Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother–Child Cohort in Spain

Objective The aim of the study was to identify factors associated with non-initiation and cessation of predominant breastfeeding (PBF) in a mother–child cohort from Spain. Materials and Methods The analysis included 2195 mother-infant from birth to 14 months post- delivery recruited between 2004 and 2008. Maternal characteristics were collected during the pregnancy. Lactation data were obtained at 6 and 14 months after delivery. PBF was defined as intake of breast milk plus liquids like juices or water. The PBF cessation was calculated using the date that women started PBF and the date that she reported to start giving infant formula and/or food. The relationship between maternal variables and PBF initiation and cessation was modeled using logistic and Cox proportional hazards regression analysis. Results The prevalence of PBF at hospital discharge was 85.3, 53.4% at 3 months, 46.1% at 4 months and 7.2% at 6 month. Only two women continued PBF at 12 months and none at 14 months. The initiating of PBF was associated with higher levels of maternal education, being a first-time mother and worked in a non-manual occupation. Higher level of physical activity, not smoking and having a healthy BMI, were also positively associated with PBF initiation. PBF cessation was higher in young, obese women, who had had complications during the pregnancy, and who had lower levels of education and smoked. The employment status of women, in week 32 of pregnancy and also in month 14 post-delivery, determined likelihood of PBF cessation. Conclusions Healthier habits and education positively influenced PBF initiation and duration. Decrease in PBF duration rates in Spain can be interpreted in part as a consequence of women returning to work.     

Evaluación de un programa comunitario para reducir el aislamiento de personas mayores debido a barreras arquitectónicas

Objective

Social isolation impairs health. An intervention to reduce isolation due to architectural barriers in elderly persons was carried out in Barcelona (Spain). This study aimed to evaluate its effects on health.

Methods

We conducted a quasi-experimental before-after study. Isolated older people were identified in three deprived urban areas from 2009 to 2011. Participants had twice-weekly outings with volunteers in a stair-climbing power wheelchair. User satisfaction was evaluated and perceived health status, quality of life, and mental health before and after four outings were compared with McNemar tests.

Results

There were 74 participants (median age: 83 years; IQR: 78-89). Perceived health improved by 21%, mental health by 24%, and psychological distress was reduced by 16%. Most participants (98%) were satisfied.

Conclusion

The intervention improved perceived health and mental health. Elderly people with impaired mobility should not live in buildings with architectural barriers and, if this cannot be avoided, similar programs should be implemented.     

The diverse roles and multiple forms of focal adhesion kinase in brain

Although it was originally characterized as a constituent of focal adhesions in fibroblasts, focal adhesion kinase (FAK) is now considered to be not only a mediator of adhesion processes but also a crucial regulator of guidance and a modulator of gene expression. FAK is the main transducer of the integrin signaling required to stabilize the actin cytoskeleton. However, additional activities have been described over the years. In the brain, FAK deserves particular attention as it is found in various alternatively spliced forms – these distributed in multiple subcellular compartments or bound to multiple partners. Moreover, its signaling involves not only phosphorylation but also ubiquitination and proteolysis. Several experimental cell models demonstrate that FAK increases or decreases migration, participates in differentiation and contributes to plasticity events. In addition, this kinase is linked to cell survival in cancer and apoptosis. This review focuses on the diversity of events involving brain‐located forms of FAK.     

Helical Structure of the Cardiac Ventricular Anatomy Assessed by Diffusion Tensor Magnetic Resonance Imaging With Multiresolution Tractography

Introduction and objectives

Deeper understanding of the myocardial structure linking the morphology and function of the heart would unravel crucial knowledge for medical and surgical clinical procedures and studies. Several conceptual models of myocardial fiber organization have been proposed but the lack of an automatic and objective methodology prevented an agreement. We sought to deepen this knowledge through advanced computer graphical representations of the myocardial fiber architecture by diffusion tensor magnetic resonance imaging.

Methods

We performed automatic tractography reconstruction of unsegmented diffusion tensor magnetic resonance imaging datasets of canine heart from the public database of the Johns Hopkins University. Full-scale tractographies have been built with 200 seeds and are composed by streamlines computed on the vector field of primary eigenvectors at the diffusion tensor volumes. We also introduced a novel multiscale visualization technique in order to obtain a simplified tractography. This methodology retains the main geometric features of the fiber tracts, making it easier to decipher the main properties of the architectural organization of the heart.

Results

Output analysis of our tractographic representations showed exact correlation with low-level details of myocardial architecture, but also with the more abstract conceptualization of a continuous helical ventricular myocardial fiber array.

Conclusions

Objective analysis of myocardial architecture by an automated method, including the entire myocardium and using several 3-dimensional levels of complexity, reveals a continuous helical myocardial fiber arrangement of both right and left ventricles, supporting the anatomical model of the helical ventricular myocardial band described by F. Torrent-Guasp.     

Rationale and Methodology of the SARAH Trial: Long-Term Cardiovascular Outcomes in Patients With Resistant Hypertension and Obstructive Sleep Apnea

Introduction

Patients with resistant hypertension (RH) have a high risk of developing cardiovascular events; therefore, new therapeutic approaches to better control blood pressure may be useful in improving cardiovascular outcomes. The prevalence of obstructive sleep apnea (OSA) is very high among patients with RH. Continuous positive airway pressure (CPAP) has been shown to be an effective treatment for reducing blood pressure in patients with RH. Nevertheless, the long-term effect of CPAP treatment on cardiovascular outcomes has not been explored.The main objective of the SARAH study is to assess the impact of OSA and its treatment on cardiovascular outcomes (morbidity and mortality) in patients with RH.

Narrowing of intersensory speech perception in infancy

The conventional view is that perceptual/cognitive development is an incremental process of acquisition. Several striking findings have revealed, however, that the sensitivity to non-native languages, faces, vocalizations, and music that is present early in life declines as infants acquire experience with native perceptual inputs. In the language domain, the decline in sensitivity is reflected in a process of perceptual narrowing that is thought to play a critical role during the acquisition of a native-language phonological system. Here, we provide evidence that such a decline also occurs in infant response to multisensory speech. We found that infant intersensory response to a non-native phonetic contrast narrows between 6 and 11 months of age, suggesting that the perceptual system becomes increasingly more tuned to key native-language audiovisual correspondences. Our findings lend support to the notion that perceptual narrowing is a domain-general as well as a pan-sensory developmental process.