Recruitment and retention of pregnant women for a behavioral intervention: lessons from the maternal adiposity, metabolism, and stress (MAMAS) study.

IntroductionRecruiting participants for research studies can be challenging. Many studies fall short of their target or must prolong recruitment to reach it. We examined recruitment and retention strategies and report lessons learned in a behavioral intervention developmental trial to encourage healthy pregnancy weight gain and stress reduction in low-income overweight pregnant women.MethodsIn the San Francisco Bay area from February 2010 through March 2011, we used direct and indirect strategies to recruit English-speaking overweight and obese pregnant women who were aged 18 to 45, were in the early stages of pregnancy, and who had an annual household income less than 500% of the federal poverty guidelines. Eligible women who consented participated in focus groups or an 8-week behavioral intervention. We identified successful recruiting strategies and sites and calculated the percentage of women who were enrolled and retained.ResultsOf 127 women screened for focus group participation, 69 were eligible and enrolled. A total of 57 women participated in 9 focus groups and 3 women completed individual interviews for a completion rate of 87%. During recruitment for the intervention, we made contact with 204 women; 135 were screened, 33% were eligible, and 69.1% of eligible women enrolled. At 1 month postpartum, 82.6% of eligible women completed an assessment. Recruiting at hospital-based prenatal clinics was the highest-yielding strategy.ConclusionThe narrow window of eligibility for enrolling early stage pregnant women in a group intervention presents obstacles. In-person recruitment was the most successful strategy; establishing close relationships with providers, clinic staff, social service providers, and study participants was essential to successful recruitment and retention

The Attractor and the Quantum States

The dissipative dynamics anticipated in the proof of 't Hooft's existence theorem -- "For any quantum system there exists at least one deterministic model that reproduces all its dynamics after prequantization" -- is constructed here explicitly. We propose a generalization of Liouville's classical phase space equation, incorporating dissipation and diffusion, and demonstrate that it describes the emergence of quantum states and their dynamics in the Schroedinger picture. Asymptotically, there is a stable ground state and two decoupled sets of degrees of freedom, which transform into each other under the energy-parity symmetry of Kaplan and Sundrum. They recover the familiar Hilbert space and its dual. Expectations of observables are shown to agree with the Born rule, which is not imposed a priori. This attractor mechanism is applicable in the presence of interactions, to few-body or field theories in particular.Comment: 14 pages; based on invited talk at 4th Workshop ad memoriam of Carlo Novero "Advances in Foundations of Quantum Mechanics and Quantum Information with Atoms and Photons", Torino, May 2008; submitted to Int J Qu Inf

A path integral for classical dynamics, entanglement, and Jaynes-Cummings model at the quantum-classical divide

The Liouville equation differs from the von Neumann equation 'only' by a characteristic superoperator. We demonstrate this for Hamiltonian dynamics, in general, and for the Jaynes-Cummings model, in particular. -- Employing superspace (instead of Hilbert space), we describe time evolution of density matrices in terms of path integrals which are formally identical for quantum and classical mechanics. They only differ by the interaction contributing to the action. This allows to import tools developed for Feynman path integrals, in order to deal with superoperators instead of quantum mechanical commutators in real time evolution. Perturbation theory is derived. Besides applications in classical statistical physics, the "classical path integral" and the parallel study of classical and quantum evolution indicate new aspects of (dynamically assisted) entanglement (generation). Our findings suggest to distinguish 'intra'- from 'inter-space' entanglement.Comment: 22 pages; based on invited talk at Quantum 2010 - Advances in Foundations of Quantum mechanics and Quantum Information with Atoms and Photons (Torino, May 2010). To appear in Int. J. Qu. Inf

Leader Perspectives on Managing Suicide-related Events in Garrison

Leaders who have personally experienced the aftermath of a suicide-related event can provide important lessons and recommendations for military leadership and policymakers. This paper executes a thematic analysis of interviews with leaders, chaplains, and behavioral health providers who responded to garrison suicide-related events and explores leader decision making related to memorials, investigations, and readiness

Patterns of Dynamical Gauge Symmetry Breaking

We construct and analyze theories with a gauge symmetry in the ultraviolet of the form $G \otimes G_b$, in which the vectorial, asymptotically free $G_b$ gauge interaction becomes strongly coupled at a scale where the $G$ interaction is weakly coupled and produces bilinear fermion condensates that dynamically break the $G$ symmetry. Comparisons are given between Higgs and dynamical symmetry breaking mechanisms for various models.Comment: 14 pages, late

Effect of lisdexamfetamine dimesylate on sleep in adults with attention-deficit/hyperactivity disorder

<p>Abstract</p> <p>Background</p> <p>Sleep problems are common in adults with attention-deficit/hyperactivity disorder (ADHD). This analysis aimed to evaluate the impact of lisdexamfetamine dimesylate (LDX) on sleep quality in adults with ADHD.</p> <p>Methods</p> <p>This 4-week, phase 3, double-blind, forced-dose escalation study of adults aged 18 to 55 years with ADHD randomized participants to receive placebo (n = 62), or 30 (n = 119), 50 (n = 117), or 70 (n = 122) mg/d LDX, taken once a day in the morning. The self-rated Pittsburgh Sleep Quality Index (PSQI) was administered at baseline and at week 4 to assess sleep quality. The PSQI global score assesses 7 sleep components (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction) each scored from 0 (no difficulty) to 3 (severe difficulty).</p> <p>Results</p> <p>The mean baseline PSQI global score was 5.8 for LDX and 6.3 for placebo (<it>P </it>= .19) indicating poor overall sleep quality. At endpoint, least squares (LS) mean change from baseline was -0.8 for LDX vs -0.5 for placebo (<it>P </it>= .33). The daytime functioning component showed significant improvement in LS mean change at endpoint for LDX compared with placebo (LDX -0.4 vs placebo 0.0, <it>P </it>= .0001). LS mean changes for the other 6 PSQI components did not significantly differ from placebo. Sleep-related treatment-emergent adverse events with an incidence ≥2% in the active treatment and placebo groups, respectively, were insomnia (19.3% and 4.8%), initial insomnia (5.0% and 3.2%), middle insomnia (3.6% and 0%), sleep disorder (0.6% and 3.2%), somnolence (0.3% and 3.2%), and fatigue (4.7% and 4.8%), and were generally mild or moderate in severity.</p> <p>Conclusion</p> <p>For most subjects, LDX was not associated with an overall worsening of sleep quality and significantly improved daytime functioning in adults with ADHD.</p> <p>Trial Registration</p> <p>clinicaltrials.gov Identifier: NCT00334880</p

Spacetime Emergence and General Covariance Transmutation

Spacetime emergence refers to the notion that classical spacetime "emerges" as an approximate macroscopic entity from a non-spatio-temporal structure present in a more complete theory of interacting fundamental constituents. In this article, we propose a novel mechanism involving the "soldering" of internal and external spaces for the emergence of spacetime and the twin transmutation of general covariance. In the context of string theory, this mechanism points to a critical four dimensional spacetime background.Comment: 11 pages, v2: version to appear in MPL