the natural mortality estimate. SPR could be raised to 30% or 40% with a reduction in F, or by increasing the age at entry to the fisheries. The latter could be enhanced now if fishermen, particularly recreational, comply with minimum size regulations. However, released fish mortality, modeled in the assessment at 27%, will continue to make the achievement of 30% and 40% SPR more difficult. (PDF contains 63 pages

Estimated ages of red porgy (Pagrus pagrus) from fishery-dependent and fishery-independent data and a comparison of growth parameters

The red porgy, Pagrus pagrus, is an important reef fish in several offshore fisheries along the southeastern United States. We examined samples from North Carolina through southeast Florida from recreational (headboat) and commercial (hook and line) fisheries, as well as samples from a fishery-independent source. Red porgy attain a maximum age of at least 18 years and 733 mm total length. The weight-length relationship is represented by the ln-ln transformed equation: W = 8.85 × 10–6(L)3.06, where W = whole weight in grams, and L = total length in mm. The von Bertalanffy growth equation fitted to the most recent, back-calculated lengths from all the samples is Lt = 644(1 – e –0.15(t + 0.76)). Our study revealed a difference in mean length at age of red porgy from the three sources. Red porgy in fishery-independent collections were smaller at age than specimens examined from fishery-dependent sources. The difference in length-at-age may be related to gear selectivity and have important consequences in the assessment of fish stocks

Financial Literacy in Retirement Planning

Studying finance, I have been exposed to the retirement plan options and how they work in most of my classes. But when I would talk to my family and friends about what I was learning, I quickly discovered that many people simply had no interest or understanding about the subject. I believe everyone needs to have a basic understanding of where income will come from once they retire. This realization pushed me to study the level of financial literacy about retirement and plan options of adults in the working world and determine how I could bring information about this topic to the Bowling Green, Kentucky community. I administered a survey to employees of a local business to gauge their basic financial literacy, and then determined how they most prefer to learn about finance topics. In this thesis, I explain the basic retirement options and products in today’s market and discuss my findings in surveying a company in the Bowling Green area on their financial literacy and how to develop the retirement plan knowledge of the employees I surveyed

Sialic Acid Mutarotation Is Catalyzed by the Escherichia coli β-Propeller Protein YjhT

The acquisition of host-derived sialic acid is an important virulence factor for some bacterial pathogens, but in vivo this sugar acid is sequestered in sialoconjugates as the {alpha}-anomer. In solution, however, sialic acid is present mainly as the β-anomer, formed by a slow spontaneous mutarotation. We studied the Escherichia coli protein YjhT as a member of a family of uncharacterized proteins present in many sialic acid-utilizing pathogens. This protein is able to accelerate the equilibration of the {alpha}- and β-anomers of the sialic acid N-acetylneuraminic acid, thus describing a novel sialic acid mutarotase activity. The structure of this periplasmic protein, solved to 1.5Å resolution, reveals a dimeric 6-bladed unclosed β-propeller, the first of a bacterial Kelch domain protein. Mutagenesis of conserved residues in YjhT demonstrated an important role for Glu-209 and Arg-215 in mutarotase activity. We also present data suggesting that the ability to utilize {alpha}-N-acetylneuraminic acid released from complex sialoconjugates in vivo provides a physiological advantage to bacteria containing YjhT

A Pilot Randomized Controlled Trial of Acceptance and Commitment Therapy Guided Self-Help for Overweight and Obese Adults High in Weight Self-Stigma

Weight self-stigma, in which individuals internalize stigmatizing messages about weight, is a prevalent problem that contributes to poor quality of life and health. This pilot randomized controlled trial evaluated acceptance and commitment therapy (ACT) guided self-help using The Diet Trap (Lillis, Dahl, & Weineland, 2014) for 55 overweight/obese adults high in weight self-stigma. Participants were randomized to the ACT self-help book plus phone coaching (GSH-P; n=17), self-help book plus email prompts only (GSH-E; n=20), or a waitlist condition (n=18), with online self-report assessments at baseline and posttreatment (8 weeks later). Participants reported high satisfaction ratings and engagement with the ACT self-help book, with no differences between GSH-P and GSH-E. Both GSH-P and GSH-E improved weight self-stigma relative to waitlist with large effect sizes. There were mixed findings for health outcomes. The GSH-P condition improved more on healthy eating behaviors and general physical activity, but neither ACT condition improved more than waitlist on self-reported body mass index, emotional eating, and a second measure of physical activity. Results suggest an ACT self-help book with email prompts can reduce weight self-stigma and potentially improve some health behavior outcomes. Phone coaching may provide additional benefits for generalizing ACT to diet and physical activity

A Randomized Controlled Trial of Multiple Versions of an Acceptance and Commitment Therapy Matrix App for Well-Being

Mobile apps may be useful in teaching psychological skills in a high-frequency, low-intensity intervention. The Acceptance and Commitment Therapy (ACT) matrix is a visual tool to help develop psychological flexibility by categorizing moment-to-moment experience and is well suited to a mobile app. This pilot study tested the effects of a simple and complex version of a novel app using the ACT matrix in two distinct samples: help-seeking individuals (n = 35) and students receiving SONA credit (n = 63). Findings indicated no differences between app conditions and a waitlist condition in the SONA credit sample. However, in the help-seeking sample improvements were found on well-being and valued action in participants who used the app, with greater improvements and app adoption for those using a complex version with additional skills. A mobile app based on the ACT matrix has benefits for help-seeking individuals, but supplementary features may be necessary to support consistent use and benefits

Scaling up Access to Misoprostol at the Community Level to Improve Maternal Health Outcomes in Ethiopia, Ghana, and Nigeria

Over the past decade (2004–2014), the Population and Reproductive Health area of the MacArthur Foundation has focused on supporting projects aimed at reducing maternal mortality. In particular, it has supported efforts to use misoprostol to prevent postpartum hemorrhage, the anti-shock garment to aid in the treatment of hemorrhage, and magnesium sulfate to decrease deaths from eclampsia. In recent years, the Foundation has invested in a range of research and evaluation efforts to better understand these interventions, their effectiveness, and the extent to which successful pilot projects have been scaled up.In 2014, the Foundation commissioned the Public Health Institute to evaluate the grants it had made to increase community-based access to misoprostol for postpartum hemorrhage prevention in Ethiopia, Ghana, and Nigeria. Specifically, the Foundation was interested in documenting the models and approaches used and the progress toward scaling up the respective models in the three countries. Between June and November 2014, the evaluation team reviewed grantee reports, proposals, and the literature; interviewed key informants and global, national, and local stakeholders; conducted focus group discussions with local stakeholders; and made observations during site-visits in each country. From this the team produced case study reports relating to misoprostol use in each country. This report is a synthesis of those three case studies, highlighting the common findings across the projects, identifying differences, and interpreting the lessons learned for broader use and scale up of misoprostol at the community level in Africa and globally