Client experiences in a prenatal home visiting program: A prenatal care coordination program evaluation.

OBJECTIVE(S): Prenatal home visiting programs are a strategy to promote positive birth outcomes. Ongoing evaluations of these programs are important to promote fidelity and quality. The goal of this program evaluation was to gain clients' perspectives of their experiences in one Wisconsin Health Department's Prenatal Care Coordination program including: (a) why clients entered the program, (b) whether client expectations were met, and (c) how expectations impacted client retention. DESIGN: A Health Department in Wisconsin undertook a three-part program evaluation of their Prenatal Care Coordination program in 2014-2015. Highlighted here is the final phase of this evaluation. The evaluation was guided by the CDC's (1999) Framework for Program Evaluation in Public Health. SAMPLE: Clients meeting eligibility criteria were divided into representative clusters using k-means clustering model. Twenty semi-structured interviews with former clients of the Wisconsin Health Department's Prenatal Care Coordination program were conducted. RESULTS: Most clients had no expectations coming into the program and were satisfied with the services they received. Participants named the nurse-client relationship and support from this relationship as a key benefit of the program, while a secondary benefit was the information and resources received. The Health Department used these findings for program improvement and strategic planning.

A complex LuxR-LuxI type quorum sensing network in a roseobacterial marine sponge symbiont activates flagellar motility and inhibits biofilm formation.

Bacteria isolated from marine sponges, including the Silicibacter-Ruegeria (SR) subgroup of the Roseobacter clade, produce N-acylhomoserine lactone (AHL) quorum sensing signal molecules. This study is the first detailed analysis of AHL quorum sensing in sponge-associated bacteria, specifically Ruegeria sp. KLH11, from the sponge Mycale laxissima. Two pairs of luxR and luxI homologues and one solo luxI homologue were identified and designated ssaRI, ssbRI and sscI (sponge-associated symbiont locus A, B and C, luxR or luxI homologue). SsaI produced predominantly long-chain 3-oxo-AHLs and both SsbI and SscI specified 3-OH-AHLs. Addition of exogenous AHLs to KLH11 increased the expression of ssaI but not ssaR, ssbI or ssbR, and genetic analyses revealed a complex interconnected arrangement between SsaRI and SsbRI systems. Interestingly, flagellar motility was abolished in the ssaI and ssaR mutants, with the flagellar biosynthesis genes under strict SsaRI control, and active motility only at high culture density. Conversely, ssaI and ssaR mutants formed more robust biofilms than wild-type KLH11. AHLs and the ssaI transcript were detected in M. laxissima extracts, suggesting that AHL signalling contributes to the decision between motility and sessility and that it may also facilitate acclimation to different environments that include the sponge host.