Perceived Control and Maternal Satisfaction with the Childbirth Experience

The quality of the childbirth experience, particularly whether the mother perceives a sense of control over the birth environment, can significantly impact postpartum adjustment. Although maternal "satisfaction" is a common outcome variable in childbirth research, studies have not adequately distinguished satisfaction from affective reactions to birth. Furthermore, adequate measures of perceived control and maternal satisfaction are lacking. Drawing from a person-environment fit theory of satisfaction, the current study examined the validity of two new instruments to assess perceived control over the childbirth environment (PCCh) and satisfaction with the childbirth experience (SWCh). Items constructed from existing measures and qualitative data were administered to 187 women who had given birth to a healthy infant in the last four months. Exploratory factor analysis supported single-factor structures for the PCCh and the SWCh, with high internal consistency reliability for both instruments (alpha .90). The PCCh was significantly correlated with childbirth self-efficacy, satisfaction, and external control. The SWCh was only moderately correlated with positive and negative affect, childbirth self-efficacy, and external control. Low scores on both instruments were significantly associated with postpartum stress symptoms. Preliminary analyses revealed that perceived control accounted for more variance in childbirth satisfaction than obstetric variables such as labor pain, duration of labor, obstetric complications, and having an unplanned cesarean section. Results of these analyses are presented with recommendations for future development and clinical use of the PCCh and SWCh

Measuring Desire for Control in the Childbirth Environment

The experience of childbirth has demonstrable impact on a new mother's postpartum adjustment. The substantial prevalence of negative childbirth experiences has lead researchers to investigate factors characterizing positive versus negative experiences. Researchers have questioned whether congruence between desired and perceived control influences childbirth satisfaction. The current study was designed to develop an instrument to assess desire for control. Items were modified from three original instruments and administered to pregnant women recruited from outpatient obstetric clinics and online. Twenty-one items loaded on a single common factor reflecting desire for behavioral control in the childbirth setting. Four items loaded on a second factor reflecting desire for information. The 21 item scale (DCCh-B) discriminated from self-efficacy and health locus of control. Women who reported higher desire for control were more likely to choose non-traditional caregivers and labor support. Results of these preliminary analyses are presented with recommendations for future development of the DCCh-B

Autotransporters and Their Role in the Virulence of Burkholderia pseudomallei and Burkholderia mallei

Burkholderia pseudomallei and Burkholderia mallei are closely related Gram-negative bacteria responsible for the infectious diseases melioidosis and glanders, respectively. Autotransporters (ATs) comprise a large and diverse family of secreted and outer membrane proteins that includes virulence-associated invasins, adhesins, proteases, and actin-nucleating factors. The B. pseudomallei K96243 genome contains 11 predicted ATs, eight of which share homologs in the B. mallei ATCC 23344 genome. This review distils key findings from in silico, in vitro, and in vivo studies on the ATs of B. pseudomallei and B. mallei. To date, the best characterized of the predicted ATs of B. pseudomallei and B. mallei is BimA, a predicted trimeric AT mediating actin-based motility which varies in sequence and mode of action between Burkholderia species. Of the remaining eight predicted B. pseudomallei trimeric autotransporters, five of which are also present in B. mallei, two (BoaA and BoaB), have been implicated in bacterial adhesion to epithelial cells. Several predicted Burkholderia ATs are recognized by human humoral and cell-mediated immunity, indicating that they are expressed during infection and may be useful for diagnosis and vaccine-mediated protection. Further studies on the mode of secretion and functions of Burkholderia ATs will facilitate the rational design of control strategies

Inverse Function: Pre-Service Teachers’ Techniques and Meanings

Researchers have argued teachers and students are not developing connected meanings for function inverse, thus calling for a closer examination of teachers’ and students’ inverse function meanings. Responding to this call, we characterize 25 pre-service teachers’ inverse function meanings as inferred from our analysis of clinical interviews. After summarizing relevant research, we describe the methodology and theoretical framework we used to interpret the pre-service teachers’ activities. We then present data highlighting the techniques the pre-service teachers used when responding to tasks that involved analytical and graphical representations of functions and inverse functions in both decontextualized and contextualized situations and discuss our inferences of their meanings based on their activities. We conclude with implications for the teaching and learning of inverse function and areas for future research

Regional Climate Trends and Scenarios for the U.S. National Climate Assessment Part 4. Climate of the U.S. Great Plains

This document is one of series of regional climate descriptions designed to provide input that can be used in the development of the National Climate Assessment (NCA). As part of a sustained assessment approach, it is intended that these documents will be updated as new and well-vetted model results are available and as new climate scenario needs become clear. It is also hoped that these documents (and associated data and resources) are of direct benefit to decision makers and communities seeking to use this information in developing adaptation plans. There are nine reports in this series, one each for eight regions defined by the NCA, and one for the contiguous U.S. The eight NCA regions are the Northeast, Southeast, Midwest, Great Plains, Northwest, Southwest, Alaska, and Hawai‘i/Pacific Islands. These documents include a description of the observed historical climate conditions for each region and a set of climate scenarios as plausible futures – these components are described in more detail below. While the datasets and simulations in these regional climate documents are not, by themselves, new, (they have been previously published in various sources), these documents represent a more complete and targeted synthesis of historical and plausible future climate conditions around the specific regions of the NCA. There are two components of these descriptions. One component is a description of the historical climate conditions in the region. The other component is a description of the climate conditions associated with two future pathways of greenhouse gas emissions

Evaluating Evidence for the Role of Sleep in Fibromyalgia: A Test of the Sleep and Pain Diathesis Model

The Sleep and Pain Diathesis (SAPD) Model predicts that sleep quality is related to Fibromylagia (FM) outcomes such as disability and depression and that these relationships are mediated by both pain and impaired emotional dysregulation. The purpose of this paper is to provide a preliminary test of this model using cross-sectional data. 35 adult women, who had been living with FM for an average of 13 years, completed a battery of questionnaires that included reports of pain, sleep, affect, and disability. Consistent with this model, FM patients who reported more disrupted sleep also reported higher levels of psychological disability (i.e., BDI depression symptoms) and physical disability. Moreover, the trajectory of the relationship between sleep and pain appears to be mediated by cognitive processes such as increased pain helplessness and, thus, the relationship between sleep and disability appears to be mediated via pain. These data are consistent with the SAPD model, and lend support for the need to include sleep related factors as a critical contributor to our understanding of FM

Communal mastery and associations with depressive and PTSD symptomatology among urban trauma-exposed women.

Objective: Racial and ethnic minority women from low-resource urban communities experience disproportionately high rates of trauma exposure. Higher rates of lifetime trauma exposure are strongly associated with subsequent psychological sequela, specifically depression and posttraumatic stress disorder (PTSD). Communal mastery is the ability to cope with challenges and achieve goals by being closely interconnected with friends, family, and significant others. Yet, it is unknown if communal mastery is protective specifically against PTSD and depressive symptoms. Method: Participants (N = 131) were Black and Latina women (88.5% Black, mean monthly income: < $750) recruited from an urban outpatient obstetric-gynecological clinic at an academic medical center. Participants completed an online questionnaire that assessed trauma history, PTSD and depressive symptoms, types of individualistic coping, social support, and communal mastery. Results: Hierarchical multiple regression models demonstrated that communal mastery is uniquely associated with fewer PTSD symptoms (β = −.23, p = .003). More severe trauma history, more use of passive coping skills, and poorer social support were also significantly associated with PTSD symptoms, explaining over half of the variance in PTSD symptoms. Although significantly correlated, communal mastery was not uniquely associated with fewer depressive symptoms (β = −.13, p = .201). Conclusions: These findings suggest that connectedness as assessed through communal mastery serves as an important shield against the effects of traumatic stress for Black and Latina women. Future research would benefit by exploring interventions that aim to increase communal mastery in order to help highly trauma-exposed racial and ethnic minority women in low-resource environments

An empirical approach towards the efficient and optimal production of influenza-neutralizing ovine polyclonal antibodies demonstrates that the novel adjuvant CoVaccine HT(TM) is functionally superior to Freund's adjuvant

Passive immunotherapies utilising polyclonal antibodies could have a valuable role in preventing and treating infectious diseases such as influenza, particularly in pandemic situations but also in immunocompromised populations such as the elderly, the chronically immunosuppressed, pregnant women, infants and those with chronic diseases. The aim of this study was to optimise current methods used to generate ovine polyclonal antibodies. Polyclonal antibodies to baculovirus-expressed recombinant influenza haemagglutinin from A/Puerto Rico/8/1934 H1N1 (PR8) were elicited in sheep using various immunisation regimens designed to investigate the priming immunisation route, adjuvant formulation, sheep age, and antigen dose, and to empirically ascertain which combination maximised antibody output. The novel adjuvant CoVaccine HT™ was compared to Freund’s adjuvant which is currently the adjuvant of choice for commercial production of ovine polyclonal Fab therapies. CoVaccine HT™ induced significantly higher titres of functional ovine anti-haemagglutinin IgG than Freund’s adjuvant but with fewer side effects, including reduced site reactions. Polyclonal hyperimmune sheep sera effectively neutralised influenza virus in vitro and, when given before or after influenza virus challenge, prevented the death of infected mice. Neither the age of the sheep nor the route of antigen administration appeared to influence antibody titre. Moreover, reducing the administrated dose of haemagglutinin antigen minimally affected antibody titre. Together, these results suggest a cost effective way of producing high and sustained yields of functional ovine polyclonal antibodies specifically for the prevention and treatment of globally significant diseases.Natalie E. Stevens, Cara K. Fraser, Mohammed Alsharifi, Michael P. Brown, Kerrilyn R. Diener, John D. Haybal