Introduction: The Quest for Birth Equity and Justice—Now is the Time

Maternal and Child Health Journal -     

Myocardial protective effects of the class Ic antiarrhythmic agent flecainide

The class Ic antiarrhythmic agent flecainide has recently become available in this country for management of ventricular arrhythmias. The pharmacologic and electrophysiologic features of this class of drug--marked sodium channel blockade producing inhibition of phase 0 of the myocardial action potential, moderate blockade of slow inward (calcium) channels, and general lack of systemic toxicity--suggest that these agents may exert significant myocardial protective effects. This hypothesis was tested in isolated, perfused rat hearts subjected to 30 minutes of global normothermic ischemia followed by 30 minutes of reperfusion after pretreatment with (1) Krebs-Henseleit buffer (n = 7); (2) Krebs-Henseleit buffer with potassium adjusted to 20.9 mmol/L with potassium chloride (n = 10); and (3) Krebs-Henseleit buffer plus flecainide acetate 50 mg/L (0.12 mmol/L) (n = 11). Severity of ischemic injury was assessed by time to ischemic contracture: 9.9 +/- 1.3 (Krebs-Henseleit buffer), 18.4 +/- 1.1 (potassium chloride), and 25.4 +/- 1.0 (flecainide) minutes (mean +/- standard error of the mean) (p less than 0.05 among all groups). Functional recovery after ischemia and reperfusion was measured by developed pressure (expressed as percent of preischemic control): 19.6 +/- 5.4 (Krebs-Henseleit buffer), 70.8 +/- 3.2 (potassium chloride), and 67.3 +/- 2.7 (flecainide). These results suggest that class Ic agents afford significant myocardial protection from global normothermic ischemia.     

Anticipated Negative Police-Youth Encounters and Depressive Symptoms among Pregnant African American Women: A Brief Report

The widely publicized violent encounters between police and African American youth have unknown consequences for the emotional and mental health of pregnant African American women. Since studies document the hypervigilance black mothers exert to protect children from violence and racism and findings also reveal the association between racial and gendered stress (which includes parenting stressors) and depressive symptoms during pregnancy, an examination of the effects of stress from anticipated negative experiences between black youth and police on maternal mental health is warranted. Between July and August 2014, 100 mostly low income pregnant African American women who lived in metropolitan Atlanta and were in their first and second trimesters completed the Edinburgh postnatal depression scale, selected items from the Jackson, Hogue, Phillips contextualized stress measure, and a demographic form. Bivariate and logistic regression analyses were conducted in response to questions that asked: (1) is the anticipation of negative encounters between black youth and police associated with antenatal depressive symptoms and (2) how does the presence of prior children, male or female, contribute to the association? For question 1, the results showed that anticipated negative African American youth-police experiences were significantly associated with antenatal depressive symptoms χ ² (2, N?=?87)?=?12.62, p?=?.002. For question 2, the presence of a preschool-aged male child in the home was significantly associated with antenatal depression (p?=?.009, odds ratio?=?13.23). The observed associations between antenatal depressive symptoms and anticipated negative police-youth encounters have implications for clinical- and community-based interventions responding to the unique psychosocial risks for pregnant African American women.     

Comparison of the WISC-R and the leiter international performance scale with average and above-average students

Compared the WISC-R and the Lieter by administering both tests to 20 third- and 20 fifth-grade students who ranged in age from 8.1 to 11.0 years. Previous research has indicated significantly lower Leiter scores than WISC-R Full-Scale scores for a sample of educationally handicapped students. The present study was concerned with comparison of the two measures with average and above-average students. Pearson productmoment correlation coefficients and t-tests for pairs were used to analyze the data. Correlations were found comparing the Full-Scole score of the WISC-R and the Leiter for three groups: Group I consisted of all Ss, group 2 consisted of 27 Ss whose Full-Scale score was between 85 and 115, and group 3 consisted of 11 Ss whose Full-Scale score was 116 and above. WISC-R and Leiter scores from all three groups correlated positively from 0.35 to 0.61. However, a significant difference between the WISC-R and Leiter was found with Ss whose Full-Scale score was 116 and above.     

Splenic infarction in a white man with sickle cell trait

We report the third case of splenic infarction from sickle cell trait in a young white man traveling through mountains. Apparently the hypoxemia at 10,800 feet, along with a relatively high hemoglobin S concentration of 40%, interacted with the known conditions of splenic blood flow to cause sickling and infarction, even though our patient was not exercising. The optimal management for this rare complication of sickle cell trait remains unknown, but surgery may not be required for either diagnosis or therapy.     

Save 100 Babies©: Engaging Communities for Just and Equitable Birth Outcomes Through Photovoice and Appreciative Inquiry

This paper presents a community engagement model designed to advance social justice and equity for African American birth outcomes through the combined techniques of Photovoice and Appreciative Inquiry. In response to the persistent racial disparities in birth outcomes, Save 100 Babies© was constructed as a 2-day summit where the emphasis was placed on individual and community assets rather than deficits. The engagement was designed to create a level of readiness among individuals working within and outside the field of Maternal and Child Health to envision strategies to attain equitable birth outcomes. The goal of the conference was to facilitate higher level consciousness by guiding the participants though a process aimed at articulating assets, possibilities and the potential for co-creating the desired future where racial disparities in birth outcome are eliminated. As the result of the guided discourse that began with photographs of the lives of African American women, participants articulated the strengths they detected from the pictures, their recommendations for multifaceted changes in policies and practices, and their individual and organizational commitments for a changed future. Since the summit, participants have indicated ways they have fulfilled their vows that include informing families and communities about pregnancy risks, working with youth programs, supporting fatherhood involvement in pregnancy and birth, and advancing case management that is more attuned to women’s strengths. Save 100 Babies© is evolving into a network and clearinghouse for sharing and disseminating information and resources for collaboration.