Pre-eclampsia is a common hypertensive disorder of pregnancy that substantially affects maternal and neonatal morbidity and mortality worldwide. Despite decades of research, the aetiology of the disease remains poorly understood, and the clinical management of it is hampered by the lack of reliable diagnostic tests and effective therapy. Several screening tests have been suggested for the prediction of preeclampsia; however, none possess the sufficient specificity and sensitivity. Moreover, multiple pathways are known to be involved in the pathogenesis of pre-eclampsia, so it is very unlikely that a single or a small group of biomarkers will accurately predict the disease. In this thesis, two separate targeted LC-MS/MS methods were developed and validated to quantify plasma glycoproteins in pre- eclampsia to increase the pool of preeclampsia biomarker candidates and explore new pathways associated with the disease. The first method was hypothesis-driven and aimed to quantify the oxidation level of the plasma glycoprotein angiotensinogen (AGT), which has been proposed to be involved in the increased blood pressure characteristic of pre-eclampsia. The second method was hypothesis-generating and aimed to detect glycoprotein fold changes between different disease conditions using a simple and cost-effective conventional LC-MS/MS workflow. For both methods, a reproducible workflow for efficient glycoprotein/AGT extraction from human plasma was developed by coupling ConA lectin affinity chromatography with reversed-phase solid phase extraction fractionation (RP-SPE). Analysis of the enzymatically digested proteins was conducted using targeted LC-MS/MS working under the multiple reaction monitoring mode. For the quantification of the two distinct forms of AGT in the plasma (the sulphydryl-bridged oxidised form and the free thiol reduced form), a differential alkylation strategy was coupled with targeted LC-MS/MS to recognise and quantify the cysteine (Cys) peptides involved in the redox switch of AGT. The developed method enabled the reproducible detection of the two distinct forms of AGT in the plasma with CV% < 15%, and confirmation of the identity of the differentially alkylated Cys peptides was supported by LC-MS/MS. Analysis of clinical plasma samples using the developed method showed a significantly higher level of the oxidised AGT in pre-eclamptic women compared to gestational age-matched normotensive controls (P=0.008), whilst maintaining a similar total AGT level in the plasma. The research findings indicate that the elevated level of oxidised AGT rather than its total level might be a contributing factor to the hypertension characteristic of pre-eclampsia, and provide an extra line of evidence linking the oxidative state and the generation of reactive oxygen species with hypertension in pre-eclampsia. In the second part of the research, 54 clinically relevant glycoproteins were selected to be profiled by label-free targeted LC-MS/MS. Measurement of the analytical precision of the method revealed acceptable CV values for the majority of the assays (median CV 11.8%). Analysis of plasma samples collected from early- and late-onset preeclamptic women using the developed glycoprotein profiling methodology successfully identified significant changes in the level of several proteins in pre-eclampsia. Two of them, apolipoprotein D and kallikrein, are reported for the first time to be altered in the plasma of pre-eclamptic women suggesting that they could be further evaluated as novel biomarkers. Some pre-eclampsia-relevant pathways and biological processes, including iron transport and metabolism, coagulation, and lipid metabolism and oxidative stress were found to be altered in the disease. Moreover, different glycoproteins were changed in early-onset compared to late-onset pre-eclampsia which might reflect different pathophysiological mechanisms. Additionally, the method was applied to identify any altered glycoproteins in plasma samples from women with polycystic ovary syndrome (PCOS). These were subsequently compared with those found to be altered in pre-eclampsia, resulting in the proposal of possible underlying pathophysiological mechanisms that may explain the reported association between the two conditions, such as hypofibrinolysis and thrombophilia and iron overload. Moreover, the study detected, for the first time, significant changes in the plasma levels of vitronectin and insulin growth factor acid labile subunit, suggesting that these may also be further appraised as potential biomarkers for the diagnosis of PCOS. Taken together, the two targeted LC-MS/MS methods developed in this thesis provided relevant information regarding pre-eclampsia by identifying potential pre-eclampsia protein biomarkers. This sheds light on the different biochemical processes altered in the disease and points to possible pathophysiological mechanisms that might assist in explaining the link between PCOS and pre eclampsia, all of which should improve the understanding of the molecular mechanisms of the disease. The present work offers information that may play a key role in improving the health care of women with preeclampsia and serves as a foundational cornerstone for future work.

The success of any civilisation rests on a number of factors, to include their ability to procreate and produce heirs. This given, the health of women in any society is of most importance given their primary role in both birth and raising children. The study of medicine dedicated to the care of women in ancient Egypt is of vital importance and to this end, various archaeological finds have been consulted and analysed. Information in the field gynaecology shows a relatively advanced discipline with many overlaps with modern medicine and modern pharmacopoeia. Information on obstetrics is more limited with reliance on mythological texts, inscriptions, artifacts, conjecture and deductive reasoning required. A lot of areas still require exploration in the field and the study raises issues for future research / Biblical and Ancient Studies / M.A. (Ancient Near Eastern Studies)

Epithelial ovarian cancer is the deadliest gynaecological cancer: most women die within five years of their diagnoses. Moreover, survival of women with ovarian cancer (OC) has not significantly improved in the past decade. Oncolytic viruses (OVs), a new class of anti-cancer agent, infect and replicate selectively within malignant cells, whilst sparing normal cells. OVs also induce profound immune responses, for example disruption of chemokine and cytokine networks, with potential influence on therapeutic effectiveness. On the other hand, Natural Killer cells (NK cells), a key immune population that surveillance against cancers and viruses, may hinder the spread of OVs or promote anti-tumoural effects of OVs. This work investigated the role of innate immune responses, in particular NK cells and interleukin (IL)-17F, on the efficacy of oncolytic adenovirus in OC. I demonstrated that NK cells were activated by adenovirus-infected OC cells. Activated NK cells then augmented oncolytic adenovirus in eliminating OC via contact-dependent interactions between activating NK receptor DNAM-1 and adenovirus-infected malignant cells. In addition, consistent changes in chemokines and cytokines were observed after wild-type and oncolytic adenovirus infection. In particular, IL-17F, but not IL-17A, was significantly upregulated in different established and primary OC lines after adenovirus infections. Moreover, a range of inflammatory chemokines, including CCL2, CXCL1, CXCL2 and CXCL5, were down-regulated after oncolytic adenovirus infection. This work also revealed the logistical and technical challenges of the use of primary patient materials. I identified that our primary culture method for expanding OC cells was suboptimal. I subsequently evaluated a simple immunohistochemical method to screen for successful primary expansion of malignant cells from OC ascites. I showed that PAX8, but not CK7, was a specific marker of successful ex vivo expansion of HGSOC.

Introduction and background: Malnutrition, particularly undernutrition remains a major development challenge for sub-Saharan Africa. There has been mixed progress in reducing undernutrition and the numbers remain unacceptably high. However, high impact nutrition interventions have been recommended for implementation in high burden malnutrition countries to address undernutrition. Countries have responded by designing policies and programmes that reflect these recommendations. However, there is limited evidence of what works and how in local contexts. Objectives: This research explored the efficacy of nutrition interventions and modality of delivery of interventions and programmes in Uganda at national, local government and community levels. Specifically this study examined key stakeholders’ experiences of current nutrition interventions at district level in Uganda; assessed the effectiveness of previous nutrition specific and nutrition sensitive interventions on maternal and child health outcomes in Uganda; and examined the relationship between socio demographic and health factors on nutrition outcomes in Uganda. Methods and subjects: Using a combination of methods (mixed methods), this study explored nutrition interventions targeting mothers of reproductive age and children (0-5 years) in three separate studies. A systematic review was conducted to explore existing evidence on the nature of maternal and child health and nutrition interventions; and methods used to deliver them since 1986-2014. Studies were included if they were done in Uganda and reported health and nutrition related outcomes among the study group. Included studies were assessed for quality using the Newcastle Ottawa Scale. Twenty-two predominantly cross-sectional and longitudinal studies were included in the review. A qualitative study covering project implementers and project beneficiaries (n=85) in local communities was conducted using face-to-face interviews. Interviews explored methods used to deliver interventions and implementers’ and community participants’ perspectives and experiences of on-going nutrition interventions at local government (LG) and community level. Community beneficiaries were mothers or caretakers of children aged 0-59 months accessing interventions from two studied projects, while implementers were project staffs or health workers on the same projects. Interviews were transcribed verbatim and thematically analysed. Population based data of the 2011 Uganda demographic and health Survey (DHS) was quantitatively analysed. Logistic regressions analyses were done to establish factors that influence child stunting and anaemia in Uganda. Models were constructed based on 2350 stunted and 2056 child anaemia cases in the data set. Using a multilevel model design of mixed methods research, findings from each study were triangulated to obtain complementary information on the study phenomena. Results: Results suggest that planning and implementation of nutrition interventions in Uganda has transformed from random to systematic implementation since 1986. Nutrition interventions delivered diverse activities to address multiple causes of undernutrition in Uganda. However, activities were predominantly non-integrated delivered specifically at facilities or in communities. Methods of delivering interventions were broad to include community and health system compatible strategies (community mobilisation, outreaches and individual or group nutrition education and counselling) to prevent, manage and treat undernourished cases at facilities and within communities. Results further showed that maternal anaemia status, age of child and geographic factors were associated with stunting and anaemia in children. Further, the qualitative study showed, there was a conducive policy environment to implement multi-sectoral nutrition interventions in Uganda. There were linkages, collaborations and partnerships to delivery multi-sectoral integrated nutrition actions in communities and LG. Results however reveal that the dominance of external partners in implementing nutrition interventions; and absence of functional coordinating structures and mechanisms hinders intervention scale up. Further there was a need to address system and community barriers that affect implementation to improve nutrition outcomes and scale up at LG and community level. Conclusion: There have been great strides towards solving challenges of malnutrition in Uganda. Integrated approaches using community mobilisation and nutrition education and counselling at health facilities were among common delivery methods. However, bottlenecks exist in prioritisation and commitment to scale. There is a need to strengthen integrated approaches to delivering interventions across the LG and communities for multi-sectoral programming and implementation to reduce the number of undernourished Ugandans.

Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-28Bitstream added on 2014-06-13T21:07:53Z : No. of bitstreams: 1 silva_eg_dr_botfm.pdf: 973178 bytes, checksum: 4a8313adf342022e0a48ef10b96e7f10 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Analisar possíveis associações entre resistência e reactância, avaliadas pela análise de impedância bioelétrica (BIA), no primeiro, segundo e terceiro trimestres de gestação, e ocorrência de pré-eclâmpsia; identificar qual o momento mais precoce da associação. Coorte prospectiva. Hospital das Clinicas da Faculdade de Medicina de Botucatu/Unesp. 380 gestantes acompanhadas no Serviço. As gestantes foram submetidas à BIA, no primeiro (até 14 semanas), segundo (15 a 28 semanas) e terceiro (29 a41 semanas) trimestres, para avaliação dos valores de resistência e reactância. Considerou-se o desenvolvimento de hipertensão arterial, após a 20ª semana, com ou sem proteinúria, respectivamente, Pré-eclâmpsia (PE) e Hipertensão Gestacional (HG). Foi realizada a análise estatística através teste T de student e do Odds-Ratio considerando p<0,05. No primeiro trimestre a média da resistência e reactância do grupo PE (508Ω;57Ω) foi significativamente menor que a observada no grupo normotenso (580Ω;66Ω). No segundo trimestre as médias de resistência e reactância no grupo PE, respectivamente, (502Ω e 53Ω), foram menores significativamente do que as encontradas no grupo normotenso (566Ω e 57Ω). No terceiro trimestre foram também significativamente menores quando comparadas com o grupo normotenso (452 Ω e 47 Ω). No primeiro trimestre o Odds ratio (OR) para a resistência foi de 0,99 (IC 0,98 – 1,0) com p=0,002 e reactância foi de 0,93 (IC 0,85- 1,01) com p=0,07. No Segundo trimestre o OR foi de 0,99 (IC 0,98-0,99) e p=0,001 e a reactância o OR foi de 0,95 (IC=0,9-1,00) com p=0,05. No terceiro trimestre o OR foi de foi de 0,99 (IC 0,98-0,99) e p=0,0010 para resistência e de 0,93 (IC 0,88 – 0,98) e p=0,01 para reactância. A bioimpedância mostrou associação através da resistência tanto no primeiro quanto no segundo... / To analyze possible associations between resistance and reactance, as evaluated by electrical impedance analysis (BIA) in the first, second and third pregnancy trimesters, and preeclampsia occurrence; to identify the earliest moment of association. Prospective cohort. Botucatu School of Medicine University Hospital/Unesp. Population: 380 pregnant women attended to by the Service. The pregnant women underwent BIA in the first (up to 14 weeks), second (15 to 28 weeks) and third (29 to 41 weeks) trimesters for evaluation of resistance and reactance values. The development of arterial hypertension, after the 20th week, with or without proteinuria, respectively, Preeclampsia (PE) and Gestational Hypertension (GH) was considered. Statistical analysis by Odds-Ratio was performed considering p<0.05. In the first trimester, the resistance and reactance means in the PE group (508Ω;57Ω) were significantly lower than those observed in the healthy group (580Ω;66Ω). In the second trimester, the resistance and reactance means in the PE group, respectively (502Ω and 53Ω), were lower than those found in the healthy group (566Ω and 57Ω). In the third trimester were lower than than those found in the healthy group (452 Ω e 47 Ω). In the first trimester, the Odds ratio (OR) for resistance was 0.99 (CI 0.98 – 1.0) with p=0.002, and reactance was 0.93 (CI 0.85-1.01) with p=0.07. In the second trimester, OR was 0.99 (CI 0.98-0.99) and p=0.001, and for reactance, OR was 0.95 (CI=0.9-1.00) with p=0.05. In the third trimester, the Odds ratio (OR) for resistance was (IC 0,98-0,99) with p=0,0010 and 0,93 (IC 0,88 – 0,98) with p=0,01 for reactance. Bioimpedance showed association by means of resistance both in the first... (Complete abstract click electronic access below)

Simulation affords the student a safe and supportive environment in which to practise skills repeatedly without causing any harm to a real patient. The Department of Nursing Sciences at the University of Fort Hare has a laboratory that offers lowto medium-fidelity simulation in the form of task trainers and mannequins. These task trainers and mannequins are used in general nursing, and in community and midwifery nursing sciences, for the demonstration of skills, the practising of skills by students and for formative assessments. In midwifery, task trainers are used for vaginal examinations, abdominal palpation breech and vaginal deliveries and the management of post-partum haemorrhage (PPH). Given that in a real-life clinical environment limited opportunities exist for students to practise during an obstetrical emergency, medium-fidelity simulation (MFS) in midwifery ideally positions the student in a practical environment without risking the patient’s safety. Despite the availability of MFS at UFH, its benefit on the clinical readiness of student midwives is not known. The present study was designed to assess the effectiveness of MFS in enhancing the clinical readiness of student midwives at the University of Fort Hare. The main research objective of the study was to explore, describe and analyse the effect of medium-fidelity simulation on student midwives’ confidence, critical thinking ability, communication, satisfaction and team work in an obstetrical clinical emergency environment. This was a qualitative, interpretive, phenomenological analysis designed to explore the student midwives’ lived experiences regarding the effectiveness of mediumfidelity simulation and the effect of these experiences on clinical readiness. The target population was fourth-year Bachelor of nursing student midwives at the University of Fort Hare. Purposive sampling was used to select five student midwives who were team leaders during the management of PPH using MFS. Ethical approval was granted by the University of Fort Hare Ethics Committee. Informed consent was obtained from the participants prior to data collection. Trustworthiness was ensured by observing the principles of transferability, credibility, confirmability and dependability. Data was collected through individual face-to-face interviews and a semi-structured interview guide. All fourth-year student midwives had viewed an on-line video entitled Essential Steps in Management of Obstetrical Emergency(ESMOE) Postpartum Haemorrhage, in which the procedure was demonstrated. The video, sent via Backboard, was presented in such a way that student midwives had the opportunity to watch it repeatedly in order to thoroughly comprehend the demonstrated skill. A semi-structured interview guide was used for data collection. Interviews were conducted in the simulation laboratory. A Samsung smartphone was used to record interviews and a notepad was used to make notes of gestures, such as smiles or other facial expressions. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using the six steps: reading and re-reading; initial noting taking; developing emergent themes; searching for connections across the emergent themes; moving to the next case and lastly, looking for patterns across cases. The major findings indicated that the participants had differing views regarding the concept of clinical readiness; some held that clinical readiness meant being ready or prepared to handle any eventuality in the course of work, others opined that it was a state of being conversant with the policies and procedures in the clinical ward. Participants believed that clinical readiness was parallel to being competent and that midwives should always be ready to anticipate complications that might arise with the patient, endeavouring to analyse and interpret such conditions clinically. Participants expressed the need to see the simulation skill demonstrated repeatedly for thorough understanding of the technique, so that they could work independently in an obstetrical emergency situation. During simulation, participants were confident in delegating duties to team members, affirming that in order to ensure that tasks were carried out, team leaders should receive regular updates from team members.

Numerous studies have shown the benefits of breastfeeding, however, the incidence and duration of breastfeeding in the UK is low and static, and breastfeeding rates in Liverpool in the North West of the UK are even lower. Breastfeeding is frequently promoted as being free yet little research has been carried out to substantiate this claim. Further, little is known about breastfeeding practices in Liverpool. Four inter-related studies were conducted to investigate the cost of infant feeding and associated practices. Initially a database was compiled of infant feeding products, this revealed a vast number of products marketed to both breast and formula feeding mothers. Semi-structured interviews were then conducted to identify all the items purchased for feeding infants up to the age of four months. The results of these interviews revealed that breastfeeding was more expensive than formula feeding but high and low cost models suggest that substantial savings could be made. Many mothers purchased items and subsequently did not use or need them. The suggestion that infant feeding and particularly breastfeeding has become unnecessarily commercialised was supported by content analysis of a wide range of UK pregnancy and baby magazines. These were consistent with parenthood being a consumer experience to be 'perfected', in addition to emphasising the need for 'expert' advice. Breastfeeding messages were undermined by formula company advertisements and breastfeeding was frequently presented as being painful and problematic. With these conflicting messages, it may not be surprising that many women initiated breastfeeding but ceased within three months. Those who did initiate breastfeeding frequently gave 'baby-centred' reasons such as breast is best whilst those who initiated formula feeding gave 'mother-centred' reasons such as others could help with feeding. Many women who ceased breastfeeding would have liked to have continued, and cited reasons that could have been overcome with increased support and encouragement. The importance of being supported was further highlighted by the women who attended the infant feeding clinic. This study has demonstrated that the materials needed for breastfeeding are clearly identified and health professionals are trained to support parents. In addition, the media needs to be persuaded to help create and support a breastfeeding culture, with the risks of formula feeding clearly communicated.

Polycystic ovarian syndrome (PCOS) is a highly prevalent heterogeneous syndrome associated with abdominal obesity, insulin resistance and the metabolic syndrome. This clustering of risk factors could translate into an adverse cardiovascular disease (CVD) risk profile. Endothelial dysfunction, an early barometer of CVD, has been exhibited by women with PCOS; however, it remains unclear whether endothelial dysfunction is independent of CVD risk factors in this population. Exercise training has been found to enhance conduit artery and cutaneous microvessel endothelial function in various populations. Nevertheless, limited research exists regarding the cardiovascular effects of exercise in PCOS, and its impact on endothelial function in conduit arteries and cutaneous microvessels, has not been explored. The primary aim of this thesis was to examine nitric oxide (NO)-mediated endothelial function at different levels of the vascular tree in women with PCOS and to establish whether supervised exercise training induces a therapeutic effect on endothelial function. A systematic review of published studies comparing FMD in PCOS and control women was conducted. Twenty-one published studies were identified for inclusion (pCOS n=908; controls n=566). Differences in FMD between PCOS and controls were synthesised and meta-regressed against BMI and age. The pooled mean FMD was 3.5% lower (95% CI=3.4, 3.7%; P < 0.001) in women with PCOS compared with controls; and the PCOS-mediated reduction in FMD was most evident in studies involving less obese women. PCOS [n=35, 28y (95% CI=26, 30), 31kg/m2 (95% CI=27, 35)] and control women [n=16, 32y (95% CI=30, 35), 30kg/m2 (95% CI=25, 32)] were recruited. Brachial artery endothelial function was assessed using flow-mediated dilation (FMD). Internal adipose tissue (lAT), subcutaneous (SAT), visceral (VAT) and abdominal SAT was quantified using whole body magnetic resonance imaging and IH magnetic resonance spectroscopy quantified liver and skeletal muscle fat. Cardiorespiratory fitness, glycaemic control, reproductive hormone and lipid profiles were also assessed. FMD was impaired in PCOS when compared with control women [-4.5% (95% CI=-6.3, -2.8), P < O.OOl]. When FMD was adjusted for individual differences in IAT [-4.3% (95% CI=-6.l, -2.4), P < O.OOl], VAT [-4.4% (95% CI=-6.3, -2.5), P < O.OOl] and insulin resistance [-3.9% (95% CI=-5.6, -2.1), P < O.OO 1], the difference in FMD between groups remained. Ten women with PCOS [27y (95% CI=23, 32), 31 kg/rrr' (95% CI=28, 34)] completed a 16-week supervised exercise programme while 7 women with PCOS [29y (95% CI=24, 35), 35kg/m2 (95%CI=31, 40)] opted for conventional care and followed simple lifestyle advice. Exercise training improved FMD to a greater degree than conventional care [3.4% (95% CI=1.8, 5.1), P > 0.0005] and in parallel greater improvements in cardiorespiratory fitness were observed with exercise [4.7ml/kg/min (95% CI=1.4, 7.9), P=0.005]. These changes with exercise occurred independently of changes in VAT, SAT or insulin resistance. NO-mediated vasodilation in the cutaneous microvessels was examined in 11 PCOS [29y (95% CI=25, 34), 34kg/m2 (95% CI=30, 38)] and 6 control women [29y (95% CI=21, 37), 34kg/m2 (95% CI=28, 39)] using laser Doppler flowmetry combined with intra-dermal microdialysis of L-NG-monomethyl arginine to assay the NO dilator system in response to incremental local heating of the forearm. Six women with PCOS [30y (95% CI=22, 37), 31kg/m2 (95% CI=25, 37)] then undertook a 16-week exercise-training programme. Nitric oxide contribution was attenuated in women with PCOS at peak heating [-16.0CVCmax (95% CI=-32.5, 0.6), P=0.05] and during prolonged maximal heating [-15.4CVCmax (95% CI=- 29.6, -1.3), P=0.04], compared with control women. Cardiorespiratory fitness improved by 5.0ml/kg/min (95% CI=0.9, 9.2) following exercise training (P=0.03). This was accompanied by increased NO contribution to cutaneous blood flow between 36.5-42°C (P < 0.05), at peak heating [19.6CVCmax (95% CI=4.3, 34.9), P=0.02] and during prolonged maximal heating [17.1CVCmax (95% CI=2.2, 32.2), P=0.03]. The findings from this thesis suggest that endothelial dysfunction is an intrinsic characteristic of PCOS and that supervised exercise training enhances endothelial function in both conduit vessels and cutaneous microvessels, independent of adiposity or traditional CVD risk factors. The direct impact of exercise training on the vasculature of women with PCOS may decrease the risk of CVD morbidities, such as hypertension, and consequently reduce cardiovascular mortality in post-menopausal years.

<p> Using a biopsychosocial framework, I examined whether an intervention of an electronic app <i>VeedaMom</i>, specifically designed to mitigate depression, is effective in reducing depression, improving well-being, and in providing a sense of social support. This study examined the mitigation of postpartum depressive symptoms and sense of well-being in two groups over three weeks. The first group (23 women) was provided an electronic app for iPhone called the <i>VeedaMom</i> app, and the second group (20 women) was provided a customized educational booklet obtained from state resources. After three weeks, the group of mothers who used the app reported a 14% decrease in symptoms of depression (<i>p</i> &lt; .05 with a large effect size), suggesting that the app may have acted as a wellness companion. Women using the app also indicated an enhanced sense of social support on using the app, over women who used the educational booklet. In the same period, there was an increase in well-being in the group of mothers who were provided with the educational booklet. This increase in well-being was greater than the increase observed in women who used the app. Women in the group provided with the educational booklet had multiple support systems as opposed to women using the app who had fewer support systems, despite the perception of greater social support in the latter group. Thus, multiple support systems may have acted as a covariate in improving well-being. Amazon Analytics data for the app indicated a higher preference for use of some features like the meditation timer, videos, and action list. A health literacy survey showed that both the groups had similar health literacy numbers indicating that this experimental design used similar cross-sections of the population. Although this was a pilot study, the results provide evidence that the use of an electronic app like <i>VeedaMom</i> can mitigate postpartum depression.</p><p>

abstract: The object of this study is to charac terize the effect of focused ultrasound stimulation (FUS) on the rat ce rvix which has been observed to speed its ripening during pregnancy. Ce rvical ripening is required for successful fetal delivery. Timed-pregnant Sprague-Dawley rats (n=36) were used. On day 14 of gestation, the FUS system was placed on the body surface of the rat over the cervix and ultrasound energy was applied to cervix for variable times up to 1 hour in the control group, the FUS system was placed on rats but no energy was applied. Daily measurement of cervix light-induced florescence (LIF, photon counts of collagen x-bridge fluorescence) were made on days 16 of gestation and daily until spont-aneous delivery (day22) to estimate changes in cervical ripening. We found that pulses of 680 KHz ultrasound at 25 Hertz, 1 millisecond pulse duration at 1W/cm^2 applied for as little as 30 minutes would immediately afterwards show the cervix to hav e ripened to the degree seen just before delivery on day 22. Delivery times, fetal weights and viability were unaffected in the FUS-treated animals. / Dissertation/Thesis / M.S. Bioengineering 2012