Barriers and Facilitators to the Implementation of a Community Doula Program for Black and Pacific Islander Pregnant People in San Francisco: Findings from a Partnered Process Evaluation

Maternal and Child Health Journal - Increasingly, community-based models of doula care are receiving attention as possible interventions to address racial inequities in maternal health care...     

Changes in expectation of relationship permanence,pregnancy acceptability and desire,and contraceptive use over time among young Latino/a women and men: An exploratory analysis

ObjectiveWe longitudinally assess associations between changes in expectation of relationship permanence—a measure that incorporates both relationship duration and commitment—pregnancy desire and acceptability, and highly effective contraception use among young U.S. Latino/as.Study designWe used multivariable logistic regression to analyze associations between changes in relationship factors, pregnancy acceptability and desire, and contraceptive method use over 6 months among 299 U.S. Latino/a women and men (ages 18–34) in relationships in a longitudinal study (retention rate: 32.4%).ResultsRespondents who found a pregnancy less acceptable at endline than at baseline were more likely to use highly effective contraception at endline (OR 2.97, 95% CI 1.09, 8.08). Respondents estimating an increase in relationship permanence more than one standard deviation of the mean were 4.90 (95% CI 1.17, 20.55) times more likely to use highly effective contraception at endline, compared to those without a change in estimation of relationship permanence.ConclusionIn this longitudinal study of young adult Latino/as in relationships, we found associations between changes in respondents’ perceptions of the acceptability of a pregnancy and expectation of the permanence of their relationship and highly effective contraceptive use. Our findings reiterate the complicated, intertwined links between relationship dynamics, pregnancy orientation, contraception, and time.ImplicationsThe significance of decreased pregnancy acceptability (but not desire) for using highly effective contraception suggests the importance of acknowledging pregnancy acceptability in contraceptive counseling, particularly because providers are more likely to direct Latino/a young adults towards methods that may not fulfill their contraceptive desires. Including discussion of young people’s expectations of relationship permanence may also be meaningful in counseling.     

Detection of p53 gene mutation by rapid PCR-SSCP and its association with poor survival in breast cancer

We examined the association between mutation of the p53 gene and survival in a large cohort of breast cancer patients. Using a rapid, non-isotopic single-strand conformation polymorphism (SSCP) method we screened for mutations in exons 4–10 of the p53 gene in 375 primary breast cancers from patients with a median follow-up of 57 months. Mutations were found in 19% of tumours. Statistically significant associations were found between p53 mutation and histological grade, hormone receptor status, ploidy and S-phase fraction. No association was found between p53 mutation and axillary lymph node involvement, histological type, tumour size, vascular invasion or patient age. In univariate survival analysis, p53 mutation was strongly associated with poor prognosis. This was maintained in the lymph node-negative and hormone receptor-positive patient subgroups. In multivariate analysis, p53 mutation was associated with poor survival independent of lymph node status, estrogen receptor status and S-phase fraction. Our results demonstrate the feasibility of using a rapid and simple polymerase chain reaction-SSCP screening procedure to detect p53 gene mutation in breast cancer for the provision of prognostic information. Int. J. Cancer 74:642–647, 1997.© 1997 Wiley-Liss, Inc.     

Effects of peroxisome proliferator-activated receptor γ agonists on Na+ transport and activity of the kinase SGK1 in epithelial cells from lung and kidney

Background and purpose:

Peroxisome proliferator-activated receptor γ (PPARγ) agonists, such as rosiglitazone and pioglitazone, sensitize cells to insulin, and are therefore used to treat type 2 diabetes. However, in some patients, these drugs induce oedema, and the present study tests the hypothesis that this side effect reflects serum and glucocorticoid-inducible kinase 1 (SGK1)-dependent enhancement of epithelia Na⁺ absorption.

Experimental approach:

Na⁺ absorbing epithelial cells (H441 cells, mpkCCD cells) on permeable membranes were mounted in Ussing chambers, and the effects of rosiglitazone (2 µM) and pioglitazone (10 µM) on transepithelial Na⁺ absorption were quantified electrometrically. Changes in SGK1 activity were assessed by monitoring phosphorylation of residues within an endogenous protein.

Key results:

Both cell types absorbed Na⁺ via an electrogenic process that was enhanced by insulin. In mpkCCD cells, this stimulation of Na⁺ transport was associated with increased activity of SGK1, whereas insulin regulated Na⁺ transport in H441 cells through a mechanism that did not involve activation of this kinase. Rosiglitazone and pioglitazone had no discernible effect on transepithelial Na⁺ absorption in unstimulated or insulin-stimulated cells and failed to alter cellular SGK1 activity.

Conclusions and implications:

Our results do not support the view that PPARγ agonists stimulate epithelial Na⁺ absorption or alter the control of cellular SGK1 activity. It is therefore likely that other mechanisms are involved in PPARγ-mediated fluid retention, and a better understanding of these mechanisms may help with the identification of patients likely to develop oedema or heart failure when treated with these drugs.     

Nuclear DNA content and prognosis in human breast cancer: A static cytophotometric study

Summary Nuclear DNA content was measured by static cytophotometry in smears from breast carcinomas from 80 women, and the results were correlated with other prognostic variables and survival using multivariate statistical analysis. 49% of patients had diploid tumors and 51% hyperdiploid tumors. There was a strong correlation between DNA ploidy and axillary lymph node status, tumor size, ER status, and short term survival (median follow-up 40 months). Of all parameters measured, ploidy showed the strongest correlation with survival, and was a significant prognostic indicator even when other prognostic factors were taken into account.