Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Using demographic risk factors to explain variations in the incidence of violence against women

This article offers statistical support for the contention that demographic risk factors influence the incidence of some women's experiencing violence more than others. Our results were generated using a binary probit model and 6,332 observations from the 1996 Australian Women's Safety Survey. For purposes of comparison, we identified a set of benchmark demographic characteristics as those occurring most frequently in the data set and estimated that if a woman were to have all of these characteristics, the probability she would have experienced violence in the past 12 months was 6.7%. We found that the risk varied with levels of post school education, income, ethnic background, number and age of children, marital status, and age. Employment status, school-leaving age, and socioeconomic status had no statistically significant effect on the risk of experiencing violence once other factors were considered. This analysis may provide a basis for violence reduction and prevention programs

The benefits of cooperative inquiry in health services research : lessons from an Australian Aboriginal and Torres Strait Islander health study

Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research

Mustn1 ablation in skeletal muscle results in increased glucose tolerance concomitant with upregulated GLUT expression in male mice

Abstract Glucose homeostasis is closely regulated to maintain energy requirements of vital organs and skeletal muscle plays a crucial role in this process. Mustn1 is expressed during embryonic and postnatal skeletal muscle development and its function has been implicated in myogenic differentiation and myofusion. Whether Mustn1 plays a role in glucose homeostasis in anyway remains largely unknown. As such, we deleted Mustn1 in skeletal muscle using a conditional knockout (KO) mouse approach. KO mice did not reveal any specific gross phenotypic alterations in skeletal muscle. However, intraperitoneal glucose tolerance testing (IPGTT) revealed that 2‐month‐old male KO mice had significantly lower glycemia than their littermate wild type (WT) controls. These findings coincided with mRNA changes in genes known to be involved in glucose metabolism, tolerance, and insulin sensitivity; 2‐month‐old male KO mice had significantly higher expression of GLUT1 and GLUT10 transporters, MUP‐1 while OSTN expression was lower. These differences in glycemia and gene expression were statistically insignificant after 4 months. Identical experiments in female KO and WT control mice did not indicate any differences at any age. Our results suggest a link between Mustn1 expression and glucose homeostasis during a restricted period of skeletal muscle development/maturation. While this is an observational study, Mustn1's relationship to glucose homeostasis appears to be more complex with a possible connection to other key proteins such as GLUTs, MUP‐1, and OSTN. Additionally, our data indicate temporal and sex differences. Lastly, our findings strengthen the notion that Mustn1 plays a role in the metabolic capacity of skeletal muscle

Gynecologic cancer outcomes in the elderly poor: A population-based study

BACKGROUND: Adults ≥ 65 years dually enrolled in Medicare and Medicaid (Duals) are an at-risk group in healthcare, however outcomes of women with gynecologic cancers in this population are unknown. METHODS: This is a population-based cohort study of North Carolina state cancer registry cases of uterine, ovarian, cervical, and vulvar/vaginal cancers (2003-09), with linked enrollment in Medicare and state Medicaid. Outcomes of all-cause mortality and stage of diagnosis were analyzed as a function of enrollment status using multivariate analysis and survival curves. RESULTS: Of 4,522 women ≥ 65, (3,702 (82%) Medicare and 820 (18%) were Dually enrolled), there were 2286 (51%) uterine, 1587 (35%) ovarian, 302 (7%) cervix, and 347 (8%) vulvar/vaginal cancers. Dual enrollees had increased all-cause mortality overall (aHR 1.34, 95%CI 1.19–1.49), and within each cancer site: uterine aHR 1.22 (95%CI 1.02-1.47); ovarian aHR 1.25 (95%CI 1.05-1.49); cervical aHR 1.34 (95%CI 0.96–1.87); and vulvar/vaginal aHR 1.93 (95%CI 1.36–2.72). Increased odds of advanced stage disease at diagnosis among Dual enrollees was only present in uterine cancer (aOR 1.38, 95%CI 1.06–1.79). Stratified survival curves demonstrate the strongest disparities amongst women with early stage uterine and early stage vulvar/vaginal cancers. CONCLUSIONS: Women ≥ 65 dually enrolled in Medicare and Medicaid have an overall 34% increase in all-cause mortality after diagnosis with a gynecologic cancer compared to the non-dual Medicare population. Women with early stage uterine and vulvar/vaginal cancers have the most disparate outcomes. As these malignancies are generally curable they have the most potential for benefit from targeted interventions