Loss of control eating during pregnancy is associated with excessive gestational weight gain among individuals with overweight and obesity.

BACKGROUND: Excessive gestational weight gain (GWG) predicts negative health outcomes among individuals with overweight or obesity. Loss of control eating (LOC), the ingestion of food associated with being unable to control eating, is the core psychopathology of binge eating disorders. We evaluated the contribution of LOC to GWG among pregnant individuals with prepregnancy overweight/obesity. METHODS: In a prospective longitudinal study, individuals with prepregnancy BMI ≥ 25 (N = 257) were interviewed monthly to assess LOC and reported demographic, parity, and smoking information. GWG was abstracted from medical records. RESULTS: Among individuals with prepregnancy overweight/obesity, 39% endorsed LOC prior to or during pregnancy. After adjusting for factors that have previously been linked to GWG, LOC during pregnancy, uniquely predicted higher GWG and greater likelihood of exceeding GWG recommendations. Participants with prenatal LOC gained 3.14 kg (p = 0.03) more than did those without LOC during pregnancy and 78.7% (n = 48/61) exceeded IOM guidelines for GWG. The frequency of LOC episodes was also associated with greater weight gain. CONCLUSIONS: Prenatal LOC is common among pregnant individuals with overweight/obesity and predicts greater GWG and increased likelihood of exceeding IOM GWG guidelines. LOC may represent a modifiable behavioral mechanism to prevent excessive GWG among individuals at risk for adverse pregnancy outcomes.

Adapting the eating disorder examination for use during pregnancy: Preliminary results from a community sample of women with overweight and obesity.

OBJECTIVE: The Eating Disorder Examination (EDE) is a structured clinical interview that is widely used for assessing disordered eating. Although the EDE has been used in pregnant women, no standard pregnancy version has been developed. Accordingly, the present study aimed to document adaptations made to a pregnancy version of the EDE (EDE-PV) and to describe the internal reliability of this adapted version. METHOD: Three major modifications were made in the development of the EDE-PV. First, disordered eating was assessed during and prior to pregnancy to account for changes across the perinatal period. Second, items were adapted and rules governing ratings were altered to distinguish eating attitudes and behaviors that are considered normative during pregnancy from disordered eating. Third, several items were omitted. RESULTS: The EDE-PV was administered to 129 women with overweight and obesity who were between 12 and 20 weeks gestation. Women were 27.25 (SD = 5.48) years of age and 56% were African American. Women endorsed low levels of disordered eating on the EDE-PV, and the internal reliability was similar to previous reports. CONCLUSION: These findings provide support for use of the EDE-PV to assess disordered eating among pregnant women with overweight and obesity. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:597-601).

Gender, music, and distortion product otoacoustic emission components.

OBJECTIVES: The prevalence of personal music (PM) system use with earphones is high among young adults. Although previous research has demonstrated that the majority of these adults may not be listening at levels or for durations considered dangerous, the long-term consequences of PM system use are not fully understood. In this report the relationship between self-reported PM use (i.e., non, light, moderate, or heavy) and peripheral auditory function as assayed through distortion product otoacoustic emission (DPOAE) components and fine structure was explored. The purpose was to evaluate the relationship between PM system use and peripheral auditory function. DESIGN: One hundred and one (N = 101) young adults, 18 to 30 years of age, with normal hearing. Survey data were first obtained to determine PM system user status along with type of earphones used, most common listening volume, and most common listening duration. Once normal-hearing sensitivity was confirmed with a hearing screening, the DPOAE research protocol was administered. DPOAEs (2f1 to f2) were measured between 1 and 6 kHz with stimulus levels fixed at L1, L2 = 55,40 dB SPL and f2/f1 = 1.22. DPOAE level as well as fine-structure depth and spacing in 1/3rd octave (oct) bands around 1, 1.5, 2, 3, 4, and 6 kHz were compared across various PM system user groups. The ear-canal DPOAE was separated into the so-called generator and characteristic frequency (CF) components. The characteristics of the components were also compared across user groups. RESULTS: Almost all participants reported listening to a PM system between < 1 hr/d to 3 hr/d, and 67% of the participants reported medium/comfortable as the most common volume used during a typical day. There was no significant effect of user status on 3rd oct DPOAE data, 1/3rd oct band component data, or fine-structure spacing data. Women exhibited significantly higher DPOAE as well as generator and CF component levels in the lower half of the frequency range evaluated. There were no significant gender differences for fine-structure spacing or depth. The slope of the CF component was significantly steeper in women. CONCLUSIONS: In this cross-sectional study, there were no significant effects of self-reported PM use on either the ear-canal DPOAE or its constituent parts. Fine-structure depth varied across user groups in a nonsystematic manner. Women exhibited higher DPOAE and component levels in the lower portion of the frequency range evaluated. It is interesting to note that a greater proportion of men reported listening to their PM system at loud or very loud levels. The size of the effect relative to the sample size of each user group may be masking the deleterious effects of PM system use on the peripheral auditory system.

Trial design and methodology for a non-restricted sequential multiple assignment randomized trial to evaluate combinations of perinatal interventions to optimize women's health.

Pre-pregnancy overweight/obesity and excessive gestational weight gain (GWG) independently predict negative maternal and child health outcomes. To date, however, interventions that target GWG have not produced lasting improvements in maternal weight or health at 12-months postpartum. Given that interventions solely aimed at addressing GWG may not equip women with the skills needed for postpartum weight management, interventions that address health behaviors over the perinatal period might maximize maternal health in the first postpartum year. Thus, the current study leveraged a sequential multiple assignment randomized trial (SMART) design to evaluate sequences of prenatal (i.e., during pregnancy) and postpartum lifestyle interventions that optimize maternal weight, cardiometabolic health, and psychosocial outcomes at 12-months postpartum. Pregnant women (N = 300; ≤16 weeks pregnant) with overweight/obesity (BMI ≥ 25 kg/m2) are being recruited. Women are randomized to intervention or treatment as usual on two occasions: (1) early in pregnancy, and (2) prior to delivery, resulting in four intervention sequences. Intervention during pregnancy is designed to moderate GWG and introduce skills for management of weight as a chronic condition, while intervention in the postpartum period addresses weight loss. The primary outcome is weight at 12-months postpartum and secondary outcomes include variables of cardiometabolic health and psychosocial well-being. Analyses will evaluate the combination of prenatal and postpartum lifestyle interventions that optimizes maternal weight and secondary outcomes at 12-months postpartum. Optimizing the sequence of behavioral interventions to address specific needs during pregnancy and the first postpartum year can maximize intervention potency and mitigate longer-term cardiometabolic health risks for women.

A review of maternal and paternal filicide.

Filicide, the murder of a child by a parent, is a multifaceted phenomenon with various causes and characteristics. This review of the existing literature delineates the present state of knowledge regarding filicide and illustrates similarities and differences between offenses perpetrated by mothers and by fathers. The importance of numerous reports of an association between filicide and parental pre-existing psychiatric disorders is compounded by indications that a significant number of homicidal parents come to the attention of psychiatrists or other health professionals before the offense occurs. As prevention implies the recognition of causes involved in particular situations, a better understanding of potentially fatal parental/familial dynamics leading to filicide could facilitate the identification of risk and enable effective intervention strategies.

ICP0 antagonizes Stat 1-dependent repression of herpes simplex virus: implications for the regulation of viral latency.

BACKGROUND: The herpes simplex virus type 1 (HSV-1) ICP0 protein is an E3 ubiquitin ligase, which is encoded within the HSV-1 latency-associated locus. When ICP0 is not synthesized, the HSV-1 genome is acutely susceptible to cellular repression. Reciprocally, when ICP0 is synthesized, viral replication is efficiently initiated from virions or latent HSV-1 genomes. The current study was initiated to determine if ICP0's putative role as a viral interferon (IFN) antagonist may be relevant to the process by which ICP0 influences the balance between productive replication versus cellular repression of HSV-1. RESULTS: Wild-type (ICP0+) strains of HSV-1 produced lethal infections in scid or rag2-/- mice. The replication of ICP0- null viruses was rapidly repressed by the innate host response of scid or rag2-/- mice, and the infected animals remained healthy for months. In contrast, rag2-/- mice that lacked the IFN-alpha/beta receptor (rag2-/- ifnar-/-) or Stat 1 (rag2-/- stat1-/-) failed to repress ICP0- viral replication, resulting in uncontrolled viral spread and death. Thus, the replication of ICP0- viruses is potently repressed in vivo by an innate immune response that is dependent on the IFN-alpha/beta receptor and the downstream transcription factor, Stat 1. CONCLUSION: ICP0's function as a viral IFN antagonist is necessary in vivo to prevent an innate, Stat 1-dependent host response from rapidly repressing productive HSV-1 replication. This antagonistic relationship between ICP0 and the host IFN response may be relevant in regulating whether the HSV-1 genome is expressed, or silenced, in virus-infected cells in vivo. These results may also be clinically relevant. IFN-sensitive ICP0- viruses are avirulent, establish long-term latent infections, and induce an adaptive immune response that is highly protective against lethal challenge with HSV-1. Therefore, ICP0- viruses appear to possess the desired safety and efficacy profile of a live vaccine against herpetic disease.

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers.

BACKGROUND: Following tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy. METHODS: Pregnant former tobacco smokers (n=273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy. RESULTS: In total, 14% (n=38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR=36.44; 95% CI=5.03-264.27; p<0.001) followed by a lifetime alcohol use disorder (OR=3.54; 95% CI=1.27-9.87; p<0.05). In addition, more frequent attempts to quit smoking tobacco (OR=1.12; 95% CI=1.01-1.25; p<0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR=0.78; 95% CI=0.62-0.97; p<0.05) also were significantly associated with a lifetime CUD. CONCLUSIONS: Women with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.

Changes in distortion product otoacoustic emission components after music exposure.

BACKGROUND: Young adults experience some type of recreational noise exposure on a daily basis; this includes using personal music (PM) systems with earphones. In most cases, this exposure is intermittent and the short-term effects of this exposure on the auditory system are becoming better understood. PURPOSE: The purpose of this study was to examine the effects of one hour of music exposure using a PM system on distortion product otoacoustic emission (DPOAE) absolute levels and generator and characteristic frequency (CF) component levels. STUDY SAMPLES: Young adults (n = 101) between 18-30 years with normal hearing participated listened to one hour of music through earphones. A second group of young adults (n = 21) served as controls and did not listen to music, but sat in the sound-treated room for one hour. DATA COLLECTION AND ANALYSIS: Otoscopy, tympanometry, and a hearing screening (≤20 dB HL at 0.5, 1, 2, and 4 kHz) were completed in a randomly determined test ear. Preferred listening level, in dBA, was obtained and DPOAEs (2f1-f2) were measured between 1 and 6 kHz with stimulus levels fixed at L1,L2 = 55,40 dB SPL. Absolute DPOAE levels, along with generator and CF components levels were measured before and after each participant listened to one hour of music at their preferred level in a quiet setting. For data analyses, absolute DPOAE and generator and CF component levels were collapsed into 1/3rd octave bands centered around 1, 1.5, 2, 3, 4, and 6 kHz. RESULTS: Mean preferred listening level was 57.8 dBA, with males having a higher mean level of 61.1 dBA compared with females who had a mean level of 55.7 dBA. Females and males had negligible mean changes in absolute DPOAE levels at 1, 1.5, and 2 kHz, but males had 0.4-1 dB mean decreases after music at 3, 4, and 6 kHz compared to females, although not statistically significant. For DPOAE generator component data, females had small mean decreases for the two lower frequencies whereas males had mean decreases of 0.4-0.8 dB at 3, 4, and 6 kHz. Because of missing data, analyses of the CF component were limited, although females had small mean decreases at four frequencies while males had small mean decreases at two frequencies. There was no effect of listening to music on changes in DPOAEs but control participants had strong reliability (i.e., little or no change) after sitting in quiet for one hour. CONCLUSIONS: Young adults listened to music well below what would be considered hazardous. Because of the lower listening levels, DPOAEs showed very little change after music. Although there were no significant short-term changes in DPOAEs after music, the cumulative effect of this noise exposure is still unknown.

Architectural distribution of foliage in individual Pinus radiata D. Don crowns and the effects of clumping on radiation interception.

The architectural arrangement and leaf area of representative branch units, on one branch complex from each cluster on the stem, were measured on six trees in a widely spaced 7-year-old Pinus radiata D. Don plantation. There was a linear relationship between leaf area and the basal area of branch complexes. Assuming similarity in the arrangement of branch units within concomitant branch complexes at each cluster, the 3-dimensional distribution of leaf area density (leaf area per unit volume) in an array of cubic cells, each 10(-3) m(3), comprising the volume of each tree crown, was reconstructed. The fraction of cells in which foliage was present varied from 0.08 to 0.23 in the crowns with the highest (Tree 4) and lowest (Tree 3) degree of clumping, respectively. This difference was related to the number, length, and leaf area per unit length of Order 3 branch units, in particular. The actual distributions of leaf area density were used with a simple radiative transfer model to estimate the probability of penetration of beam and diffuse photosynthetically active radiation (PAR) through individual tree crowns. The average probability of beam penetration was greater for the tree with the most clumped foliage than for the tree with the least clumped foliage. For both trees, the average probabilities of penetration were greater than the values that would have resulted if a random distribution of foliage had been assumed. The negative binomial model was used to estimate an index of foliage dispersion for the tree crowns. For beam PAR, the index of foliage dispersion was 3.3 and 2.3 for the trees with the most, and the least clumped foliage, respectively. These results were supported by analysis of the architectural arrangement of foliage in the tree crowns. For two days in summer, the assumption that leaf area density was randomly distributed would have resulted in a 20 to 30% overestimation of intercepted PAR flux by the tree crowns.