Content Analysis of Public Instagram Posts about Pelvic Floor Disorders and Pelvic Floor Muscle Training in Pregnancy

Objective: To analyze the content of public Instagram posts and describe the discussion of pelvic floor disorders (PFDs) and pelvic floor muscle training (PFMT)/pelvic floor physical therapy (PFPT) in pregnancy. Methods: Public Instagram accounts based in the U.S. with posts within the past 7 days focused on pregnancy were included. We analyzed English posts related to pelvic floor health, PFDs or PFMT. We categorized accounts by user type, health-related expertise, business endorsement, and influencer status. We categorized posts by content (informative, recommendation, sharing experience, meme, advertisement), context (informative, preventive, interventive), and terminology (scientific, lay). We used chi-squared tests to compare scientific terminology use and PFMT/PFPT recommendation presence by user type and health-related expertise. Results: 156 posts from 21 Instagram accounts were included. Most users presented as companies (43%), provided a link to a business (95%), claimed licensed health-related expertise (43%), and were meso-influencers (72%). Most posts were in an informative (45%) or interventive (41%) context, and included information (81%), an advertisement (48%) and/or a recommendation (47%). Fifty-two percent of posts with a recommendation endorsed PFMT/PFPT. Most posts used lay terminology (40%) or scientific and lay terminology (36%). Use of scientific terminology differed by health-related expertise (p=0.0014) but not user type (p=0.1489). Recommendations for PFMT/PFPT did not differ by user type (p=0.0654) or health-related expertise (p=0.1277). Conclusions: Public health policy should target preventive information and resources for PFMT towards pregnant persons on social media. Future research is needed to evaluate quality of pelvic floor health information and recommendations during pregnancy

The relationship of certain word analysis abilities to the reading achievement of first, second, and third grade children,

Thesis (M.A.)--Boston Universit

Positive information facilitates response inhibition in older adults only when emotion is task-relevant

Emotional information is integral to everyday life and impacts a variety of cognitive abilities including response inhibition, a critical skill for maintaining appropriate and flexible behaviour. However, reported effects of emotion on response inhibition are inconsistent in younger adults, and very limited in older adults. Effects of aging are especially relevant because emotion regulation improves with aging despite declining inhibitory control over neutral information. Across three studies, we assessed the impact of emotional facial expressions on response inhibition in younger and older adults while manipulating attention to task stimuli. Emotional faces (versus neutral faces) altered response inhibition only when task instructions required explicit attention to emotional attributes of the faces. When directly comparing fear faces to happy faces, both age groups had better response inhibition to happy faces. Age further influenced differences across conditions, in that happy faces enhanced response inhibition relative to neutral faces in older adults but not younger adults. Thus, emotional response inhibition for task-relevant (but not task-irrelevant) positive information is enhanced in late life compared to early adulthood. The present work extends the nascent literature on emotional response inhibition in aging, and proffers a framework to reconcile the mixed literature on this topic in younger adults

e-Prescribing and Patient Safety: Results From a Mixed Method Study

Objective: To describe the perspectives of ambulatory care clinicians on the effect of electronic prescribing (e-prescribing) systems on patient safety outcomes. Study Design: Mixed method study of clinicians and staff in 64 practices using 1 of 6 e-prescribing technologies in 6 US states. Methods: We used clinician surveys (Web-based and paper) and focus groups to obtain the perspectives of clinicians on e-prescribing and patient safety. Results: Providers highly valued having medications prescribed by other providers on the medication list and the ability to access patient medication lists remotely. Providers thought that there will always be prescription or medication errors and that the implementation of e-prescribing software changes rather than eliminates prescription or medication errors. New errors related to the dosing or scheduling of a medication, accidentally prescribing the wrong drug, or duplicate prescriptions. Conclusions: Lessons from the ambulatory care trenches must be considered as technology moves forward so that the hypothesized patient safety gains will be realized

Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study

BACKGROUND: Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. OBJECTIVE: This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. METHODS: Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. RESULTS: Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). CONCLUSIONS: Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. TRIAL REGISTRATION: ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2). Danielle E Jake-Schoffman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 20.06.2018

Using an art-based approach to develop critical reflection in initial teaching trainees

This paper outlines a small-scale Case Study, which took place in England, involving six School Direct Primary teacher trainees acting as participants. Important assessment points, evidencing progress against the Teachers' Standards, are 'Units of Learning'. These contain sequences of lessons, planned and evaluated by the trainees, assessing impact on both pupils' progress and their own professional development. The final element of each Unit is a critical reflection and it was felt this needed support. At the start of the project, the reflective elements of the Units of Learning were analysed and, using an online forum, participants shared their understanding of the term 'critical reflection'. Responding to this, a teaching session, using both flipped learning techniques (Flipped Learning Network: 2014) and Loads' 'Cut up and Collage' (2010) approach was designed to support their developing understanding: an approach that could also be applied in different context. It was hoped improved reflection about practice would lead to change and identifiable progress from 'novice' to 'competence'. Subsequent Units of Learning were analysed following the intervention and participants' opinions canvassed to assess how their reflections had developed. Findings revealed some improvement in critical thinking, with participants becoming more reflective about their personal and professional identities as teachers

Infrared reflectance measurements of Missouri waters for water quality applications

Students supported: 2 studentsThe relative specular reflectance of laboratory solutions of 3.0 M Sulfuric Acid and 0.5 M Sodium Nitrate was measured in the 2.0 - 20-[mu]m wavelength region of the infrared. The relative specular reflectance of natural samples of (1) acid mine drainage taken from a ditch leading from the Peabody Mark Twain Mine to Hinkson Creek; (2) surface water runoff from an agricultural test plot which had received a 314 lb/acre application of nitrate fertilizer; and (3) an oil sample from the Mexico, Missouri oil release into the Salt River was measured in the same spectral region. The data was collected using a Perkin Elmer E-14 spectrophotometer and a reflectometer consisting of a Cassegrain unit which collimated the radiant flux to about 18 mrad divergence, a sample holder and a Cassegrain condenser for focusing the radiant flux, reflected by the sample, onto the entrance slit of the monochromator. The angle of incidence was 70 degrees. The index of refraction, extinction coefficient and phase difference spectrum throughout the 2-20-[mu]m wavelength region was determined for the mine drainage, fuel oil, sulfuric acid, sodium nitrate and nitrate runoff samples using the relative reflectance measurements, the optical constants of distilled water and an algorithm for Kramers-Kronig analysis. The absolute reflectance spectrum of the alluvium and loess was determined using the relative reflectance measurements, the optical constants of distilled water and the Cauchy equation for reflectance. It is very desirable to make water quality measurements remotely. However before such measurements can be taken the characteristic manner in which aqueous solutions reflect electromagnetic radiation (in the optical properties) must be known. Thus the results obtained from this research are a part of a much larger goal to determine water quality remotely.Project # A-063-MO Agreement # 14-31-0001-382

Diet quality and history of gestational diabetes mellitus among childbearing women, United States, 2007-2010

INTRODUCTION: Women with a history of gestational diabetes mellitus (GDM) have elevated risk of developing type 2 diabetes. Diet quality plays an important role in the prevention of type 2 diabetes. We compared diet quality among childbearing women with a history of GDM with the diet quality of childbearing women without a history of GDM. METHODS: We used data from the National Health and Nutrition Examination Survey for 2007 through 2010. We included women without diabetes aged 20 to 44 years whose most recent live infant was born within the previous 10 years and who completed two 24-hour dietary recalls. The Healthy Eating Index (HEI)-2010 estimated overall and component diet quality. Multivariable linear regression models estimated the association between a history of GDM and current diet quality, adjusting for age, education, smoking status, and health risk for diabetes. RESULTS: A history of GDM was reported by 7.7% of women. Compared with women without a history of GDM, women with a history of GDM had, on average, 3.4 points lower overall diet quality (95% confidence interval [CI], -6.6 to -0.2) and 0.9 points lower score for consumption of green vegetables and beans (95% CI, -1.4 to -0.4). Other dietary component scores did not differ by history of GDM. CONCLUSION: In the United States, women with a history of GDM have lower diet quality compared with women who bore a child and do not have a history of GDM. Improving diet quality may be a strategy for preventing type 2 diabetes among childbearing women

Association between First Trimester Pregnancy Associated Plasma Protein–A and the Development of Gestational Diabetes Mellitus

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism. Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk. Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014, 2015) was assembled by abstracting electronic medical records. PAPP-A was measured in first trimester (11-14 weeks), and reported as quartiles of multiples of the mean (MoM) based on gestational age and adjusted for maternal weight and race/ethnicity. GDM diagnosis based on standard 2-step protocol (~24-28 weeks; failed 50g 1hr glucola screen then ≥2 abnormal values per Carpenter-Coustan criteria on 100g 3hr glucose tolerance test). Crude and multivariable-adjusted logistic regression models estimated the association between PAPP-A MoM quartiles and GDM. Results: Women (N=1,251) were 29.7 (SD:5.7) years old and 12.5 (SD:0.6) weeks gestation at PAPP-A measurement. 7.6% (n=95) developed GDM. Median PAPP-A MoM were 0.7 (inter-quartile range [IQR]=0.5-1.0) among women with GDM and 0.9 (IQR=0.6-1.3) among controls; 39% versus 23% were in the 1st quartile, respectively. After adjusting for pre-pregnancy body mass index, nuchal translucency, crown rump length, smoking status, and parity, women with PAPP-A MoM in 2nd, 3rd, and 4th quartiles had 52% (OR=0.48, 95%CI=0.26-0.88), 45% (OR=0.55, 95%CI=0.30-0.99) and 73% (OR=0.27, 95%CI=0.13-0.53) lower odds of GDM compared to women in the 1st quartile. Conclusion: Higher PAPP-A MoM levels were associated with lower GDM risk. Future studies will assess whether higher PAPP-A levels are associated with enhanced IGF-1 signaling and improved pregnancy metabolic homeostasis