Regular Exercise Throughout Pregnancy and Maternal Recovery Postpartum

Abstract Introduction: The American College of Obstetricians and Gynecologists recommends that “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”1 Many pregnant mothers seek guidance regarding exercise regimens’ safety and efficacy. This paper is a systematic review of the current literature on the topic of exercise regimens performed throughout pregnancy and maternal postpartum recovery. Purpose: To determine if following the American College of Obstetricians and Gynecologists recommendation to engage in regular aerobic and strength-conditioning exercises throughout pregnancy contributes to easier deliveries as measured by the number of caesarean sections, time spent in labor, and time needed for maternal recovery postpartum when compared to mothers who do not participate in exercise regimens. Methods: Databases including Ovid and Pubmed were utilized to identify peer-reviewed articles that met inclusion criteria. The quantitative and qualitative results from these articles were compiled and synthesized. Articles screened were included or excluded based on inclusion and exclusion criteria initially, followed by a more thorough assessment of the abstract and finally of the full text articles. Articles providing support for and evidence against different exercise regimens during pregnancy and their effects on maternal postpartum recovery are included in the synthesis. Results: Outcomes measured by the articles reviewed included type of delivery, requests for analgesia, pregnancy weight gain, length of labor, self-reported postpartum recovery, and hospitalization during pregnancy. Statistically significant findings were reported for exercise relating to less pregnancy related weight-gain, a decrease in the number of caesarean deliveries, a decrease in the number of requests for analgesia, and decrease in maternal recovery time postpartum. Discussion: These findings provide better evidence with which to encourage pregnant mothers to exercise even when they have not participated in exercise regimens before. Limitations of this study and the articles analyzed include the following: articles often reported statistically significant data on one or more topics regarding maternal recovery postpartum, but often the articles did not agree. Many articles did not measure the same variables and few found similar conclusions. Conclusion: There is evidence for utilizing a structured exercise regimen throughout pregnancy to decrease pregnancy related weight-gain, to decrease risk of caesarean section, to decrease the need for anesthesia during labor and delivery, and to decrease maternal recovery time postpartum. More research needs to be done to strengthen the evidence for encouraging regular exercise in pregnant women to decrease these risks and to establish statistical significance for other measures of maternal postpartum recovery. Studies should be reproduced on a larger scale in order to achieve statistical significance and allow for better clinical evidence to be utilized by providers and taught to patients

Landscaping in Lockup: The Effects of Gardening Programs on Prison Inmates

Background: Incarcerated individuals in the United States suffer fromdisproportionately poor mental health outcomes.Objective: This paper examines the effects of prison gardening programs on the psychosocial health of incarcerated individuals in the United States prison system through a systematic review of the literature.Methods: Databases including Academic Search Premier, Web of Science, PsycArticles, and Google Scholar were used to identify peer-reviewed articles that met inclusion criteria. The quantitative and qualitative results from these articles were compiled and synthesized.Results: Selected prison gardening programs were shown to increase self-efficacy and self-worth and decrease anxiety in inmates involved in these initiatives. Reduced recidivism rates were reported for participants of prison gardening programs compared to the general prisoner population. Prison gardening programs were shown to enhance incarcerated individuals’ psychosocial wellbeing in three key ways: 1) increase in self-efficacy and self-worth, 2) decrease in anxiety and depression spectrum symptoms, and 3) reduction in recidivism rates. Communities within geographic proximity of prisons implementing gardening programs also benefited from organic produce donated by the prison programs to local charities.Conclusion: There is evidence for using prison gardening programs as an alternative therapy to treat symptoms of mental illness and to help prisoners gain vocational skills that can be used upon release

Targeting G-Quadruplexes within the ADAM-15 Promoter: A Novel Therapeutic Approach for Breast Cancer

ADAM-15 is a protein that is up-regulated in many diseases, particularly breast cancer; its over-expression is correlated with more aggressive and invasive phenotypes. The critical core promoter region of ADAM-15 is capable of forming a secondary DNA structure known as a G-quadruplex. The stabilization of this G-quadruplex has the potential to decrease the transcription of the over-expressed ADAM-15 protein. Six hundred forty compounds were screened for their ability to cause a shift in the melting temperature of an ADAM-15 oligonucleotide using FRET melt. Two compounds, NSC 146771 and NSC 260594, produced a significant shift in the melting temperature; further experimentation, such as circular dichroism, cytotoxicity MTS assays, and RT-qPCR, was performed to confirm the ability of these small molecules to stabilize the G-quadruplexes within the ADAM-15 promoter. Neither compound showed cytotoxicity, and NSC 260594 showed an increased capacity for reducing the transcription of ADAM-15. Further pharmacokinetic and pharmacodynamic experimentation needs to be completed, but NSC 260594 shows potential to significantly decrease ADAM-15 expression and therefore improve the prognosis of breast cancer patients

Whither mental health policy-where does it come from and does it go anywhere useful? Comment on “Cross-national diffusion of mental health policy”

Factors influencing cross-national diffusion of mental health policy are important to understand but complex to research. This commentary discusses Shen’s research study on cross-national diffusion of mental health policy; examines the extent to which the three questions researched by Shen (whether countries are more likely to have a mental health policy (a) the earlier a country becomes a member of World Health Organization (WHO), (b) the more international aid a country receives, and (c) the more neighbouring countries already have a mental health policy) are in fact able to assess WHO’s impact on cross-national diffusion of mental health policy. The commentary then suggests a range of more specific questions which may be used to further elucidate the impact of WHO on an individual country, and considers the relative value of published mental health policy compared with the integration of mental health into national health sector strategies and other sector reforms, and concludes with a call for more integration of mental health across all WHO activities at international, regional and country levels

School-community libraries of South Australia: The lived experience. A report of 2018 research results

SSHRCNon-Peer ReviewedAustralia has widely embraced the joint use library structure. Many Australian states have guidelines around joint use libraries and the Australian Library and Information Association has developed its own policy. In particular, the state of South Australia has over forty joint use libraries and is unique in its statewide programmatic approach to school-community libraries. The purpose of this research project was to learn from the robust South Australian experience in establishing, working with, and managing rural and remote joint use libraries. Initially the research project aimed to look broadly at the variety of joint use library models in place in the state. Visits to joint use libraries near Adelaide and in the southeastern corner of the state, initial discussions with the Interim Director of the State Library, and further reading resulted in a narrowing of the project’s focus. Ultimately, the project explored the potential of the South Australian school-community library program as a model for rural and remote community libraries. Research questions focused on what is working well with the program and where there are challenges. This report is a summary of what was heard during the project’s data-gathering phase, between August and December 2018. The report contains no recommendations, as the purpose of the project was to learn from the current school-community library program in South Australia, not to review it. The report was provided to the Libraries Board of South Australia, the Department for Education (South Australia), and the Local Government Association (South Australia) to help inform their work in delivering library services to schools and communities across the state

A Way Forward: Presenting a Post-modern Framework for Disability

People with disability continue to be engaged in a rights struggle which is reinforced through processes of modernity. This paper reviews the modern framework and its far-reaching effects in influencing understandings of disability, using the Australian experience as an example. An alternative post-modern framework is then presented in contrast. A post-modern conceptualisation of disability is presented as a way forward for understanding disability and for application to disability studies and research

A position of strength: The value of evidence and change management in master plan development

Peer ReviewedLibraries are experiencing significant change in how space is being used as well as increasing pressure from their funding and governance bodies to demonstrate the continued need for library physical space. There is a growing demand for library spaces that reflect different ways of accessing and using information, support learning and building community, and encourage creativity and the creation of new knowledge. To assist them in determining how to move forward, many libraries are developing master plans – multi-year high-level plans providing direction and vision but allowing flexibility to accommodate unanticipated needs – for their physical spaces and service delivery models. The challenge for libraries is to ensure that their master plans reflect the dynamic world in which they are situated and are supported by clients and other library stakeholders

Why Market? Reflections of an academic library administrator

Purpose - The paper looks at the assumption that the captive audience of students and faculty lessens the need to market the academic library. The paper highlights the challenges experienced by academic libraries and discusses the vital importance of focusing library marketing and services on the needs of the clients rather than the needs of the library itself. Findings - Academic libraries are affected by many of the same issues found in public and special libraries, particularly changing information access and distribution models and budget restrictions, resulting in the need to market library services to clients. Academic libraries need to ensure that library marketing focuses on client needs

Drought-Damage Functions for the Estimation of Drought Costs under Future Projections of Climate Change

Drought events and their impacts pose a considerable problem for governments, businesses and individuals. Superimposed on this is the risk of anthropogenic climate change. Climate models are increasingly being used to understand how climate change may affect future drought regimes. However, methodologies to quantify economic costs which could occur under these future scenarios are virtually non-existent. In this study, historic drought events were identified in regional precipitation data using the Standardized Precipitation Index, and their magnitude quantified and linked to reported economic costs. Drought damage functions were created for Australia, Brazil, China, India, Spain/Portugal and the USA. Projections of drought magnitude for 2003–2050 were modeled using the Community Integrated Assessment System, for a range of climate and emission scenarios, and future economic costs estimated. Severe and extreme drought events were projected to cause estimated additional losses ranging between 0.04 and 9 percent of national GDP in Australia, the USA and Spain/Portugal under future scenarios of climate change. The combined effect on global GDP from projected long-term drought events in the countries analyzed resulted in additional annual losses of 0.01 to 0.25 percent. This is considered conservative as the analysis is representative of seven countries only; does not incorporate the possibility of successive drought events, or compounding effects on vulnerability from interactions with other extreme events. Furthermore, it excludes indirect economic effects; social and environmental losses; the possibility of increasing vulnerability due to changing socio-economic conditions; and the possibility of irreversible or systemic collapse of economies as the study highlighted that under future climate change drought magnitude may exceed current experience potentially passing thresholds of social and economic resilience. Stringent mitigation had little effect on the increasing impacts of drought in the first half of the 21st century, so in the short-term adaptation in drought “hot spots” will be crucial

Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations

<p>Abstract</p> <p>Background</p> <p>Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources.</p> <p>Methods</p> <p>A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems.</p> <p>Results</p> <p>The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines to accompany the general health policy, tobacco legislation, adaptation of the WHO primary care guidelines for Kenya, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, some strengthening of intersectoral liaison with police, prisons and schools, and public education about mental health.</p> <p>Conclusions</p> <p>The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate assessment and treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, social inclusion, promotion and advocacy to mobilize community engagement.</p