35 research outputs found
Person-centered decision-making and socio-cultural contexts influencing cesarean deliveries: a national analysis.
The cesarean delivery rate has increased and accounts for a third of pregnancies in the U.S., especially among marginalized women. This study applied a newly developed conceptual model to identify potential areas of influence that could reduce rates of cesarean deliveries. The Giving Voice to Mothers - United States data was used for analyses to predict covariates associated with having a cesarean delivery vs. spontaneous vaginal delivery (n=1,876). Significant covariates were determined and included the following: having a prior cesarean delivery (OR: 14.11, 95% CI: 7.99 - 24.90); more than one child (OR: 0.21, 95% CI: 0.13 - 0.35); elevated pregnancy risk (OR: 2.22 - 4.90, 95% CI: 2.22 - 4.90); doctor as perinatal care provider (OR: 2.25, 95% CI: 1.40 - 3.61); and receiving disrespectful perinatal care (OR: 2.16, 95% CI: 1.13 - 4.12). Significant covariates associated with race/ethnicity with white women as the reference group included the following: Asian women had higher odds of having a prior cesarean delivery (OR: 2.59, 95% CI: 1.31 - 5.12) and doctor as their perinatal care provider (OR: 2.31, 95% CI: 1.22 - 4.35); Black women had higher odds of having one or more child (OR: 2.15, 95% CI: 1.11 - 4.14); and Hispanic (OR: 1.89, 95% CI: 1.04 - 3.45) and Indigenous (OR: 3.17, 95% CI: 1.34 - 7.48) women had higher odds of receiving disrespectful perinatal care. Cesarean delivery rates could reduce by intervening at individual and interpersonal levels of influence that incorporate fewer medical interventions and improved patient-provider interactions
Population synthesis of radio and gamma-ray millisecond pulsars from the Galactic disk
We present results of a population synthesis of millisecond pulsars from the
Galactic disk. Excluding globular clusters, we model the spatial distribution
of millisecond pulsars by assuming their birth in the Galactic disk with a
random kick velocity and evolve them to the present within the Galactic
potential. We assume that normal and millisecond pulsars are standard candles
described with a common radio luminosity model that invokes a new relationship
between radio core and cone emission suggested by recent studies. In modeling
the radio emission beams, we explore the relativistic effects of time delay,
aberration and sweepback of the open field lines. While these effects are
essential in understanding pulse profiles, the phase-averaged flux is
adequately described without a relativistic model. We use a polar cap
acceleration model for the gamma-ray emission. We present the preliminary
results of our recent study and the implications for observing millisecond
pulsars with GLAST and AGILE.Comment: 38 pages, 10 figures, accepted in ApJ - new versio
Population statistics study of radio and gamma-ray pulsars in the Galactic plane
We present results of our pulsar population synthesis of ordinary isolated
and millisecond pulsars in the Galactic plane. Over the past several years, a
program has been developed to simulate pulsar birth, evolution and emission
using Monte Carlo techniques. We have added to the program the capability to
simulate millisecond pulsars, which are old, recycled pulsars with extremely
short periods. We model the spatial distribution of the simulated pulsars by
assuming that they start with a random kick velocity and then evolve through
the Galactic potential. We use a polar cap/slot gap model for -ray
emission from both millisecond and ordinary pulsars. From our studies of radio
pulsars that have clearly identifiable core and cone components, in which we
fit the polarization sweep as well as the pulse profiles in order to constrain
the viewing geometry, we develop a model describing the ratio of radio
core-to-cone peak fluxes. In this model, short period pulsars are more
cone-dominated than in our previous studies. We present the preliminary results
of our recent study and the implications for observing these pulsars with GLAST
and AGILE.Comment: 6 pages, 3 figures, 1 table, accepted in Astrophysics and Space
Scienc
Bolstering Confidence in Obesity Prevention and Treatment Counseling for Resident and Community Pediatricians
Objective- To assess whether equipping resident pediatricians and community pediatricians with both training and practical tools improves their perceived confidence, ease, and frequency of obesity related counseling to patients.
Methods- In 2005-2006, resident pediatricians (n = 49) and community pediatricians (n=18) received training regarding three evidence-based obesity prevention/treatment tools and responded to pre-and post-intervention questionnaires. We analyzed changes in reported mean confidence, ease, and frequency of dietary, physical activity, and weight status counseling.
Results- Baseline scores of confidence, ease, and frequency of counseling were higher in community pediatricians than residents. Mean scores increased significantly in the combined group, among residents only, and trended towards improvement in the community pediatricians following the intervention. Means for "control" questions were unchanged.
Conclusion- Training and tools for residents and community pediatricians improved their confidence, ease, and frequency of obesity-related counseling.
Practice Implications- This study demonstrates that when feasible and appropriate tools and training were provided through a simple intervention, physicians gained confidence and ease and increased their counseling frequency. The results here suggest that widespread implementation of such educational interventions for community practitioners and practitioners in training could change the way physicians counsel patients to prevent the often frustrating problem of childhood obesity. Originally published Patient Education and Counseling, Vol. 73, No. 2, Nov 200
Developing an agenda for research about policies to improve access to healthy foods in rural communities: a concept mapping study
Background
Policies that improve access to healthy, affordable foods may improve population health and reduce health disparities. In the United States most food access policy research focuses on urban communities even though residents of rural communities face disproportionately higher risk for nutrition-related chronic diseases compared to residents of urban communities. The purpose of this study was to (1) identify the factors associated with access to healthy, affordable food in rural communities in the United States; and (2) prioritize a meaningful and feasible rural food policy research agenda.
Methods
This study was conducted by the Rural Food Access Workgroup (RFAWG), a workgroup facilitated by the Nutrition and Obesity Policy Research and Evaluation Network. A national sample of academic and non-academic researchers, public health and cooperative extension practitioners, and other experts who focus on rural food access and economic development was invited to complete a concept mapping process that included brainstorming the factors that are associated with rural food access, sorting and organizing the factors into similar domains, and rating the importance of policies and research to address these factors. As a last step, RFAWG members convened to interpret the data and establish research recommendations.
Results
Seventy-five participants in the brainstorming exercise represented the following sectors: non-extension research (n = 27), non-extension program administration (n = 18), “other� (n = 14), policy advocacy (n = 10), and cooperative extension service (n = 6). The brainstorming exercise generated 90 distinct statements about factors associated with rural food access in the United States; these were sorted into 5 clusters. Go Zones were established for the factors that were rated highly as both a priority policy target and a priority for research. The highest ranked policy and research priorities include strategies designed to build economic viability in rural communities, improve access to federal food and nutrition assistance programs, improve food retail systems, and increase the personal food production capacity of rural residents. Respondents also prioritized the development of valid and reliable research methodologies to measure variables associated with rural food access.
Conclusions
This collaborative, trans-disciplinary, participatory process, created a map to guide and prioritize research about polices to improve healthy, affordable food access in rural communities