Adverse Childhood Experiences and Pregnancy Intentions among Pregnant Women Seeking Prenatal Care

BackgroundThis study examined whether adverse childhood experiences (ACEs) are associated with increased risk of having an unwanted or mistimed pregnancy.MethodsWomen in two medical centers within an integrated health system were screened for ACEs during standard prenatal care (N = 745). Multinomial multivariable logistic regression analyses examined the associations of ACEs (count and type) with pregnancy intentions, adjusting for covariates.ResultsOverall, 58.3% of pregnant women reported no ACEs, 19.1% reported one ACE, and 22.7% reported two or more ACEs; 76.2% reported wanting to get pregnant, 18.5% reported wanting to get pregnant but not at this time (i.e., mistimed pregnancy), and 5.2% reported not wanting to get pregnant at all (i.e., unwanted pregnancy). Having two or more (vs. 0) ACEs was associated with higher odds of an unwanted pregnancy (odds ratio, 2.60; 95% confidence interval, 1.19–5.68). Further, childhood loss of parent (odds ratio, 2.20; 95% confidence interval, 1.03–4.71) and neglect (odds ratio, 5.67; 95% confidence interval, 1.72–18.72) were each associated with higher odds of an unwanted pregnancy in separate analyses. ACEs count and type were not significantly associated with having a mistimed pregnancy.ConclusionsAmong women screened for ACEs during standard prenatal care, ACEs were associated with increased odds of having an unwanted pregnancy, but not a mistimed pregnancy. Additional research is needed to better understand the mechanisms through which ACEs and other individual, social, and contextual factors impact pregnancy intentions to better support women and provide appropriate resources to help prevent unintended pregnancies.     

Factors Associated with Nodal Pathologic Complete Response Among Breast Cancer Patients Treated with Neoadjuvant Chemotherapy: Results of CALGB 40601 (HER2+) and 40603 (Triple-Negative) (Alliance)

Annals of Surgical Oncology - De-escalation of axillary surgery after neoadjuvant chemotherapy (NAC) requires careful patient selection. We seek to determine predictors of nodal pathologic complete...     

Whose Line Is It Anyway?: Dismantling the Foundations of Rape Culture

Archives of Sexual Behavior -     

A mammalian model of optic-flow utilization in the control of locomotion

Summary Gibson (1966, 1979) and Lee (1976) have described the potential usefulness of optic-flow information for the control of locomotion. One variable that might be particularly important for an animal approaching a target is time-to-collision, which Lee argues is most efficiently specified by the tau margin (the inverse of the relative rate of expansion of the target image on the retina). In humans, most empirical studies of optic flow have required perceptual judgements or have examined catching/intercepting behaviours. In animals, most studies have been strictly observational. This is particularly true for mammals, where there has been no experimental work of any kind looking at the control of locomotion. The present experiment demonstrates that the Mongolian gerbil (Meriones unguiculatus) uses time-to-collision information to control deceleration as it runs towards a target. The development of this animal model will aid investigation of the neural circuitry underlying optic flow utilization in motor control.     

Behavioural interaction between the NMDA antagonist MK-801 and the dopaminergic antagonist haloperidol: support for a balance model

One hundred and four male Sprague-Dawley rats were divided into three experiments. The first two experiments were to assess the effect of different MK-801 doses (0.1-0.3 mg/kg) and combinations of MK-801/ haloperidol (0.3/0.1-0.5 mg/kg) on locomotor behaviour. The animals from the third experiment were administered either saline, MK-801 (0.3 mg/kg), haloperidol (0.5 mg/kg) or MK-801/haloperidol (0.3/0.5 mg/kg). Locomotor activity measurements showed that the NMDA antagonist MK-801 induced a dose-dependent hyperactivity, while haloperidol, the D-2 dopamine receptor antagonist, induced hypoactivity. Significantly the highest doses of combined MK-801/haloperidol treatment (0.3/0.5 mg/kg) showed behavioural equivalence to the saline animals in both total locomotion, locomotion patterns and within-session habituation. Thus, the behavioural effects of each drug given alone were cancelled when the drugs were given together. This cancellation effect could not be ascribed to direct drug interference effects on dopamine metabolism since the ex vivo biochemical data revealed that the combined MK-801/haloperidol (0.3/0.5 mg/kg) treatment increased dopamine metabolism to the same extent as haloperidol given alone. None of the drug treatments, however, had any effect on brain serotonin metabolism. Serum measurement indicated that dopamine, homovanillic acid, 3,4-dihydroxyphenyl-acetic acid, 5-hydroxyindole-3-acetic acid, norepinephrine and corticosterone were not differentially affected by the drug treatment. Haloperidol-treated animals, however, had higher serum serotonin concentration than saline-treated animals. Taken together, these results support the hypothesis that the effect of MK-801 on behaviour is independent of biochemical changes in dopaminergic neuro transmission per se. Rather, the present results support the hypothesis of a glutamatergic-dopaminergic balance which when disturbed leads to behavioural changes along an excitatory-inhibitory behavioural gradient.     

SCREENING PROCEDURES IN PEDIATRICS

Pediatric health screening procedures, both prenatal and postnatal, have a tremendous potential in improving the health status of children and in turn reducing the resource burden on the parents and the State. The existing recommendations, inherent problems and different screening procedures are discussed. The need for suitable mass screening pediatric procedures in the Indian context is stressed.KEY WORDS: Pediatric screening procedures     

Staff responsibility to exercise

Recent attention has been focused on the importance of exercise for improving the physical functioning of renal patients. The involvement of the dialysis staff in encouragement and implementation of programs is critical to the success of patient efforts in improving physical functioning. Staff responsibility initially consists of various developmental steps that are focused on gaining staff support and developing a plan that matches the needs and the resources available to the unit. Each staff member plays a critical role in the development, implementation, and evaluation of the exercise program. A concerted effort from all staff to incorporate exercise as a routine part of the patient care will enhance the potential of success and patient participation.     

Phorbol ester stimulated Cip1 expression in p53-negative leukemic cells

In differentiating leukemic cells, cyclin-dependent kinase interacting protein (Cip1) is induced and stimulates a G(1) arrest. TPA treated U937 monoblastoid cells expressed Cip1, hypophosphorylated retinoblastoma protein (Rb), arrested in G(1) and differentiated. PKC-zeta cells are U937 cells that overexpress the zeta isoform and display alterations in endogenous PKC isoform expression. TPA treated PKC-zeta cells undergo apoptosis without differentiating. TPA treated PKC-zeta cells express Cip1 and display substantial hypophosphorylation of Rb but fail to arrest in G(1). Thus, a novel phorbol ester dependent signalling pathway exists in which Cip1 induction is associated with the absence of a G(1) arrest and induction of apoptosis rather than differentiation.     

Cervical Cancer among Asian American Women: A Neglected Publica Health Problem?

PURPOSE OF THE PAPER: Relatively little attention has been paid to cervical cancer control in Asian American populations. We summarize available cervical cancer incidence and mortality dat, present information on levels of Pap testing use, and review factors that may be associated with cervical cancer screening participation. METHODS: We reviewed the literature pertaining to cervical cancer and Pap testing among Asian populations in North America. PRINCIPAL FINDINGS: Cancer registry data suggest that women from Southease Asia have a nearly five­fold increased risk of invasive cervical cancer (when compared to non­Hispanic White women). Filipino and Korean populations also have elevated risks. The excess invasive cervical cancer burden appears to be concentrated among women aged 40 and older. Pap testing use by Asians is less than for all toher racial/ethnic groups in the U.S., and recent studies suggest that over one­third of Vietnamese immigrants have never been screened. Barriers to Pap testing participation by less acculturated Asian women include a lack of familiarity with Western preventive concepts, a lack of knowledge concerning cervical cancer, embarrassment in association with gynecologic exams, the role of women in some Asian cultures, the cost of health care, and language difficulties. CONCLUSIONS: There is a considerable need for ethnoculturally appropriate cervical cancer control programs targeting Asian American populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper is relevant to Asian American women from East, South, Southeast, and Island Asia.