A Comparison of Two Statewide Datasets to Understand Population Prevalence of Substance Use in Pregnancy: Findings and Considerations for Policy & Research.

Mental health conditions including substance use disorder are the leading cause of pregnancy-related deaths in the U.S. Unfortunately, fears of child protective services' involvement interfere with maternal self-disclosure of substance use in pregnancy. Seeking to identify more mothers with substance use disorder in pregnancy or at delivery, and responsive to changes to the federal Child Abuse Prevention and Treatment Act (CAPTA), Connecticut requires hospital personnel to submit a deidentified notification to CPS for all newborns with prenatal substance exposure. However, it is unknown whether this approach aligns with maternal self-report on substance use. For the present study, we compared population parameters derived from CAPTA notifications submitted between March-December 2019 with parameters derived from self-report data on substance use in pregnancy from mothers who gave birth during the same timeframe. Results revealed that three times as many mothers self-reported any alcohol or drug use in pregnancy compared to the rate measured with CAPTA notifications. Compared to mothers who self-reported drug use in the third trimester, CAPTA notifications were made for statistically similar rates of Black mothers but half the self-reported rate of White and Hispanic mothers. This disparity reflects that CAPTA notifications were made for twice as many Black mothers as White or Hispanic. Although CAPTA notifications are not punitive in nature, this disparity reveals that the public health aims of this policy are not yet achieved.

"The elephant in the room;" a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia.

BACKGROUND: Diagnoses of perinatal opioid use disorder (OUD) continue to rise in the United States. Patients and providers report obstacles to OUD treatment access. Difficulties include legal ambiguity related to Social Services notification requirements following a birth to people using opioids or in medication-assisted treatment for OUD. METHODS: Through semi-structured interviews, participant-observation, and a focus group conducted in a mostly rural, region of the Southern United States (where perinatal OUD is more prevalent), patients' and providers' perspectives about perinatal substance use treatment were initially sought for a larger study. The findings presented here are from a subset analysis of patients' experiences and perspectives. Following ethics review and exemption determination, a total of 27 patient participants were opportunistically, convenience, and/or purposively sampled and recruited to participate in interviews and/or a focus group. Data were analyzed using modified Grounded Theory. RESULTS: When asked about overall experiences with and barriers to accessing perinatal substance use treatment, 11 of 27 participants reported concerns about Social Services involvement resulting from disclosure of their substance use during pregnancy. In the subset analysis, prevalent themes were Fears of Social Services Involvement, Preparation for Delivery, and Providers Addressing Fears. CONCLUSIONS: Perinatal OUD patients may seek substance use treatment with existing fears of Social Services involvement. Patients appreciate providers' efforts to prepare them for this potential reality. Providers should become aware of how their own hospital systems, counties, states, and countries interpret laws governing notification requirements. By becoming aware of patients' fears, providers can be ready to discuss the implications of Social Services involvement, promote patient-centered decision-making, and increase trust.

Aerobiologia de Cercospora kikuchii / Aerobiology of Cercospora kikuchii

Neste estudo, foram quantificados os conídios de Cercospora kikuchii [crestamento foliar em soja (Glycine max)] presentes no ar, sua relação com a intensidade da doença e com os fatores ambientais [temperatura, umidade relativa do ar (UR), precipitação e molhamento foliar] no período de novembro a março de 2006/07 e 2007/08 em Brasília, DF. Para tanto, foi instalada uma armadilha volumétrica capta-esporos 'Burkard' de sete dias em campo experimental com soja. Houve maior captura de conídios no período diurno, com mais de 60 por cento dos esporos coletados entre 8h e 15h. Os dados climáticos variaram de acordo com a safra, mas, de modo geral, em ambos os experimentos, o período de maior captura de esporos ocorreu quando houve redução da precipitação e do molhamento foliar. A UR acima de 80 por cento e temperatura entre 20 e 24°C foram mais favoráveis para a captura de conídios e a intensidade do crestamento foliar. Nos dois anos de avaliação, a maior quantidade de esporo capturado ocorreu quando a soja se apresentava no estádio R6-R7, assim como a intensidade da doença foi maior após o início do estágio reprodutivo da cultura. Apesar da quantidade de conídio capturado em 2006/07 ter sido maior que em 2007/08, o padrão da flutuação aérea de conídios foi semelhante.

The objective of this study was to evaluate the relation of airborne released conidia of Cercospora kikuchii [cercospora leaf blight of soybean (Glycine max)] with the disease intensity and some environmental factors [temperature, relative humidity (RH), precipitation and leaf wetness period) under experimental field conditions in Brasília, DF, Brazil. The evaluation was from November to March of 2006/07 and 2007/08. Data for the amount of airborne conidia were collected using a Burkard's seven-day volumetric spore trap set in a field with soybean. Most of the conidia were collected during the day, with over 60 percent of the spores collected between 8h and 15h. Climatic data varied according to the crop period, but for both periods the highest amount of spores occurred with reduction of precipitation and leaf wetness period. RH above 80 percent and temperature from 20 to 24°C were more favorable to capture of conidia and disease intensity. For both crop period of evaluation the major amount of spores were collected when plant stage was R6-R7, as well as, disease intensity increased after beginning of reproductive stage of soybean. Although the number of captured conidia in the 2006/07 crop period was higher than in 2007/08, the variation of fluctuation of airborne spores occurred similarly.