Excerpt: The conclusions by Zhang et al. (2015) were notable, but the support for the conclusions was not particularly strong because of two issues. The first weakness is that although some studies have found correlations between self-efficacy and pain, the study did not consider the possibility that it is symptom distress that affects self-efficacy in colorectal cancer patients. Rather, it was assumed only that self-efficacy caused reduced symptom effects instead of a reverse or mutual relationship. The study did not consider the possibility that low self-efficacy in those with high symptom distress was actually caused by the distress itself, which is a plausible explanation. In fact, Chiarotto et al. (2014) found that cancer patients on pain medication have higher rates of self-efficacy, which would appear to show that distress reduces self-efficacy, rather than the other way around, as assumed in the above study.

Excerpt: The study by Lee and Jung (2012) recently published in Workplace Health and Safety concluded that, “A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant” (p. 25). However, that conclusion over-reaches their data and consequently is not supported. First, inconsistencies existed in the odds ratios (ORs), indicating uncertainties in the stability of the statistical findings. Second, the study used a nonexperimental design with low internal validity, preventing conclusions about causation due to the possibility of external intervening variables.

This pilot study sought to describe the patterns of health risk factors and objective physical findings in well rural Appalachian women. A retrospective chart review was conducted of the records of 50 women who received a health history, physical examination, and appropriate laboratory testing as part of a rural community wellness project. The most prevalent risk factors found were past or present smoking, history of lung disease, physical inactivity, obesity, and hypercholesterolemia. Higher numbers of risk factors per person were correlated with lower levels of education. The most prevalent physical findings were systolic blood pressure greater than 140 and diastolic greater than 90, diastolic blood pressure greater than 90 with normal systolic, total cholesterol greater than 240, low-density lipoprotein levels greater than 130, and greater than 20% over ideal weight. This sample reveals a high prevalence of risk factors for the leading causes of mortality in middle-aged women, partially accounted for by low formal education levels, poverty, and limited access to health care.

Book Summary: Break the Cycle of Children’s Environmental Health Disparities (or simply, Break the Cycle) is an annual collaborative interdisciplinary research and training program involving university students in academic tracks that focus on the impact of adverse social, economic, and environmental factors on children’s health, development, and education. The target populations are communities where environmental hazards are related to circumstances of social and economic disadvantage. Each student develops a project that focuses on preventing or reducing adverse environmental factors to benefit the children who live in these communities. At the end of the project, the students present their studies and findings at a national conference and write papers which are then published. This book is the result of the 12th annual Break the Cycle program. The projects cover a range of factors that operate over a period of time and have an influence on individual, community, and social perspectives. Most importantly, they inform us about children’s environmental health disparities and propose solutions to reduce health disparities in order to promote health equity for all children.

No description available.

No description available.

Introduction & Background: Pre-eclampsia is a serious complication of pregnancy that is characterized by high blood pressure, swelling, and proteinuria as the primary symptoms. Preeclampsia affects 5-8 percent of pregnancies in the U. S. Medications can help to manage symptoms; however, delivery is the only way to resolve pre-eclampsia. Preterm delivery is sometimes necessary and is dependent on the gestational age of the fetus and the severity of symptoms in the mother. Women who have hypertension, diabetes, kidney disease or are pregnant with multiples are at higher-risk to develop pre-eclampsia. Purpose Statement Question: The purpose of this research was to identify what complications occur in women after a pre-eclampsia diagnosis. A systematic review of the literature was used to identify relevant articles that address complications of pre-eclampsia. Literature Review: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to guide this systematic review. PubMed, CINAHL, and Google Scholar were used to identify relevant articles. Articles were published with the last 5 years (2018-2023). Search terms were “complications following pre-eclampsia.” A total of 128 results were found and reviewed. Nineteen articles were determined to be eligible for inclusion. Findings: A pre-eclampsia diagnosis comes with considerable risks for women. Short-term risks include elevated blood pressure, preterm delivery, renal dysfunction, and electrolyte imbalance. Longer term complications include chronic hypertension, cardiovascular disorders, stroke, and later memory problems including Alzheimer’s disease. Conclusions: A pre-eclampsia diagnosis confers significant risk to women. Complications can be severe and may affect women and infants long-term.

Introduction: Short- and long-term health outcomes of children stem from their first 1000 days of development (3 months prior to conception to 2 years postpartum). Research shows a correlation between poor maternal nutrition and adverse birth outcomes. Various factors such as human breast milk (HBM), gut microbiome (GM), and body mass index (BMI) correlate with nutrition. The purpose of this study was to determine if maternal factors such as BMI impact preterm infant microbiome and short chain fatty acid (SCFA) profiles. Methods: Sample Collection: In order to understand the effect of maternal health factors on neonatal GM, deidentified stool samples were collected from the NICU at the MUSC and were utilized for GM and SCFA analysis at ETSU. Microbiome Analysis: GM analysis was performed on stool samples using the Qiagen QIAmp PowerFecal Pro DNA Kit. DNA was sequenced using Amplicon sequence of the 16s rRNA region with a modified Klindworth et al method. GM was analyzed using CLC Genomics Workbench v. 23 where Alpha diversity indexes were calculated with the Abundance Analysis tool and the Beta diversity (inter-sample diversity) was calculated using the weighted Unifrac metric. Short Chain Fatty Acid Analysis: The stool samples were subjected to SCFA extraction and analysis via a modified Schwiertz et al. method. Results: Significance was observed between the groups in microbiome for; C-section (yes, no), gestation (<28, 28-32, 33-36 weeks), week of sample collection (1, 2, 3, 4, >4 weeks), and maternal BMI + antibiotics (no antibiotics + normal, overweight, or obese BMI and antibiotics + normal, overweight, or obese BMI). Significance was detected between the groups in fecal fermentation for; recreational drug use (use, no use), preeclampsia (preeclamptic, not), sepsis evaluation (yes, no), week of sample collection (1, 2, 3, 4, >4 weeks), and Fenton measurements for birth length, birth weight, and occipital frontal circumference (small, average, large for gestational age). Conclusions: These results provide valuable insights into the various maternal and neonatal factors on the GM and SCFA profiles of preterm infants, which can have implications for their overall health and development. It is possible for future adverse health outcomes of premature neonates to be attenuated through HBM ingested and GM.

BACKGROUND: The prevalence of neonatal abstinence syndrome (NAS) is on the rise in the United States, as the epidemic of opioid misuse continues1. Several infants with in utero exposure to opioids are born with NAS, and exhibit symptoms of withdrawal and dependence upon birth when the maternal source of opioid is discontinued2. Due to the novelty of the syndrome, there are several knowledge gaps in current literature that remain to be explored. LITERATURE REVIEW: The exact mechanism of development of NAS in infants remains unknown, yet the clinical symptomatology and results of a few recent studies suggest that there is an association with NAS severity and dysregulation of autonomic nervous system (ANS) functioning in these infants3. In recent years, pharmacological treatments for these infants have become standardized4. However, non-pharmacological treatments have been adopted from treatment guidelines of other high-risk infant populations and their efficacy warrants further evaluation in infants with NAS. Kangaroo care (KC) is a supportive therapy commonly applied to many high-risk infant populations because of its physiologically stabilizing effects5. The therapy has been demonstrated to be especially beneficial in the treatment of preterm infants, a population that similarly requires additional maturation of their ANS upon birth,6. Neurobehavioral theories suggest ANS functioning in infancy is a strong predictor of long-term social, behavioral, and cognitive development outcomes7,8. PROPOSED PROJECT: This prospective cohort study is designed to provide pilot data to establish if KC can be utilized to mature ANS maturation in infants with NAS. CONCLUSIONS AND SIGNIFICANCE: KC is an inexpensive, readily available, low risk intervention that could improve neurobehavioral outcomes in infants with NAS. The results of this study could reduce clinical symptoms, potentiate long-term behavior outcomes, and better define treatment practices for infants with NAS by facilitating a targeted intervention to improve outcomes.

<p> Fetal exposure to cigarette smoke is associated with an increased risk of adult-onset metabolic abnormalities. In Canada, nicotine replacement therapy (NRT) is recommended as a safe smoking cessation aid for pregnant women. However, our laboratory has demonstrated that fetal and neonatal nicotine exposure results in glucose intolerance in adult rats. The goal of this thesis was to determine the mechanism(s) underlying the observed dysglycemia following fetal and neonatal nicotine exposure, with a specific focus on the effects of nicotine on pancreatic development and postnatal beta cell function.</p> <p> Nulliparous female Wistar rats received daily subcutaneous injections of either saline or nicotine bitartrate (1 mg/kg/d) for 2 weeks prior to mating until weaning (postnatal day 21 - PND21 ). Pancreatic tissue was collected from male offspring at birth (PND1), 3, 7, 15 and 26 weeks of age. For the critical windows study, dams received nicotine or saline during different stages of pancreatic development, including: A) pre-mating only, B) pre-mating + pregnancy only, C) pre-mating, pregnancy and lactation, or D) pre-mating + lactation only. For the intervention study, nicotine-exposed dams received either normal chow or diet containing antioxidants (1000 IU/kg vitamin E, 0.25% w/w coenzyme Q10 and 0.05% w/w α-lipoic acid) during mating, pregnancy and lactation.</p> <p> Results from this thesis demonstrate that exposure to nicotine during both fetal and neonatal development (but neither stage alone) causes a permenant loss of beta cell mass beginning at birth, and adult-onset dysglycemia in rodents. Furthermore, nicotine exposure induces pancreatic oxidative stress and mitochondrial-mediated beta cell apoptosis in neonates, followed by a progressive decline in mitochondrial structure and function. Maternal treatment with a dietary antioxidant cocktail during pregnancy and lactation protected the developing beta cells from nicotine-induced apoptosis and mitochondrial swelling. These data indicate that the safety of NRT use during pregnancy should be re-evaluated.</p> / Thesis / Doctor of Philosophy (PhD)