Outbreak of Salmonella Chailey Infections Linked To Precut Coconut Pieces - United States and Canada, 2017.

Foodborne salmonellosis causes an estimated 1 million illnesses and 400 deaths annually in the United States (1). In recent years, salmonellosis outbreaks have been caused by foods not typically associated with Salmonella. On May 2, 2017, PulseNet, CDC's national molecular subtyping network for foodborne disease surveillance, identified a cluster of 14 Salmonella Chailey isolates with a rare pulsed-field gel electrophoresis (PFGE) pattern. On May 29, Canadian health officials informed CDC that they were also investigating a cluster of five Salmonella Chailey infections in British Columbia with the same PFGE pattern. Nineteen cases were identified and investigated by CDC, U.S. state health departments, the Public Health Agency of Canada, and the British Columbia Centre for Disease Control. Isolates from all cases were highly related by whole genome sequencing (WGS). Illness onset dates ranged from March 10 to May 7, 2017. Initial interviews revealed that infected persons consumed various fresh foods and shopped at grocery chain A; focused questionnaires identified precut coconut pieces from grocery chain A as a common vehicle. The Canadian Food Inspection Agency (CFIA) and the U.S. Food and Drug Administration (FDA) conducted a traceback investigation that implicated a single lot of frozen, precut coconut as the outbreak source. Grocery chain A voluntarily removed precut coconut pieces from their stores. This action likely limited the size and scope of this outbreak.

Women's Self-Reported Factors That Influence Their Postpartum Exercise Levels.

The birth of a child is a life transition that can signal an opportunity to promote wellness and self-care. Nurses and other health care providers can encourage women to engage in exercise for physical and mental health and to enhance weight loss after birth. However, incorporating an exercise routine into life with an infant can be challenging. Sixty-two women provided feedback about their exercise patterns before and during pregnancy, and 18 of these women gave additional insight into barriers to and facilitators of exercise engagement after childbirth. Three broad categories were identified as influencing exercise patterns in the postpartum period: Time, Maternal Responsibilities, and Physical Status. Recommendations for increasing exercise include providing individualized activity suggestions, identifying exercise groups specific to postpartum women, and connecting exercise with social support for better adherence.

Depressive Symptoms and Influencing Factors in Low-Risk Mothers.

INTRODUCTION: Depressive symptoms burden not only postpartum women, but can also compromise partner relationships and mother-infant interactions. With approximately 15% of women affected by perinatal mood and anxiety disorders (PMADs) each year, maternity care providers must be sensitive to personal characteristics and complaints that influence women's potential to develop postpartum depression (PPD). The purpose of the study was to identify personal characteristics and modifiable factors associated with depressive symptoms in low-risk postpartum women. METHODS: A descriptive, correlational design was used to identify predictors of depressive symptoms among mothers who were considered to be at low risk for PPD. Self-report data related to mood, stress, sleep disturbance, and fatigue were collected near the sixth week post-delivery from women (N = 62) in a southern US state. RESULTS: The levels of stress and reports of sleep disturbance approached clinical concern in the low-risk sample (n = 62), in addition to being positively correlated depressive symptoms. Cesarean delivery was also associated with increased depressive symptoms and predictive of depression symptoms when combined with perceived chronic stress, sleep disturbance, and fatigue. DISCUSSION: The findings underscore the importance of assessing maternal mental health and adjustment during the postpartum period. While some mothers may not report depressive symptoms at post-delivery visits, they may be experiencing symptoms that predispose them to a mood disorder. Using a more holistic approach to postpartum care, with concern for both physical and mental well-being, may be a necessary shift to promote health in new mothers and families.

Does activity matter: an exploratory study among mothers with preterm infants?

The purpose of this study was to describe the daytime activity levels and their association with sleep, fatigue, depressive symptoms, and quality of life. Wrist actigraphy and questionnaires were used to examine 51 mothers with a preterm infant during their second week postpartum. Circadian activity rhythms (CAR) were less synchronized in these mothers; they experienced sleep disturbances, fatigue, depressive symptoms, and poor health-related quality of life (H-QOL). Compared to high-activity mothers, mothers with low activity levels slept less during nighttime but napped more during daytime, and reported more postpartum depressive symptoms. Further research is needed to examine the effect of low activity level and sleep loss on postpartum depression, and to develop interventions for improving rest/activity patterns for new mothers.

AN OVERVIEW OF FORENSIC PSYCHIATRIC CARE OF THE ADOLESCENT.

The field of forensic psychiatric nursing is a relatively recent addition to the specialty of psychiatric nursing. This paper provides an overview of forensic psychiatric care of adolescent patients. It describes the juvenile justice system, identifies various theoretical models useful for understanding youthful offenders, and explores risk and protective factors. Psychiatric comorbidities and treatment considerations also are presented.