Foram realizados quatro trabalhos visando avaliar a substituição da fibra em detergente neutro (FDN) do feno de &#39:coastcross&#39: (Cynodon sp.) pela FDN da casca de soja (CS) sobre a digestibilidade dos nutrientes em cordeiros e sobre a produção e composição de leite, comportamento ingestivo e atividade ovariana pós-parto de ovelhas Santa Inês. Todas as rações experimentais foram isonitrogenadas, contendo teores semelhantes de FDN e balanceadas de acordo com o NRC (1985). O tratamento controle foi uma ração composta de 70% de feno na matéria seca (MS) da ração (CS0), sendo a FDN proveniente do feno substituída em 33% (CS33), 67% (CS67) e 100% (CS100) pela FDN proveniente da CS. No experimento de digestibilidade, 24 cordeiros Santa Inês (42,5 &#177; 3,6 kg PV e 6 meses de idade) foram arranjados em delineamento blocos completos casualizados definidos pelo peso vivo (PV). No experimento de produção, composição de leite, comportamento ingestivo e retorno da atividade ovariana pós-parto, 56 ovelhas (56 &#177; 0,5 kg PV) foram individualmente alojadas em baias cobertas e distribuídas em delineamento blocos completos casualizados definidos pelo número, tipo e data do parto, além do sexo das crias. As ovelhas foram ordenhadas manualmente, uma vez por semana, da segunda até a oitava semana de lactação (data do desmame). A produção diária foi estimada pelo cálculo do total de gramas obtido durante o intervalo de 3h. As observações de comportamento foram feitas a cada cinco minutos durante 24h. A colheita de sangue foi feita pela veia jugular, duas vezes por semana, da segunda até a décima segunda semana pós-parto. O retorno da atividade ovariana pós-parto foi definido quando a concentração sérica de P4 foi &#8805; 1 ng/mL. As digestibilidades da matéria orgânica (P < 0,05), da FDN (P < 0,05) e da fibra em detergente ácido (P < 0,01) apresentaram efeito quadrático com a inclusão de CS, enquanto a digestibilidade da proteína bruta (PB) apresentou decréscimo linear (P < 0,0001). Efeito quadrático (P < 0,01) foi observado na produção de leite em 3h (142,4; 179,8; 212,6; 202,9 g) e no consumo de MS (2,27; 2,69; 3,25; 3,00 kg/dia). Os teores de gordura (7,59; 7,86; 7,59; 7,74%), de proteína (4,53; 4,43; 4,40; 4,55%) e sólidos totais (18,24; 18,54; 18,39; 18,64%) foram similares (P > 0,10). Houve efeito linear decrescente (P < 0,001) com a inclusão de CS no tempo de ingestão (min/dia, min/g MS e min/g FDN) e no tempo de ruminação e de mastigação (min/g MS e min/g FDN). Não houve diferença (P > 0,10) no número de dias necessários ao retorno da atividade ovariana. Em média, 34,5 dias foram necessários para a primeira ovulação. A CS é um interessante substituto à forragem na ração de ovinos Santa Inês e pode ser usada em altos teores na MS da ração. A utilização de intervalo entre partos menor do que oito meses é viável para ovelhas Santa Inês. / Four trials were conducted to evaluate the effects of replacing coastcross hay neutral detergent fiber (NDF) by soybean hulls (SH) NDF on nutrient digestibility of lambs and milk yield, milk composition, ingestive behavior and postpartum ovarian activity of Santa Inês ewes. Experimental diets were formulated to meet NRC (1985) requirements and to provide a similar amount of NDF and crude protein (CP). Hay NDF from a 70% roughage-based diet (SH0) was replaced with SH NDF by 33% (SH33), 67% (SH67) and 100% (SH100). In the digestibility trial, 24 Santa Inês ram lambs (42.5 &#177; 3.6 kg of BW and 6 months old) assigned in a complete randomized block design defined by body weight (BW) were allotted in suspended metabolism crates. In the milk yield, milk composition, ingestive behavior and postpartum ovarian activity trials, 56 lactating ewes (initial BW 56.0 &#177; 0.5) were penned individually and used in a complete randomized block design according to parity, type of rearing (single or twin), offspring gender and lambing date. Ewes were milked by hand once a week, from second to eighth week of lactation (weaning time). Milk production was recorded in a 3h-interval. Behavior observations were visually recorded in a five-min interval during 24h. Blood samples were collected by venipuncture two times a week, from the first to the twelfth week after lambing. Ovarian activity resumption was defined when P4 concentration was &#8805; 1 ng/mL. Organic matter digestibility showed a quadratic effect (P < 0.05) with SH inclusion while CP digestibility showed a linear decrease (P < 0.0001). Quadratic effect was also observed for NDF digestibility (P < 0.05) and acid detergent fiber digestibility (P < 0.01). A quadratic effect (P < 0.01) for 3-h milk production (142.4, 179.8, 212.6, 202.9 g) and dry matter intake (2.27, 2.69, 3.25, 3.00 kg/day) was observed as SH level increased from 0 to 85%. Milk fat (7.59, 7.86, 7.59 and 7.74%), protein (4.53, 4.43, 4.40 and 4.55%) and total solids (18.24, 18.54, 18.39 and 18.64%) were similar (P > 0.10) for SH0, SH33, SH67 and SH100, respectively. Ingestion time (min/day, min/g DM and min/g NDF) and time expended in rumination and chewing activities (min/g DM and min/g NDF) showed a linear decrease (P < 0.001) with addition of SH in the diets. There was no treatment effect (P > 0.10) on ovarian activity resumption. The mean value for the first ovulation was 34.5 days. SH are an interesting forage replacer for sheep diets and may be used in high levels of inclusion. A lambing interval shorter than eight months is possible for Santa Inês ewes.

INTRODUÇÃO: Manter hábitos alimentares saudáveis durante a gravidez evita a retenção de peso pós-parto, desfecho que contribui para a elevação da prevalência de obesidade em mulheres. OBJETIVO: Estudar, em coorte de grávidas clientes de serviço público de pré-natal: o consumo alimentar e fatores sócio-econômicos associados; e a influência do consumo alimentar sobre a retenção de peso pós-parto. MÉTODOS: Em estudo de coorte realizado em 5 Unidades Básicas de Saúde do Município de São Paulo, foram acompanhadas 88 gestantes entrevistadas nas consultas de pré-natal e em visita domiciliar 15 dias pós-parto. Para avaliação do consumo alimentar utilizou-se o inquérito Recordatório de 24h, aplicado no 2º trimestre de gestação. Foram calculados o consumo energético e de frutas, verduras e legumes (FLVs), fibras, gordura saturada, açúcar adicionado, alimentos processados e a densidade energética da dieta por meio de tabelas de composição de alimentos. O consumo alimentar foi comparado com as metas de ingestão da OMS. Avaliou-se a retenção de peso pós-parto pela diferença entre a medida de peso 15 dias pós-parto e a realizada no início da gestação. A influência das variáveis sócio-econômicas (renda familiar per capita, escolaridade, estado marital e idade) sobre a adequação do consumo alimentar foi avaliada utilizando-se análise de regressão logística múltipla. Estudou-se a associação entre as variáveis de consumo alimentar (divididas em terços) e a retenção de peso pós-parto mediante análise de regressão linear múltipla. RESULTADOS: Mais de 30 por cento das mulheres apresentaram consumo excessivo de açúcar adicionado e gordura saturada, 64 por cento não atingiram a ingestão mínima de FLVs e nenhuma consumiu a quantidade de fibra alimentar recomendada. O aumento da renda reduziu o Odds Ratio de consumo insuficiente de FLVs (p=0,007). O Odds Ratio de consumo excessivo de açúcar adicionado elevou-se nas mulheres com companheiro (p=0,011) e com maior escolaridade (p=0,008). Maior consumo de gordura saturada elevou a retenção de peso pós-parto de forma estatisticamente significativa no modelo ajustado (p de tendência=0,033). Não foi encontrada relação significativa entre retenção de peso pós-parto e as demais variáveis de consumo alimentar. CONCLUSÃO: O padrão alimentar das gestantes não se mostrou adequado diante as recomendações da OMS, principalmente quanto à ingestão de alimentos saudáveis. O aumento da renda foi um fator de proteção para o consumo inadequado de FLVs na gestação. Houve aumento da retenção de peso pós-parto com a elevação do consumo de gordura saturada nas mulheres estudadas. / Introduction: Healthy food habits during pregnancy prevent postpartum weight retention, which contributes for increasing obesity prevalence among women. Objectives: To study in a cohort of pregnant women: dietary intake and related socioeconomic factors; and the influence of dietary intake on postpartum weight retention. Methods: In this cohort study, 88 pregnant women were interviewed during prenatal appointments in five Primary Units of Public Health and during a domiciliary visit 15 days after delivery, in the city of São Paulo, Brazil. For dietary intake evaluation, the 24-Hour Dietary Recall method was performed at the 2nd trimester of gestation. Energy, fruits and vegetables (FV), dietary fiber, added sugar, processed foods and saturated fat consumption and dietary energy density were calculated using food composition tables and adjusted by energy intake when necessary. Dietary intake variables were compared with WHO recommendations. Postpartum weight retention was calculated by the difference between the weight measured at the beginning of gestation and the same measure 15 days after delivery. The influence of socioeconomic variables (per capita familiar income, education, marital status and age) on dietary intake adequacy was analyzed by multiple logistic regression analysis. The association between dietary intake variables (divided in tertiles) and postpartum weight retention was assessed by multiple linear regression analysis. Results: More than 30 per cent of the women had inadequate added sugar and saturated fat consumption, 64 per cent didnt reach the minimum FV ingestion and none consumed the minimum recommendation for dietary fiber. Income increases reduced the odds ratio for insufficient FV consumption (p=0,007). The odds ratio for excessive added sugar consumption increased among women who lived with a partner (p=0,011) and who had higher educational levels (p=0,008). Postpartum weight retention was significantly higher with elevated ingestion of saturated fat in the adjusted model (p for trend=0,033). No significant relation was found between weight retention and the other dietary indicators. Conclusion: The dietary pattern of the pregnant women assessed in this study was not entirely adequate with regard to WHO recommendations, mainly because of the lack of healthy food ingestion. Income influenced positively the consumption of FV during gestation. Higher consumption of saturated fat increased postpartum weight retention among the studied women.

Postpartum Depression (PPD) occurs in 10-20% of new mothers. PPD can lead to serious health risks to both the mother and infant, increase the risk of complications during birth, and cause lasting effects on the development and wellbeing of the child. Many mothers suffering from PPD do not receive treatment due to fear of being stigmatized, lack of education, or not being able to access mental health services. High prevalence of PPD, along with the negative and lasting effects it can cause point to the importance of developing an effective and feasible method of assessing and treating this disorder. A pediatric primary care office may be an opportune setting to screen for PPD since mothers often accompany their children to regularly scheduled well child visits. While some studies have examined PPD screening within the pediatric primary care setting, few have explored the addition of an on-site Behavioral Health Consultant to provide brief interventions for depressed mothers as part of a stepped care model. The primary aim of the current study is assess the feasibility of implementing a stepped care protocol that assesses PPD and provides brief interventions and referrals for depressed mothers within a pediatric primary care clinic. The protocol consists of several phases including: 1) distribution of the Edinburgh Postpartum Depression Screener to every mother arriving for a well child visit during the first six months of their child’s life; 2) appropriate documentation in the clinic’s electronic health record (EHR) of the Edinburgh score and resulting plan of action; 3) a brief same day intervention by the on-site Behavioral Health Consultant and referral to outside provider, if applicable; and 4) phone call follow up with the mother and referred provider, if applicable. Research assistants will monitor the EHR to determine the clinic’s fidelity to the protocol (e.g., if the Edinburgh is being administered properly). Data will also be collected from the EHR to determine if a correlation exists between Edinburgh scores and number of Emergency Room visits made by the child, immunizations administered to the child, and number of well child checks the child attended. Data collected throughout the month of March showing the Edinburgh uptake, consistency with protocol, and any correlation between Edinburgh scores and other variables will be presented.

Postpartum Depression (PPD) affects 15% of women after childbirth. Its etiology includes psychoneuroimmunologic factors with long-lasting postpartum stressors that lead to allostatic overload. Using mindfulness-based stress reduction (MBSR) for PPD has not yet been studied. Addressing this literature gap, the potential benefits of including an 8-week MBSR component based on Beck's theory of PPD at support groups were examined in this phenomenological study based on a sample of 10 women and 2 group facilitators. Purposes of the study included describing the experience of PPD and the MBSR program, identifying the stage of behavioral change of the participants, and describing the population of women attending the PPD support groups. These assessments were carried out using coding and constant comparison, guided by the tenets of the transtheoretical model. Data triangulation safeguarded study validity and rigor. Results pointed to the value of utilizing the MBSR program in PPD support groups. Data analysis concluded in the identification of 9 stages and 5 themes of the PPD experience of which 2 constructs, unexpected experience and feeling dismissed, emerged as original contributions of the study. Positive impact on social change was evidenced at the individual level by women's report of high satisfaction with the support groups and the MBSR program; improved problem-solving and coping with anxiety, panic, and intrusive thoughts; and by positive behavioral change at Week 8. The updated knowledge about these women's experiences, along with the availability of a new tool for professionals to treat PPD, contribute to positive social change at a societal level by improving mothers' health and children's development.

Incentive-based education has a clear purpose and vision for the populations served. It is important for these organizations to demonstrate that their impact is positive, and that resources from the community are utilized efficiently. The purpose of this study is to identify the impacts of incentive-based education on the understanding and preparedness of a mother’s prenatal and postpartum experiences. Baby Steps, a non-profit incentive-based education program, was used as the research site. Clients of Baby Steps who have been involved in the program since a time during their pregnancy and who have had their baby between 3-12 months ago participated in this study. The mothers who participated in this survey reported needing financial, emotional, and/or educational support during and following their pregnancy. Survey participants’ ages ranged from 18 years to 34 years old, and came from a variety of ethnic backgrounds and countries of origin. The educational background of participants ranged from elementary school being the highest grade finished, to the completion a college degree. The findings of this study were able support the research hypothesis as these mothers were able to find at least some of the support they needed by participating in the Baby Steps program, thus yielding positive prenatal and postpartum outcomes.

The purpose of this study was to identify barriers to receiving services for women suffering with Postpartum Depression (PPD) in the San Bernardino and Riverside County areas. 11 - 20% of mothers experience symptoms of PPD, which if left untreated can negatively impact the mother-infant relationship, ultimately affecting the entire family unit. Past studies have identified a variety of barriers to receiving treatment for PPD. However, research has not focused specifically on the obstacles mothers face in these two neighboring counties. The study utilized an online self-administered questionnaire developed by the researchers to identify barriers to treatment for PPD. There were 41 participants from San Bernardino and Riverside Counties. The questionnaire was intended to be distributed to service providers that come into contact with this vulnerable population; primarily social workers, licensed therapists, masters of social work (MSW) students student interns, physicians, registered nurses, and midwives. However, because a snowball sampling technique was used, it was possibly sent to other professionals who come into contact with this population. Our study found that most of the barriers identified in previous studies also applied to our participants. The barriers rated highest in terms of limiting access to PPD services were a physician’s lack of time with patients, knowledge of PDD symptoms, the patient’s relationship to physician, and limits in coverage, as well as knowledge of services covered, lack of emotional support from significant other and/or family members, and transportation challenges including distance from providers. Additional barriers that were recognized in the literature and in our research, were education barriers, cultural barriers, stigma associated with postpartum depression, fear of child welfare officials, lack of culturally sensitive screening tools, and fears surrounding the use of medication. The results from this study may help practitioners and researchers better understand the barriers women with PPD face in accessing services, and may help service providers tailor their treatments and services accordingly. Additionally, the knowledge gained from the research may also inspire policy changes to improve women’s access to PPD services.

Introduction: Financial incentives increase smoking abstinence among pregnant and postpartum women. They have also been reported to reduce psychological symptoms using the Beck Depression Inventory (BDI) and Brief Symptom Inventory (BSI) in women at risk for perinatal depression. This prospective study aims to replicate and extend these findings using the BDI and Edinburgh Postpartum Depression Scale (EPDS). Methods: Participants were 169 pregnant cigarette smokers who were assigned to one of two treatment conditions: Best Practices only (n=88), which entails brief counseling and a referral to a pregnancy-specific quit-line, or Best Practices + Incentives (n=81). Participants were categorized as at increased risk (Dep+; n= 91) or lower risk (Dep-; n= 76) for depression based on history of depressive symptoms and baseline symptom scores. Treatment effects on smoking status and BDI/EPDS scores were examined across nine perinatal assessments using repeated measures analyses of covariance. Results: Financial incentives increased rates of biochemically-verified abstinence through 12-weeks postpartum independent of depression risk (ps ≤ .01) but did not differentially decrease BDI or EPDS scores (ps > .05). Scores decreased with both interventions for the Dep+ women (p = .001). Conclusions: These results replicate earlier evidence that financial incentives increase perinatal smoking abstinence in Dep+ women but not their efficacy in differentially reducing depressive symptoms at levels greater than Best Practices. The failure to replicate effects on depressive symptoms may be due to use of different control conditions in the current and prior study or increased screening and intervention for perinatal mental health during routine obstetrical care.

Prior research on maternal postpartum care, the transition to motherhood, pelvic floor dysfunction, and pelvic floor muscle training (PFMT) has revealed that postpartum women are often denied the basic information, instruction, and preventive strategies necessary for optimal postbirth rehabilitation and psychological well-being. Employing a dual framework of self-determination theory and personal growth initiative (PGI) theory, this quantitative study utilized a cross-sectional design to investigate if autonomy, competence, and relatedness satisfaction predicted PGI in postpartum women. Differences in autonomy, competence, relatedness, and PGI between PFMT practicing and nonpracticing postpartum women were also examined. A web-based survey method was employed to collect data from 229 postpartum women, which consisted of 121 women not practicing PFMT and 108 women practicing PFMT. The Basic Psychological Need Satisfaction and Frustration Scale measured autonomy, competence, and relatedness. The PGI Scale-II measured PGI. Standard multiple regression and 4 independent-samples t tests were used to analyze the data. Results indicated that autonomy, competence, and relatedness predicted PGI. There were no significant mean differences between PFMT practicing and nonpracticing women. These findings have implications for positive social change such that the medical community and policy makers can utilize the fulfillment of postpartum women's needs for autonomy, competence, and relatedness to improve women's odds for optimal adjustment and adaptation to life after childbirth.

Background: Consensual non-monogamous couples (CNMCs) are viewed less favourably than their heteromononormative counterparts by the general population and by healthcare providers. Research indicates that they are less likely to seek health care and are at greater risk for STIs and HIV. This stigma and judgment perceived by CNMCs can be even further compounded when these couples choose to have a child. No study to date has looked at consensual non-monogamous parenting couples (CNMPCs) during the transition to parenthood. The aim of the present study was to explore Manitoban CNMCs’ perceptions of the conciliation between their parenting role and their sexual lifestyle during the transition to parenthood. Methodology: This mixed methods descriptive, exploratory study used a triangulation design-convergence model. Six participants identifying as CNMCs during the transition to parenthood were interviewed using a semi-structured interview guide as well as completing an online questionnaire. Results: The participants in this sample experienced challenges in regard to their transition to parenthood as many other parents do, yet this transition was more harmonious for some participants compared to others. Consensual non-monogamy (CNM) was a sexual lifestyle chosen either before or during this transition. However, the lifestyle did stop during conception and pregnancy, and was resumed several months after childbirth. Relationship breakdown may occur, but not necessarily associated with CNM. The conciliation of parenting and sexual roles is facilitated when communication and intimacy are present between partners. Participants emphasized the importance of family before their chosen sexual lifestyle. The relationship with health care providers is critical for participants of CNM as it impacts how they seek health care or disclose their lifestyle. This is more important during the transition to parenthood as more challenges can be present. Three phases that CNMCs pass through were also identified, contemplation, acting and incorporation, to integrate CNM as a lifestyle. Discussion: These findings permitted a closer look at the conciliation of the parenting role and the sexual lifestyle of CNMPCs during their transition to parenthood. These findings demonstrated not only how CNMPCs were similar and different from participants in other studies, but also highlighted how they were uniquely distinct. This distinction appears to stem from a certain resilience gained from the three phases of the incorporation of CNM as a lifestyle that appears to buffer these couples in situations of stress. A new proposed model, CNMPCs’ Model of Resilience during the Incorporation of CNM as a Lifestyle While Parenting, is suggested. There is a need for more psychosexual education for perinatal nurses in regard to sexuality minorities such as CNMPCs in the context of the transition to parenthood.

Forty-eight Holstein cows at Utah State Dairy Farm were blocked statistically according to date of calving, previous milk production, and numbers of lactation at parturition. The cattle were assigned randomly to one of four treatments within blocks. The four treatments included a base ration (control, treatment #1), base ration plus .8% of sodium bicarbonate (treatment #2), base ration plus .4% of magnesium oxide (treatment #3), and base ration plus both .8% of sodium bicarbonate and .4% of magnesium oxide (treatment #4). The research was conducted from February 1983 to November 1984. A formagraph was used to measure milk coagulation parameters and pH was determined. There was no significant difference in milk coagulation parameters or pH between the control and the buffer treatments. Milk parameters were significantly different in individual cow, week, and milk pH. Milk parameters did not appear to be dependent upon season. Curd firmness was significant in interaction of season and treatment. Significant variations in milk pH were observed in relation to week, season, and individual cow. Overall treatments, the clotting time, K20, and pH value increased each wee, and A30 decreased each week. The milk parameters and pH in each treatment were significant between weeks except K20 and A30 in treatment #3, and A30 in treatment #2 (p Somatic cell count was positively correlated with clotting time, K20, and pH and negatively correlated with A30. Milk pH was the most significant and had positive correlation coefficient with clotting time and firming rate and negative correlation coefficient with curd firmness.