ABSTRACT
Traumatic events during childhood are crucial to consider when addressing children's social and emotional development, as childhood trauma is associated with negative impacts, including academic achievement. Additionally, positive classroom environments and teachers' trauma-informed attitudes and behavior play a role in supporting recovery from children's trauma-related experiences. Aspire, Connect, Thrive (ACT) is a trauma-informed school-based intervention that examined students' Social Emotional Competence (SEC) and resilience for K-8th grade students in a disadvantaged, urban elementary school in Connecticut contending with the effects of students' exposure to trauma. The present study examines the experience of ACT teachers who received professional development and subsequently implemented learned content in the classroom (N = 17; 70.6% female, mean age = 44 years; 47.1% racial/ethnic minority; mean years teaching = 15.6) through qualitative evidence of trauma sensitivity (observed and self-reported) and clinician-ratings of teachers' positive classroom environment. Quantitative results indicate significant change over time in teachers' attitudes and trauma-informed classroom responses. Interview themes suggest (1) teachers learned from and implemented the intervention content in their classrooms dependent upon the support the teacher was given, (2) teachers' perspectives on the connections between the student-teacher relationship and trauma-informed attitudes or practices influenced teacher behavior, and (3) teachers' own emotions and experiences implementing trauma-informed practices were key to classroom management.
ABSTRACT
OBJECTIVE: This study aimed to identify the impact of postpartum hemorrhage (PPH) after vaginal delivery on immediate breastfeeding success. STUDY DESIGN: This is a retrospective cohort study examining the impact of PPH on breastfeeding for nulliparous patients after term, singleton, vaginal deliveries at a large academic institution from 2017 to 2018. Indicators of successful breastfeeding in the immediate postpartum period were measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, the average amount of time spent at each breastfeeding session, the average number of newborn stools and wet diapers produced daily, and the neonatal percentage in weight loss over the first 2 to 3 days of life. RESULTS: A total of 1,904 women met inclusion criteria during the study period, 262 (13.8%) of whom experienced PPH, defined as an estimated blood loss of 500 mL or greater after vaginal delivery. Women who had a PPH had significantly fewer breastfeeding sessions on average (ß = -0.06, p-value 0.01) and required more time at each breastfeeding session (ß = 0.08, p-value <0.002). Neonates of women with PPH had a larger percentage in weight loss over the first 2 to 3 days of life compared with those without PPH (ß = 0.06, p = 0.008). CONCLUSION: Women who experience PPH after vaginal delivery have a decreased number of breastfeeding sessions despite spending more time trying to breastfeed, and an increased percentage in neonatal weight loss over the first 2 to 3 days of life. Further work is needed to elicit the mechanism behind this association; however, it is possible that PPH results in decreased secretion of endogenous oxytocin from the hypothalamic-pituitary axis as a result of hypovolemia. These women may therefore require additional breastfeeding support for successful breastfeeding initiation in the immediate postpartum period. KEY POINTS: · Women who experience PPH after vaginal delivery have decreased breastfeeding success.. · Further work is needed to elicit the mechanism behind this association.. · These women may require additional support for successful breastfeeding initiation postpartum..
ABSTRACT
PURPOSE: To evaluate the impact of a single-step (SS) warming versus standard warming (SW) protocol on the survival/expansion of vitrified blastocysts and their clinical outcomes post-frozen embryo transfer (FET). METHODS: Retrospective analysis was performed on 200 vitrified/warmed research blastocysts equally divided amongst two thawing protocols utilizing the Fujifilm Warming NX kits (Fujifilm, CA). SW utilized the standard 14-minute manufacturer's guidelines. SS protocol required only a one-minute immersion in thaw solution (TS) before the embryos were transferred to culture media. A time-interrupted study was performed evaluating 752 FETs (SW: 376 FETs, SS 376 FETs) between April 2021-December 2022 at a single academic fertility clinic in Boston, Massachusetts. Embryologic, clinical pregnancy, and live birth outcomes were assessed using generalized estimated equation (GEE) models, which accounted for potential confounders. RESULTS: There was 100% survival for all blastocysts (n = 952 embryos) with no differences in blastocyst re-expansion regardless of PGT status. Adjusted analysis showed no differences in implantation, clinical pregnancy, spontaneous abortion, or biochemical pregnancy rate. A higher odds of multiple gestation [AdjOR(95%CI) 1.06 (1.01, 1.11), p = 0.019] were noted, even when adjusting for number of embryos transferred [AdjOR(95%CI) 1.05 (1.01, 1.10)]. Live birth outcomes showed no differences in live birth rates or birthweight at delivery. CONCLUSIONS: The study found equivalent outcomes for SS and SW in all parameters except for a slight rise in the rate of multiple gestations. The results suggest that SS warming is an efficient, viable alternative to SW, reducing thaw times without adverse effects on live birth rates or neonatal birth weights.
Subject(s)
Birth Rate , Blastocyst , Cryopreservation , Embryo Transfer , Live Birth , Pregnancy Rate , Vitrification , Humans , Female , Pregnancy , Live Birth/epidemiology , Blastocyst/physiology , Cryopreservation/methods , Embryo Transfer/methods , Adult , Embryo Culture Techniques/methods , Fertilization in Vitro/methods , Retrospective Studies , Embryo Implantation , Pregnancy OutcomeABSTRACT
OBJECTIVE: Although early diagnosis and treatment prevent the severe impairments associated with untreated phenylketonuria (PKU), individuals with early treated PKU (ETPKU) nonetheless experience significant neurocognitive and psychological sequelae, including difficulties in working memory (WM) and increased risk of anxiety. The primary objective of the present study was to examine the extent to which anxiety may moderate the relationship between ETPKU and WM performance. METHOD: A sample of 40 adults with ETPKU and a demographically comparable sample of 40 healthy adults without PKU completed a comprehensive assessment of WM performance and anxiety symptomatology. Data were collected using a variety of remote assessment methods (e.g., web-based neurocognitive tests, semistructured interview, report-based measures). RESULTS: The ETPKU group demonstrated significantly poorer WM performance as compared to the non-PKU group. The groups did not differ significantly in anxiety; however, high anxiety was more common in the ETPKU group (53% of sample) than the non-PKU group (33%). A significant interaction between anxiety, metabolic control (as reflected by Phe levels), and WM performance was observed for the ETPKU group. Individuals with high anxiety and/or high Phe levels (> 360 µmol/L) performed poorer than the non-PKU group. Individuals with low anxiety and relatively low Phe levels (< 360 µmol/L) performed comparably to the non-PKU group. CONCLUSIONS: Anxiety was found to moderate the relationship between Phe levels and WM performance in individuals with ETPKU. This finding underscores the importance of accounting for anxiety when evaluating neurocognitive performance in individuals with ETPKU whether for research or clinical purposes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
Anxiety , Memory, Short-Term , Phenylketonurias , Humans , Phenylketonurias/psychology , Phenylketonurias/complications , Male , Memory, Short-Term/physiology , Female , Adult , Anxiety/etiology , Young Adult , Neuropsychological Tests , AdolescentABSTRACT
Educators' high levels of stress have been well documented in existing literature, though little research has directly looked at comparisons of stress experiences and needs for support based on school level. The present study included 33 teachers (19 elementary and 14 middle school) from one school district who participated in semistructured interviews. Responses to questions regarding their primary source(s) of stress and their ideal solution(s) to relieve that stress revealed distinctions between elementary and middle school teachers. Elementary teachers described stress related to a sense of responsibility or need to care for students and meet their social, emotional, behavioral, and academic needs. Their ideal solution primarily involved receiving more emotional support and more support staff in the classroom to help meet all students' needs. In contrast, middle school teachers reported the majority of their stress as stemming from external demands or pressures such as test scores, high or unattainable expectations from administrators or parents, and not having enough time. Middle school teachers' ideal solutions largely entailed a shift in the use of their time, specifically to remove tasks (e.g., unnecessary staff meetings) and be able to focus their time on what matters the most (e.g., teaching students). These findings indicate that although almost all of these teachers reported being highly stressed, their sources of stress and perceived needs for support varied based on school level. Efforts to promote teacher well-being must consider school level and teachers' own perspectives on what they need in order to provide the most beneficial supports. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
School Teachers , Humans , Female , Male , Adult , Middle Aged , Qualitative Research , Schools , Occupational Stress/psychology , Stress, Psychological/psychology , Social SupportABSTRACT
As females age, they transition through menopause, experiencing a decrease in estrogen and an increase in cardiovascular and neurodegenerative disease risk. Most standard rodent chows contain phytoestrogen-rich soybean meal, which can mimic the effects of estrogen. Understanding the impact of this soybean meal on vascular outcomes is crucial to proper experimental design. Thus, this study aimed to compare the effects of standard and soy-free chows on cerebral artery endothelial function and cognitive function in ovariectomized mice. Young female C57Bl/6J mice (n = 43; â¼6 mo) were randomly assigned to three groups: sham, ovariectomy (OVX), or ovariectomy on a diet containing soy (OVX + Soy). In posterior cerebral arteries, the OVX mice had a 27% lower maximal response to insulin compared with the sham mice. The OVX + Soy mice had a 27% greater maximal vasodilation to insulin compared with the OVX mice and there were no differences in vasodilation between the OVX + Soy and sham groups. The group differences in vasodilation were mediated by differences in nitric oxide bioavailability. The OVX + Soy mice also had greater insulin receptor gene expression in cerebral arteries compared with the OVX mice. However, no differences in aortic or cerebral artery stiffness were observed between groups. Interestingly, the OVX + Soy group scored better on nesting behavior compared with both sham and OVX groups. In summary, we found that ovariectomy impairs insulin-mediated vasodilation in cerebral arteries, but a diet containing soy mitigates these effects. These findings highlight the importance of considering dietary soy when performing vascular and behavioral tests in mice, particularly in females.NEW & NOTEWORTHY To properly design experiments, we must consider how variables like diet impact our outcomes, particularly the effects of soy on females. We found that cerebral artery vasodilation in response to insulin was impaired in ovariectomized female mice compared with intact shams. However, ovariectomized mice fed a soy diet had a preserved cerebral artery insulin-mediated vasodilation. These results highlight that the effects of diet on vascular function may explain inconsistencies found between studies.