Evaluating a Stepped Care Protocol for Postpartum Depression in a Pediatric Primary Care Clinic

Postpartum depression (PPD) is a prevalent, complex illness impacting 10% to 20% of mothers and their families. Treatments for PPD, such as medication and psychotherapy, are effective at reducing the severity of symptoms and generally improving quality of life for new mothers and their families. Unfortunately, many mothers with PPD go unrecognized due to a lack of standardized screening methods. Further, mothers regularly encounter barriers to accessible, evidence-based follow-up care to treatment even when symptoms of PPD are detected. The use of a stepped care protocol, set in a pediatric primary care clinic, is one proposed strategy to address the insufficient rates of screening, detection, and maternal contact with treatment. This study examines the feasibility of implementing a stepped care protocol to screen and provide brief therapeutic treatment to mothers reporting symptoms of PPD in one pediatric primary care clinic. The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework was used to evaluate implementation outcomes. Results suggest this stepped care protocol was feasibly implemented in one pediatric primary care clinic. The protocol was largely successful in screening mothers at a majority of well child checks (83.76%) for PPD and connecting them with resources based on the severity of symptoms reported. Future studies should further evaluate the impact brief onsite mental health treatments have on reports of PPD symptoms, longitudinal maternal and child outcomes as a result of the protocol, as well as the protocol’s replicability to pediatric practices elsewhere

Double-Peaked Narrow-Line Active Galactic Nuclei. II. The Case Of Equal Peaks

Active galactic nuclei (AGNs) with double-peaked narrow lines (DPAGNs) may be caused by kiloparsec-scale binary AGNs, bipolar outflows, or rotating gaseous disks. We examine the class of DPAGNs in which the two narrow-line components have closely similar intensity as being especially likely to involve disks or jets. Two spectroscopic indicators support this likelihood. For DPAGNs from Smith et al., the "equal-peaked" objects (EPAGNs) have [Ne V]/[O III] ratios lower than for a control sample of non-double-peaked AGNs. This is unexpected for a pair of normal AGNs in a galactic merger, but may be consistent with [O III] emission from a rotating ring with relatively little gas at small radii. Also, [O III]/H beta ratios of the redshifted and blueshifted systems in the EPAGN are more similar to each other than in a control sample, suggestive of a single ionizing source and inconsistent with the binary interpretation.University Cooperative Society of the University of Texas at AustinJane and Roland Blumberg Cenntenial Professorship in AstronomyAlfred P. Sloan FoundationNational Aeronautics and Space AdministrationNational Science FoundationU.S. Department of EnergyJapanese MonbukagakushoMax Planck SocietyUniversity of ChicagoInstitute for Advanced StudyJapan Participation GroupJohns Hopkins UniversityKorean Scientist GroupLos Alamos National LaboratoryMax-Planck-Institute for Astronomy (MPIA)Max-Planck-Institute for Astrophysics (MPA)New Mexico State UniversityUniversity of PittsburghUniversity of PortsmouthPrinceton UniversityUnited States Naval ObservatoryUniversity of WashingtonFermilabAstronom

Tumor Biology and Racial Disparities in Reconstruction After Mastectomy: A SEER Database Analysis

Introduction: Significant disparities in immediate breast reconstruction after mastectomy have persisted, and may even be increasing, despite large-scale efforts to minimize them, such as the Women’s Health and Cancer Rights Act of 1998. Immediate breast reconstruction has been shown to lead to higher rates of surgical satisfaction, minimize delay in post-operative cancer treatment, and improve the quality of life and overall well-being of mastectomy patients. However only 25-40% of eligible women in the United States receive reconstruction. The rate of reconstruction is even lower in African American and Hispanic women compared to White women. To better understand this disparity, this study uses national population-based data to examine how demographic factors, socioeconomic factors, and disease characteristics interact and affect the rate of immediate breast reconstruction (IBR) after mastectomy. Methods: Women with AJCC7 Stage 0-III breast cancer who underwent mastectomy from 2010 to 2012 were identified in the Surveillance, Epidemiology and End Results Program (SEER) database. Race, Hispanic ethnicity, age, marital status, insurance status, tumor grade, AJCC7 stage and hormone receptor/ Her2Neu profile were compared between women undergoing mastectomy with IBR and mastectomy alone using univariate and multivariate analysis. Results: We identified 51,115 women who underwent mastectomy for Stage 0-III breast cancer from 2010-2012, of whom 15,389 (30.1%) received IBR. On multivariate analysis, age (p Conclusion: The decision to undergo reconstruction after mastectomy is influenced by many factors. Our results show that even after adjusting for tumor characteristics, socioeconomic factors are independently associated with receiving IBR after mastectomy. Further research is needed to elucidate the factors that influence the decision to undergo IBR in order to eliminate these persistent disparities

Contingent Faculty Performing Scholarship and Service: Examining Academic Labor and Identity at a Public Flagship University

The faculties of many colleges and universities in the United States are comprised of rising numbers of instructional contingent faculty who are ineligible for tenure. Although these positions generally do not require scholarly or service activities because their primary focus is teaching, the extent to which these faculty members still choose to perform like tenure-line faculty, with at least some kind of balance of teaching, research, and service, is understudied. The current study attempted to address this omission in the literature by collecting data from contingent faculty members at a public flagship university (N = 176) about their engagement with scholarly and service activities. A majority of the respondents (63.1%) had engaged in at least one scholarly activity and in at least one service activity (69.9%). This study adds to our understanding of the lived experiences of contingent faculty and concludes that a majority of these faculty members are, at least in part, building an academic identity based off of traditional expectations and activities for tenure-line faculty

Effects of Behavioral Skills Training on Teachers Conducting the Recess-to-Classroom Transition

Elementary school teachers transition their students from recess to the classroom multiple times a day. When students do not line up quickly or are disruptive in line, teachers can spend valuable instructional time trying to manage students’ inappropriate behaviors. The result is a loss of instructional time that could lead to a decrease in student performance. This study examined how teachers could use behavioral skills training with their students as a way to reduce the length of the recess-to-classroom transition with second–fourth graders. After teachers were trained, they provided their students with training, which included instruction, modeling, rehearsal, and feedback. The result in each teacher’s classroom was that students began to line up more quickly and use their hands and feet appropriately for the duration of the transition. Appropriate behavior and reduced transition times maintained at a 2-week follow-up

Differential Effects of the Hormonal and Copper Intrauterine Device on the Endometrial Transcriptome.

The contraceptive effectiveness of intrauterine devices (IUDs) has been attributed in part to a foreign body reaction in the endometrium. We performed this study to better understand mechanisms of action of contraceptives of by studying their effects on endometrial and cervical transcriptomes. We collected endometrial and cervical biopsies from women using the levonorgestrel-releasing intrauterine system (LNG-IUS, n = 11), copper intrauterine device (cu-IUD, n = 13) or levonorgestrel-containing combined oral contraceptives (COC, n = 12), and from women not using contraceptives (control group, n = 11). Transcriptional profiling was performed with Affymetrix arrays, Principal Component Analysis and the bioconductor package limma. In endometrial samples from cu-IUD users, there were no genes with statistically significant differential expression compared to controls. In LNG-IUS users, 2509 genes were differentially expressed and mapped predominantly onto immune and inflammatory pathways. The cervical samples showed no statistically significant differential gene expression compared to controls. Hormonal and copper IUDs have significantly different effects on the endometrial transcriptome, with the LNG-IUS transcriptome showing pronounced inflammation and immune activation compared to controls whereas the cu-IUD transcriptome was indistinguishable from luteal phase endometrium. These findings argue against a foreign body reaction as a common mechanism of action of IUDs

Psychometric properties of the Stroke and Aphasia Quality of Life Scale (SAQOL-39) in a generic stroke population

Background: We previously developed the Stroke and Aphasia Quality of Life scale (SAQOL-39) and tested it with people with chronic aphasia. A scale allowing comparisons of quality of life between people with versus without aphasia post-stroke would be of value to clinicians. Objectives: To evaluate the psychometrics of the SAQOL-39 in a generic stroke sample. Should this process result in a generic-stroke version of the scale (SAQOL-39g), a further aim is to compare the latter and the SAQOL-39 as tested in chronic aphasia. Design and subjects: Repeated measures psychometric study, evaluating internal consistency, test—retest reliability, construct validity and responsiveness to change. People admitted to hospital with a first stroke were assessed two weeks, three months and six months post stroke. Measures: SAQOL-39, National Institutes of Health Stroke Scale, Barthel, Frenchay Aphasia Screening Test, General Health Questionnaire-12 and Frenchay Activities Index. Results: Of 126 eligible participants, 96 (76%) participated and 87 (69%) were able to self-report and are presented here. Testing the SAQOL-39 in generic stroke resulted in the SAQOL-39g, which has the same items as the SAQOL-39 but three domains: physical, psychosocial, communication. The SAQOL-39g showed good internal consistency (α = 0.95 overall score, 0.92—0.95 domains), test—retest reliability (interclass correlation (ICC) = 0.96 overall, 0.92—0.98 domains), convergent (r = 0.36—0.70 overall, 0.47—0.78 domains) and discriminant validity (r = 0.26 overall, 0.03—0.40 domains). It differentiated people by stroke severity and visual analogue scale (VAS)-defined quality of life. Moderate changes (d = 0.35—0.49; standardized response mean (SRM) = 0.29—0.53) from two weeks to six months supported responsiveness. Conclusions: The SAQOL-39g demonstrated good reliability, validity and responsiveness to change. It can be used to evaluate quality of life in people with and without aphasia post stroke

Testing the salinity tolerance levels of similar invasive species found in the San Francisco Bay

Testing the salinity tolerance levels of similar invasive species found in the San Francisco Bay Julia Smith1,2, Elizabeth Sheets2, and C. Sarah Cohen2 1Department of Teacher Education, California State University, Sacramento 2Department of Biology and Romberg Tiburon Center, San Francisco State University Three non-indigenous colonial ascidian species, Botrylloides violaceus, Botrylloides diegensis, and Botryllus schlosseri, have become well established in San Francisco Bay. Two species, B. violaceous and B. schlosseri, are globally distributed, and understanding the salinity ranges and tolerances of these successful invaders in their introduced habitats is important for predicting their spread. We tested the tolerance of these three morphologically similar species to salinity ranges that they may encounter locally in San Francisco Bay, and globally, in their broad distributions, including a freshwater transit experiment designed to simulate conditions for ships transiting through the Panama Canal. Botrylloides violaceus, B. diegensis, and Botryllus schlosseri were exposed to various salinities (10, 15, 18, and 20 ppt) for a period of 14 hours, and then assessed for two signs of vitality immediately after each treatment, and were monitored for survival after a week. Our preliminary results showed survival of Botrylloides diegensis, and B. violaceus at the lowest (10 ppt) salinity treatment after 1 week, but no colonies of Botryllus schlosseri survived this salinity treatment in a preliminary trial. The three species all showed survival at our higher (15, 18, and 20 ppt) salinity treatments. In a separate trial, the three target species were also exposed to a drastic salinity decrease to 0 ppt for 7 hours, related to conditions in the Panama Canal. There were no signs of immediate survival in colonies that experienced very low salinity conditions. However, small vascular fragments appear to remain in many colonies three weeks later, and are currently being monitored in the event that they may regenerate, as local colonies of each of these speceis have successfully carried out whole body regeneration from vascular fragments as small as 3.9 mm (Benson Chow, unpub. data)

A phylogenetic analysis of variation in reproductive mode within an Australian lizard (Saiphos equalis, Scincidae)

Saiphos equalis, a semi-fossorial scincid lizard from south-eastern Australia, is one of only three reptile species world-wide that are known to display geographic variation in reproductive mode. Uniquely, Saiphos equalis includes populations with three reproductive modes: oviparous with long (15-day) incubation periods; oviparous with short (5-day) incubation periods; and viviparous (0-day incubation periods). No Saipho populations show \u27normal\u27 scincid oviparity (\u3e30-day incubation period). We used mitochondrial nucleotide sequences (ND2 and cytochrome b) to reconstruct relationships among populations from throughout the species\u27 distribution in New South Wales, Australia. Under the phylogenetic species concept, phylogenetic analyses are consistent with the oviparous and viviparous populations of S. equalis being conspecific. Phylogenetic analyses suggest that the long incubation period oviparous lineage is the sister group to all other populations; and that the viviparous populations belong to a cluster of weakly supported clades basal to the short-incubation-period oviparous clade. These clades correspond to variation in reproductive mode and geographic location. © 2001 The Linnean Society of London