Cumulative poor psychosocial and behavioral health among low-income women at 6 weeks postpartum.

BACKGROUND: During the postpartum period, women may experience unfavorable psychosocial and behavioral health in multiple domains with adverse effects on parenting and maternal and infant health. Yet, little is known about the accumulation of poor health across the domains of depressive symptoms; body image; diet and physical activity; substance use including smoking and alcohol; and general self-care at 6 weeks postpartum, the usual end of maternity care. OBJECTIVES: The aims of this study were to evaluate relationships among the domains comprising psychosocial and behavioral health and to examine the distribution and risk factors associated with cumulative poor psychosocial and behavioral health at 6 weeks postpartum. METHODS: This study was a secondary analysis of cumulative poor health assessed by self-report scales for depressive symptoms, body image dissatisfaction, diet and exercise, substance use, and general self-care among 419 low-income White, African American, and Hispanic women at 6 weeks postpartum. Multivariable Poisson and logistic regression were used in key analyses. RESULTS: The correlation among psychosocial and behavioral domains had a range of r = .50-.00. In this sample of women, 45% had two or more domains in which they had poor health. The model testing risk factors for cumulative poor health was significant (likelihood ratio chi-square = 39.26, df = 11, p < 0.05), with two significant factors: not exclusively breastfeeding (odds ratio [OR] = 1.459, 95% confidence interval [CI] [1.119, 1.901]) and Hispanic ethnicity (OR = 0.707, 95% CI [0.582, 0.858], psuedo-R = .029). Within individual domains, significant risk factors (body mass index, not exclusively breastfeeding, ethnicity, education level, and parity) varied by domain. DISCUSSION: Many low-income women postpartum have poor psychosocial and behavioral health in multiple domains, which constitute areas for health promotion and early disease prevention.

Preoperative patient-reported outcome score thresholds predict the likelihood of reaching MCID with surgical correction of adult spinal deformity.

BACKGROUND CONTEXT: Preoperative (pre-op) identification of patients likely to achieve a clinically meaningful improvement following surgery for adult spinal deformity (ASD) is critical, especially given the substantial cost and comorbidity associated with surgery. Even though pain is a known indication for surgical ASD correction, we are not aware of established thresholds for baseline pain and function to guide which patients have a higher likelihood of improvement with corrective surgery. PURPOSE: We aimed to establish pre-op patient-reported outcome measure (PROM) thresholds to identify patients likely to improve by at least one minimum clinically important difference (MCID) with surgery for ASD. STUDY DESIGN: This is a retrospective cohort study using prospectively collected data. PATIENT SAMPLE: We reviewed 172 adult patients' charts who underwent corrective surgery for spinal deformity. OUTCOME MEASURES: Included measures were the Visual Analog Scale for pain (VAS), Oswestry Disability Index (ODI), and Scoliosis Research Society-22 (SRS-22). Our primary outcome of interest was improvement by at least one MCID on the ODI and SRS-22 at 2 years after surgery. METHODS: As part of usual care, the VAS, ODI, and SRS-22 were collected pre-op and re-administered at 1, 2, and 5 years after surgery. MCIDs were calculated using a distribution-based method. Determining significant predictors of MCID at two years was accomplished by Firth bias corrected logistic regression models. Significance of predictors was determined by Profile Likelihood Chi-square. We performed a Youden analysis to determine thresholds for the strongest pre-op predictors. RESULTS: At year two, 118 patients (83%) reached MCID for the SRS and 127 (75%) for the ODI. Lower pre-op SRS overall, lower pre-op SRS pain, and higher pre-op SRS function predicted a higher likelihood of reaching MCID on the overall SRS (p < 0.05). Higher pre-op ODI, lower SRS pain and self-image, and higher SRS overall predicted a higher likelihood of reaching MCID on the ODI (p < 0.05). An ODI threshold of 29 predicted reaching MCID with a sensitivity of 0.89 and a specificity of 0.64 (AUC = 0.7813). An SRS threshold of 3.89 predicted reaching MCID with a sensitivity of 0.93 and specificity of 0.68 (AUC = 0.8024). CONCLUSIONS: We identified useful thresholds for ODI and SRS-22 with acceptable predictive ability for improvement with surgery for ASD. Pre-op ODI, SRS, and multiple SRS subscores are predictive of meaningful improvement on the ODI and/or SRS at 2 years following corrective surgery for spinal deformity. These results highlight the usefulness of PROMs in pre-op shared decision-making.

Relative contributions of the male and the female to sexual behavior and reproductive success in the Japanese quail (Coturnix japonica).

Two contrasting investigative techniques provided evidence consistent with the interpretation that female quail (Coturnix japonica) regulate male copulatory behavior by the duration of their immobility and through this behavioral mechanism they also control the rate of fertilization of their eggs. In Experiment 1, copulation tests with males and females from different genetic lines showed that the type of female that participated in a copulatory test significantly influenced the latency of the male's grab, mount, and cloacal contact responses and also determined the efficiency of the male's copulatory behavior. These measures of male performance were correlated with female immobility in Experiment 2, which used a more homogeneous population of quail. Furthermore, 2 of these measures (copulatory efficiency and the latency to make cloacal contact) were correlated with fertilization rate.

Learning in intimate connections: Conditioned fertility and its role in sexual competition.

BACKGROUND: Studies of sexual conditioning typically focus on the development of conditioned responses to a stimulus that precedes and has become associated with a sexual unconditioned stimulus (US). Such a sexually conditioned stimulus (CS) provides the opportunity for feed-forward regulation of sexual behavior, which improves the efficiency and effectiveness of the sexual activity. OBJECTIVE AND DESIGN: The present experiments were conducted to provide evidence of such feed-forward regulation of sexual behavior in laboratory studies with domesticated quail by measuring how many fertilized eggs were produced by the female after the sexual encounter. During the conditioning phase, male and female quail received a conditioned stimulus paired with the opportunity to copulate with each other. RESULTS: Sexual conditioning increased the number of eggs that were fertilized as a consequence of copulation, especially if both the male and the female were exposed to the sexual CS. This conditioned fertility effect occurred with a range of CS durations and CS types. The conditioned fertility effect also occurred in situations involving sexual competition. When two males copulated with the same female, DNA fingerprinting showed that the male whose sexual encounter was signaled by a sexual CS was responsible for most of the resulting offspring. Sexual conditioning also reduced the first-male disadvantage in fertilization that occurs when two males copulate with the same female separated by several hours. Another significant finding was that sexual conditioning attenuated the usual drop in fertilization rate that occurs when the same male copulates with two females in succession. CONCLUSION: These results show that sexual conditioning increases the number of offspring that are produced in both isolated male-female encounters and in situations that involve two males copulating with the same female or one male copulating with more than one female. By increasing fertilization rates, sexual conditioning can alter genetic transmission across generations and shape evolutionary change.