Longitudinal Examination of Prenatal Tobacco Switching Behaviors and Birth Outcomes,Including Electronic Nicotine Delivery System (ENDS) and Dual Use

Maternal and Child Health Journal - In the US, approximately 8% of pregnant women smoke, and 5–11.9% currently use ENDS products. The health effects of ENDS use are debated; however, most...     

A Systemic and Value-Based Approach to Strategic Reform of the Mental Health System

Most writers now recognize that mental health policy and the mental health system are extremely resistant to real changes that reflect genuine biopsychosocial paradigms of mental disorder. Writers bemoaning the intransigence of the mental health system tend to focus on a small analytical level, only to find themselves mired in the rationalities of the existing system. Problems are acknowledged to be system-wide, yet few writers have used a method of analysis appropriate for systemic problems. Drawing upon the General System Theory (GST) analytical perspective, this article advances a systematic approach to understand the mental health system and to facilitate the development of reform strategies that recognize the system's complexity and changing nature. The article first discusses the failure of major reform efforts in the mental health system and the limitations of mainstream analysis of mental health politics and policies with respect to the objectives of analysis and reform. This article describes how systems thinking has thus far influenced the study of the mental health policy and politics system, and argues that a systemic perspective is profitable for reconceiving the mental health system, enabling a fresh basis for the development of reform strategies. The mental health system should be seen as a social system influenced by larger political and economic dimensions, not just as a 'delivery system' scientifically constructed by neutral experts. Furthermore, the policy planning process should be viewed as part and parcel of a mental health system modeled as complex and dynamic. The systemic perspective outlined here should help both to clarify the value-based objectives that we hold for the system and, consequently, to plan for the strategic reforms that have so far eluded us. This revised version was published online in July 2006 with corrections to the Cover Date.     

PURIFICATION OF MS2 BACTERIOPHAGE FROM COMPLEX GROWTH MEDIA AND RESULTING ANALYSIS BY THE INTEGRATED VIRUS DETECTION SYSTEM (IVDS)

Purification and concentration of viruses from the background material is required whatever subsequent analysis methods are used. For the analysis of viruses it is essential and detection methods depend on this solution. This report demonstrates a methodology for theremoval of growth media from a virus preparation. A sample of MS2 was purified using a new ultrafiltration (UF) technique with hollow fibers. A typical MS2 virus sample with a nominal stated concentration of 1.4 × 10 12 plaque-forming units (pfu)/mL in the original growth media was used to demonstrate this method. After UF, the growth media was removed and thevirus counted using theintegrated virus detection system (IVDS)instrument. This report further describes the use of this ultrafiltration procedure to remove other impurities, such as cesium chloride and albumin, from solutions containing a purified solution of MS2 bacteriophage. These solutions were also analyzed using the IVDS instrument.     

Prevalence of physical inactivity and recommended physical activity in community-based adults with mental retardation

Little information has been reported on the leisure time physical activity (LTPA) habits of adults with mental retardation. Prevalence of physical inactivity and recommended LTPA of adults with mild to moderate mental retardation who live in community settings was described. Adults with mental retardation (76 men, 74 women) reported their physical activity habits. Overall, men and women who resided in community settings were similarly inactive, with 47% to 51% of individuals participating in little to no LTPA. Forty-two to 47% of them reported participation in moderate to vigorous LTPA five or more times per week. Limitations to quantifying physical activity through questionnaire process is discussed and development and implementation of programs designed to increase physical activity levels recommended.     

Higher-order factor analysis of an instrument with dichotomous data

This article reports the use of higher-order factor analysis to examine the underlying dimensions of an instrument designed to measure community acceptance of nurse practitioners/physician's assistants. The instrument consisted of both dichotomous and Likert scale items. Use of factor analysis with dichotomous data is controversial. Higher-order factor analysis provides a potential solution to this dilemma. Following initial factor analysis using maximum likelihood extraction with oblique rotation, the factor correlation matrix was factored to obtain second order factors. The second order factors were interpreted using the factor pattern matrix and examining correlations of individual survey items with the second order factors. This procedure provides additional factorial validity of the underlying uni- and multidimensional concepts related to acceptance of NPs and PAs in rural settings: knowledge, competence, access, and trust.     

Fitness, inflammation, and the metabolic syndrome in men with paraplegia

OBJECTIVE: To determine the relations among peak aerobic capacity, physical activity, functional ability, components of the metabolic syndrome (high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], glucose, insulin, abdominal obesity, high blood pressure), and inflammatory factors (interleukin-6 [IL-6], C-reactive protein [CRP]) in men with paraplegia. DESIGN: Cross-sectional exploratory design. SETTING: University research laboratory. PARTICIPANTS: Twenty-two men (age, 39+/-9y; duration of injury, 17+/-9y; level of injury, T2-L2) with functionally complete paraplegia volunteered to participate. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak aerobic capacity was measured using a graded peak exercise test with an arm ergometer, and physical activity was assessed by the Physical Activity and Disability Scale. Functional ability was assessed by the Self-Report Functional Measure. Circulating glucose, insulin, HDL-C, TG, total cholesterol, IL-6, and CRP levels were determined by specific enzyme or immunologic assays. Body fat was determined by dual-energy x-ray absorptiometry, and central obesity was estimated from abdominal sagittal diameters. RESULTS: Lower peak aerobic capacities were associated with lower HDL-C and lower physical activity levels ( P <.014). Lower physical activity levels were associated with higher fasting glucose, lower HDL-C level, and larger abdominal sagittal diameters ( P <.036). Larger abdominal sagittal diameters were associated with higher fasting glucose, higher fasting and postload insulin, lower HDL-C, higher TG, and higher CRP levels ( P <.05). CONCLUSIONS: Diet and exercise trials are needed to determine the efficacy and effectiveness of lifestyle interventions aimed at slowing the progression of the metabolic syndrome in people with spinal cord injury.     

Human fetal brain imaging by magnetoencephalography: verification of fetal brain signals by comparison with fetal brain models

Fetal magnetoencephalogram (fMEG) is measured in the presence of a large interference from maternal and fetal magnetocardiograms (mMCG and fMCG). This cardiac interference can be successfully removed by orthogonal projection of the corresponding spatial vectors. However, orthogonal projection redistributes the fMEG signal among channels. Such redistribution can be readily accounted for in the forward solution, and the signal topography can also be corrected. To assure that the correction has been done properly, and also to verify that the measured signal originates from within the fetal head, we have modeled the observed fMEG by two extreme models where the fetal head is assumed to be either electrically transparent or isolated from the abdominal tissue. Based on the measured spontaneous, sharp wave, and flash-evoked fMEG signals, we have concluded that the model of the electrically isolated fetal head is more appropriate for fMEG analysis. We show with the help of this model that the redistribution due to projection was properly corrected, and also, that the measured fMEG is consistent with the known position of the fetal head. The modeling provides additional confidence that the measured signals indeed originate from within the fetal head.