Factors Associated with Bed-Sharing Within Racial Groups in a Sample of Mothers and Young Infants in Wisconsin

Since 2005, the American Academy of Pediatrics has recommended a separate but proximate sleep surface for infants (AAP, 2005). However, racial differences in the prevalence of bed-sharing and infant mortality (especially as a result of SIDS or unsafe sleep) continue. Limited research has examined predictors of bed-sharing by racial group, especially the AAP\u27s 2005 policy statement against it. The purpose of this study was to explore maternal-infant bed-sharing and infant sleep position for African-Americans and Whites in a sample of 2,530 respondents (822 African-American and 1,708 Whites) to the Wisconsin Pregnancy Risk Assessment and Monitoring System (PRAMS), a stratified sample of linked survey and birth certificate data between 2007 and 2010. Significantly more African-Americans (70.5%) reported bed-sharing than Whites (53.5%), z = 56.67, SEM = 0.005, p \u3c .001 (one-tailed). Factors associated with bed-sharing varied by race. In the final models, for African-Americans, a higher likelihood of bed-sharing was associated with ≥ 16 years of education (Odds Ratio[OR]: 2.540, 95% CI: 1.098-5.875), 13-15 years of education (OR: 1.924, 95% CI: 1.129-3.278), partner-related stress (OR: 1.859, 95% CI: 1.272-2.715), currently breastfeeding (OR: 1.598, 95% CI: 1.012-2.522), non-supine infant sleep (OR: 1.573, 95% CI: 1.077-2.297), and maternal age (OR: 0.963, 95% CI: 0.931-0.995). When Medicaid as method of payment was included, it reduced the likelihood of bed-sharing (OR: 0.550, 95% CI: 0.372-0.814). For Whites, bed-sharing was associated with currently breastfeeding (OR: 2.444, 95% CI: 1.939-3.081), income of $10,000-$14,999 (OR: 1.833, 95% CI: 1.004-3.344), income of $35,000-$49,999 (OR: 1.704, 95% CI: 1.234-2.351), being unmarried (OR: 1.667, 95% CI: 1.184-2.346), non-supine infant sleep (OR: 1.407, 95% CI: 1.069-1.852), and partner-related stress (OR: 1.381, 95% CI: 1.058-1.802). Needing money for food was also associated with bed-sharing (OR: 1.575, 95% CI: 1.158-2.143). Overall, subtle differences in the factors at play for African-American and White families who bed-share were demonstrated. Practice implications include culturally-relevant discussions and interventions. In-depth investigation of the family level context of bed-sharing, the ecology of infant sleep, and information received by families is suggested. These results help inform development of a targeted, culturally sensitive approach to educating families on sleep-related infant safety

Dual Master of Social Work / Master of Public Health Degrees: Perceptions of Graduates and Field Instructors

Despite growing interest in Master of Social Work/Master of Public Health (MSW/MPH) programs, limited research literature is available on MSW/MPH graduates and none has examined field instructors’ perceptions of MSW/MPH students. This study describes the perceptions and experiences of MSW/MPH alumni and field instructors from a recently implemented MSW/MPH program at the University of Georgia. Electronic surveys were administered to 32 alumni and 34 field instructors; response rates were 71.9% (n=23) and 70.6% (n=24), respectively. Alumni reported satisfaction with the dual degree and utilization of both social work and public health skills in the workplace. Field instructors underscored the complementary skill sets of dually-trained students and noted the added value of MSW/MPH professionals in their agencies. Dually-trained MSW/MPH practitioners are uniquely prepared to address the need for transdisciplinary and interprofessional collaborations to address long-standing social and health issues

Two approaches to the study of the origin of life.

This paper compares two approaches that attempt to explain the origin of life, or biogenesis. The more established approach is one based on chemical principles, whereas a new, yet not widely known approach begins from a physical perspective. According to the first approach, life would have begun with - often organic - compounds. After having developed to a certain level of complexity and mutual dependence within a non-compartmentalised organic soup, they would have assembled into a functioning cell. In contrast, the second, physical type of approach has life developing within tiny compartments from the beginning. It emphasises the importance of redox reactions between inorganic elements and compounds found on two sides of a compartmental boundary. Without this boundary, ¿life¿ would not have begun, nor have been maintained; this boundary - and the complex cell membrane that evolved from it - forms the essence of life

Sheldon Spectrum and the Plankton Paradox: Two Sides of the Same Coin : A trait-based plankton size-spectrum model

The Sheldon spectrum describes a remarkable regularity in aquatic ecosystems: the biomass density as a function of logarithmic body mass is approximately constant over many orders of magnitude. While size-spectrum models have explained this phenomenon for assemblages of multicellular organisms, this paper introduces a species-resolved size-spectrum model to explain the phenomenon in unicellular plankton. A Sheldon spectrum spanning the cell-size range of unicellular plankton necessarily consists of a large number of coexisting species covering a wide range of characteristic sizes. The coexistence of many phytoplankton species feeding on a small number of resources is known as the Paradox of the Plankton. Our model resolves the paradox by showing that coexistence is facilitated by the allometric scaling of four physiological rates. Two of the allometries have empirical support, the remaining two emerge from predator-prey interactions exactly when the abundances follow a Sheldon spectrum. Our plankton model is a scale-invariant trait-based size-spectrum model: it describes the abundance of phyto- and zooplankton cells as a function of both size and species trait (the maximal size before cell division). It incorporates growth due to resource consumption and predation on smaller cells, death due to predation, and a flexible cell division process. We give analytic solutions at steady state for both the within-species size distributions and the relative abundances across species

Deterministic Evolutionary Trajectories Influence Primary Tumor Growth: TRACERx Renal.

The evolutionary features of clear-cell renal cell carcinoma (ccRCC) have not been systematically studied to date. We analyzed 1,206 primary tumor regions from 101 patients recruited into the multi-center prospective study, TRACERx Renal. We observe up to 30 driver events per tumor and show that subclonal diversification is associated with known prognostic parameters. By resolving the patterns of driver event ordering, co-occurrence, and mutual exclusivity at clone level, we show the deterministic nature of clonal evolution. ccRCC can be grouped into seven evolutionary subtypes, ranging from tumors characterized by early fixation of multiple mutational and copy number drivers and rapid metastases to highly branched tumors with >10 subclonal drivers and extensive parallel evolution associated with attenuated progression. We identify genetic diversity and chromosomal complexity as determinants of patient outcome. Our insights reconcile the variable clinical behavior of ccRCC and suggest evolutionary potential as a biomarker for both intervention and surveillance

The Effects of Aging on the Molecular and Cellular Composition of the Prostate Microenvironment

Advancing age is associated with substantial increases in the incidence rates of common diseases affecting the prostate gland including benign prostatic hyperplasia (BPH) and prostate carcinoma. The prostate is comprised of a functional secretory epithelium, a basal epithelium, and a supporting stroma comprised of structural elements, and a spectrum of cell types that includes smooth muscle cells, fibroblasts, and inflammatory cells. As reciprocal interactions between epithelium and stromal constituents are essential for normal organogenesis and serve to maintain normal functions, discordance within the stroma could permit or promote disease processes. In this study we sought to identify aging-associated alterations in the mouse prostate microenvironment that could influence pathology.We quantitated transcript levels in microdissected glandular-adjacent stroma from young (age 4 months) and old (age 20-24 months) C57BL/6 mice, and identified a significant change in the expression of 1259 genes (p<0.05). These included increases in transcripts encoding proteins associated with inflammation (e.g., Ccl8, Ccl12), genotoxic/oxidative stress (e.g., Apod, Serpinb5) and other paracrine-acting effects (e.g., Cyr61). The expression of several collagen genes (e.g., Col1a1 and Col3a1) exhibited age-associated declines. By histology, immunofluorescence, and electron microscopy we determined that the collagen matrix is abundant and disorganized, smooth muscle cell orientation is disordered, and inflammatory infiltrates are significantly increased, and are comprised of macrophages, T cells and, to a lesser extent, B cells.These findings demonstrate that during normal aging the prostate stroma exhibits phenotypic and molecular characteristics plausibly contributing to the striking age associated pathologies affecting the prostate

Deterministic Evolutionary Trajectories Influence Primary Tumor Growth: TRACERx Renal.

The evolutionary features of clear-cell renal cell carcinoma (ccRCC) have not been systematically studied to date. We analyzed 1,206 primary tumor regions from 101 patients recruited into the multi-center prospective study, TRACERx Renal. We observe up to 30 driver events per tumor and show that subclonal diversification is associated with known prognostic parameters. By resolving the patterns of driver event ordering, co-occurrence, and mutual exclusivity at clone level, we show the deterministic nature of clonal evolution. ccRCC can be grouped into seven evolutionary subtypes, ranging from tumors characterized by early fixation of multiple mutational and copy number drivers and rapid metastases to highly branched tumors with >10 subclonal drivers and extensive parallel evolution associated with attenuated progression. We identify genetic diversity and chromosomal complexity as determinants of patient outcome. Our insights reconcile the variable clinical behavior of ccRCC and suggest evolutionary potential as a biomarker for both intervention and surveillance

Deterministic Evolutionary Trajectories Influence Primary Tumor Growth: TRACERx Renal.

The evolutionary features of clear-cell renal cell carcinoma (ccRCC) have not been systematically studied to date. We analyzed 1,206 primary tumor regions from 101 patients recruited into the multi-center prospective study, TRACERx Renal. We observe up to 30 driver events per tumor and show that subclonal diversification is associated with known prognostic parameters. By resolving the patterns of driver event ordering, co-occurrence, and mutual exclusivity at clone level, we show the deterministic nature of clonal evolution. ccRCC can be grouped into seven evolutionary subtypes, ranging from tumors characterized by early fixation of multiple mutational and copy number drivers and rapid metastases to highly branched tumors with >10 subclonal drivers and extensive parallel evolution associated with attenuated progression. We identify genetic diversity and chromosomal complexity as determinants of patient outcome. Our insights reconcile the variable clinical behavior of ccRCC and suggest evolutionary potential as a biomarker for both intervention and surveillance

Evaluation of a Multisite Safe Infant Sleep Education and Crib Distribution Program

Rates of sleep-related infant deaths have plateaued in the past few decades despite ongoing infant sleep practice recommendations to reduce risk of sleep-related infant deaths by the American Academy of Pediatrics. The state department of public health trained facilitators at 28 sites across the state to facilitate a group safe sleep educational program. A prospective, matched pre- and post-test cohort design with follow-up was used to evaluate changes in self-reported knowledge, intentions, and practices. The final sample included 615 matched pre- and post-test surveys, and 66 matched follow-up surveys. The proportion of correct responses on all knowledge and intended practice items increased significantly from pre- to post-test. When asked where their babies would have slept if they had not received the portable crib, 66.1% of participants planned to use a recommended sleep location (e.g., crib or bassinet). At post-test, 62.3% planned to change something about their infant’s sleep based on what they learned. At follow-up, knowledge was maintained for all but two items and practices and for half of practice items. The results suggest that participating in the education program was associated with increased knowledge and intended adherence, but that these changes were not maintained at follow-up. These results are in line with the research literature that finds a difference in intentions and actual practices after the baby is born