The Pregnant Smoker Stigma Scale - Public Stigma (P3S-PS): development and validation in general French population.

While pregnancy smoking stigma is widely acknowledged, no psychometrically sound tool to measure it exists. This study was designed to build the Pregnant Smoker Stigma Scale - Public Stigma (P3S-PS) for assessing the stigma of pregnancy smoking in the general French population. A total of 342 adults were recruited online to take the P3S-PS and some items (condemnation/rejection, and support for punitive actions) from other scales. Exploratory factor analysis was performed. Measurement invariance was tested according to gender and smoking status. Temporal reliability was checked after two weeks (n = 72). The P3S-PS has 26 items and four dimensions: "derogatory cognitions," "negative emotions and behaviors," "personal distress," and "information provision." All dimensions were correlated (r = .36 to .75) and have good internal consistency (α.>.70), temporal reliability (ICC>.75), and measurement invariance. Validity is exhibited through the P3S-PS's association with condemnation and rejection (r = .32 to .53), support for punitive actions (r = .35 to .65), and presence of pregnant smokers in the close circle (r = -.23 to -.40). The P3S-PS is a promising tool that exhibits good psychometric qualities. This scale will be useful to trigger research regarding the stigma of smoking while pregnant.

Stigma Attached to Smoking Pregnant Women: A Qualitative Insight in the General French Population.

INTRODUCTION: Cigarette consumption during pregnancy has major health consequences for women and unborn children. The stigma of smoking during pregnancy might hinder mothers-to-be's access to adequate healthcare and smoking cessation, especially in disadvantaged groups. This qualitative study was designed to describe extensively the public stigma associated with smoking during pregnancy. AIMS AND METHODS: Participants were French adults recruited from the general population through social networks (N = 100). They were asked to answer three pairs of open-ended questions regarding cognitions, emotions, and behaviors elicited in the general population by pregnant smoking women. An inductive thematic analysis was performed and interjudge agreement was computed on 30% of the corpus analyzed deductively. Finally, independence (chi-square) between themes and gender, education, parenthood, and smoking status was tested. RESULTS: Themes (n = 25) were defined regarding cognitions (n = 9, eg, irresponsible, thoughtless, and unmindful), emotions (n = 8, eg, anger and disgust), and behaviors, (n = 8, eg, inform and persuade, and moralize and blame). Global interjudge agreement was strong (κ = .8). No difference was observed in themes according to gender, parental status, or education, indicating a heterogenous awareness of stigma. However, some differences were observed according to smoking status (χ 2 = 69.59, p = .02) (eg, nonsmokers more frequently stressed immorality). CONCLUSIONS: The stigma associated with smoking during pregnancy includes various components that might be measured and targeted in interventions to improve access to adequate healthcare and smoking cessation in this specific population. IMPLICATIONS: This qualitative study explores the stigma that the general French population attaches to pregnant women who smoke. Themes regarding cognitions (eg, irresponsible, thoughtless, and unmindful), emotions (eg, anger and disgust), and behaviors (eg, inform and persuade, and moralize and blame) were identified. These themes could guide further research regarding scale development and antistigma interventions to support smoking cessation.

Pregnancy denial and early infant development: a case-control observational prospective study.

BACKGROUND: The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant). METHODS: The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a "case" group with maternal denials of pregnancy and a "control" group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the "cases" and the "controls" will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development. DISCUSSION: This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction. TRIAL REGISTRATION: Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).

E4F1-mediated control of pyruvate dehydrogenase activity is essential for skin homeostasis.

The multifunctional protein E4 transcription factor 1 (E4F1) is an essential regulator of epidermal stem cell (ESC) maintenance. Here, we found that E4F1 transcriptionally regulates a metabolic program involved in pyruvate metabolism that is required to maintain skin homeostasis. E4F1 deficiency in basal keratinocytes resulted in deregulated expression of dihydrolipoamide acetyltransferase (Dlat), a gene encoding the E2 subunit of the mitochondrial pyruvate dehydrogenase (PDH) complex. Accordingly, E4f1 knock-out (KO) keratinocytes exhibited impaired PDH activity and a redirection of the glycolytic flux toward lactate production. The metabolic reprogramming of E4f1 KO keratinocytes associated with remodeling of their microenvironment and alterations of the basement membrane, led to ESC mislocalization and exhaustion of the ESC pool. ShRNA-mediated depletion of Dlat in primary keratinocytes recapitulated defects observed upon E4f1 inactivation, including increased lactate secretion, enhanced activity of extracellular matrix remodeling enzymes, and impaired clonogenic potential. Altogether, our data reveal a central role for Dlat in the metabolic program regulated by E4F1 in basal keratinocytes and illustrate the importance of PDH activity in skin homeostasis.

[Management of women with bipolar disorders from conception through the postpartum period]. / Prise en charge des femmes souffrant d'un trouble bipolaire de la conception au post-partum.

Any plans for pregnancy must be discussed in detail with women with bipolar disorders. They must be informed about the risks related to it and the need for some precautions. Because of the risk of relapse during pregnancy, the risk/benefit ratio of maintaining or starting prophylactic treatment should be assessed, taking into account family history and frequency of recurrences. Lithium may be used during pregnancy under close monitoring. Most anticonvulsants are contraindicated because of their teratogenicity. During the post-partum period, prophylaxis is required in most cases because of the high risk of relapse. If no prophylaxis was given during pregnancy, it must be started quickly after delivery to be effective when the risk is at its highest, i.e., during the first two weeks after delivery. Women with bipolar disorders should be advised against breast-feeding to avoid exposure of the infant to psychotropic medication. Because breast-feeding can be stressful and causes sleep deprivation, it may increase the risk of relapse. Second-generation antipsychotic agents should not be used during pregnancy or breast-feeding because inadequate information is currently available about their safety.

Working memory deficits in retinoid X receptor gamma-deficient mice.

Retinoid signaling has been recently shown to be required for mnemonic functions in rodents. To dissect the behavioral and molecular mechanisms involved in this requirement, we have analyzed the spatial and recognition working memory in mice carrying null mutations of retinoid receptors RARbeta and RXRgamma. Double mutants appeared deficient in spatial working memory as tested in spontaneous alternation in the Y-maze and delayed nonmatch to place (DNMTP) test in the T-maze. These mutant mice did acquire, however, spatial place reference or right/left discrimination tasks in the T-maze set-up, indicating that basic sensorimotor functions, spatial orientation, and motivational factors are unlikely to account for deficits in working memory-sensitive tasks. Double-mutant mice were also deficient in novel object recognition at intermediate, but not short delays. RXRgamma appeared to be the functionally predominant receptor in modulation of the working memory, as RXRgamma, but not RARbeta single null mutant mice exhibited deficits similar to those observed in the double mutants. The mechanism of this modulation is potentially related to functions of RXRgamma in frontal and perirhinal cortex, structures in which we detected RXRgamma expression and which are functionally implicated in working memory processes.

Perinatal risk factors for schizophrenia: diagnostic specificity and relationships with maternal psychopathology.

Although a growing body of evidence supports the hypothesis that exposure to obstetric complications (OCs) increases the vulnerability for schizophrenia, some questions remain unanswered regarding the diagnostic specificity and the etiological significance of this association. Associations with a history of OCs have been reported for other severe psychiatric disorders, such as autism, anorexia nervosa, or psychotic affective disorder. Thus, OCs may increase in a relatively non-specific way the vulnerability for a range of severe mental disorders, the expression of this vulnerability depending on the interaction between OCs and other risk factors, such as the genetic liability for specific psychiatric disorder, or exposure to later environmental risk factors. The causal pathway between OCs, maternal psychopathology, and psychotic outcome in the offspring is not fully elucidated. The directions of the associations are often bi-directional, and the mediating variables, if any, are not clearly identified. OCs may have a direct negative impact on fetal brain development, may be on the causal pathway between prepartum maternal depression/exposure to stress and increased risk of schizophrenia, or may indirectly increase the risk of child's later psychiatric disorder by acting as risk factors for maternal postpartum depression. The links and possible interactions between somatic perinatal risk factors and maternal psychopathology in the association with offspring's increased vulnerability for psychosis have to be further explored.

Identification of a single nucleotide polymorphism in the choline acetyltransferase gene associated with Alzheimer's disease.

The dysfunction of the cholinergic system in Alzheimer's disease (AD) supports the hypothesis that a decline in choline acetyltransferase (ChAT) activity in memory as well as in cognitive functions in AD might be functionally linked. To assess the physiological relevance of an allelic variation in the ChAT gene we investigated the presence of a possible polymorphism in AD patients and in elderly non-demented subjects as controls. By using polymerase chain reaction, single stranded conformation polymorphism or the LightCycler analysis we detected a single nucleotide polymorphism in the first common coding exon of the ChAT gene. We found a G --> A transition which occurred at position +4 of the coding sequence. The association between AD and the AA genotype or A alleles were found to be significant (odds ratio 3.7 and 2.4, respectively). The frequency of the AA genotype was three times higher in AD patients than in age-matched controls. This G --> A change raises the possibility that it may influence ATG usage resulting in attenuation of translation efficacy of ChAT messenger RNA. We suggest that such a polymorphism might be one of the events conferring an increased risk for deterioration of memory and cognition functions in AD.

Synergistic activation of the human choline acetyltransferase gene by c-Myb and C/EBPbeta.

To elucidate regulatory mechanisms at the transcriptional level of the human choline acetyltransferase gene (hChAT) we performed cotransfections assays in NG108-15 and SN56 cells using ChAT-CAT reporter plasmids with c-Myb and C/EBPbeta expression plasmids. The hChAT gene has several promoters, one of which (promoter P2 or M-type) is both c-Myb and C/EBPbeta inducible as 3-4-fold trans-activation was obtained in both cell lines when using either c-Myb or C/EBPbeta expression vectors alone. The simultaneous expression of c-Myb and C/EBPbeta in the absence or presence of NGFI-C (egr4) leads respectively to a 15-fold and 32-fold synergistic transcriptional activation of promoter P2. In the region upstream of exon M (P2) we identified a functional composite element including a c-Myb next to a C/EBP binding site. An oligonucleotide containing the composite element confers c-Myb and C/EBPbeta responsiveness to a heterologous promoter which is reduced after mutation of the c-Myb binding site. We also show that the coactivators CBP/p300 are required for c-Myb and C/EBPbeta trans-activation function and that RARalpha, RXRalpha and T3R have an inhibitory action on the synergistic transcriptional activity of c-Myb and C/EBPbeta and propose a model to explain the phenomena. Taken together, the results suggest that the synergistic effect of c-Myb and C/EBPbeta, previously observed in the hematopoietic system, functions equally in the neuronal system.