During the course of pregnancy, dynamic remodeling of the gut microbiota occurs and contributes to maternal metabolic changes through an undefined mechanism. Because short chain fatty acids (SCFAs) are a major product of gut microbiome fermentation, we investigated whether serum SCFA levels during pregnancy are related to key metabolic parameters in mothers and newborns. In this prospective study, 20 pregnant women without gestational diabetes were evaluated at 36–38 weeks of gestation, and their newborns were assessed after parturition. In this cohort, which included normal (n = 10) and obese (n = 10) subjects based on prepregnancy body mass index, serum levels of SCFAs (acetate, propionate, and butyrate), maternal adipokines, maternal glucose, and C-peptide were measured at 36–38 weeks of gestation. Maternal weight gain and newborn anthropometrics were also determined. Data were analyzed using linear regression to test for associations, adjusting for prepregnancy obesity. In this cohort, serum acetate levels were associated with maternal weight gain and maternal adiponectin levels. In addition, serum propionate correlated negatively with maternal leptin levels, newborn length, and body weight. Taken together, this study observed that novel relationships exist among maternal SCFA levels and multiple interrelated maternal/newborn metabolic parameters.

A community-based participatory research study was conducted using focus groups with 39 women living with AIDS (WLA) in the rural setting of Andhra Pradesh, India. In addition, three nurses, two physicians, and five reproductive health accredited social health activists (ASHAs) took part in focus groups. The WLA offered insight Support for this research was provided by grant MH82662 from the National Institute on Mental Health.Address correspondence to Adeline M. Nyamathi, ANP, PhD, FAAN, UCLA, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA 90095-1702, USA. E-mail: anyamath@ sonnet.ucla.edu Services, 9:385-404, 2010 Copyright # Taylor & Francis Group, LLC ISSN: 1538-1501 print=1538-151X online DOI: 10.1080DOI: 10. /15381501.2010 into the benefits of HIV-trained ASHAs including emotional support, assistance with travel to health care providers and antiretroviral therapy medication adherence. Health care providers also identified benefits of using HIV-trained ASHAs and suggested modalities for how to train these individuals. These findings will contribute to the design of a future program of care involving HIV-trained ASHAs. Journal of HIV/AIDS & SocialKEYWORDS accredited social health activists (ASHAs), HIV= AIDS, rural India, women Approximately 2.3 million adults are living with HIV=AIDS in India, of whom 38% are women (Joint United Nations Programme on HIV=AIDS [UNAIDS], 2008). The state of Andhra Pradesh has the second highest HIV adult prevalence rate in all of India (0.97% total; 0.75% for women and 1.22% for men), according to the National Family Health Survey (NFHS, 2008). Data from antenatal clinics indicate that almost half of 23 districts in Andhra Pradesh have HIV prevalence rates for women above 2% to 2.5% (National AIDS Control Organization [NACO], 2007), indicating a feminization of the epidemic in this area. Indeed, 85% of HIV transmission in India is sexual, and 75% of women living with HIV=AIDS (WLA) become positive within the first few years of marriage (Solomon, Chakraborty, & Yepthomi, 2004).In India there exist gender-specific disparities in HIV prevention and treatment. One of the main factors influencing India's HIV epidemic is a high rate of gender stratification, in which women experience extreme social disadvantage (Bloom & Griffiths, 2007). Indian women suffer disproportionate vulnerability to HIV=AIDS (Kambou, Magur, Hora, & Mukherjee, 2007), often because they often lack HIV awareness, live in conditions of poverty, and experience gender inequity (Van Rompay et al., 2008). WLA have been found to have low levels of psychosocial well-being (Solomon et al., 2008), which is confounded by the fact that many women live in rural areas and are socially and physically distant from help and government resources (NFHS, 2008).The purpose of this study is to assess the benefits and challenges related to engaging HIV-trained accredited social health activists (ASHAs) in the care of WLA in the rural district of Nellore, Andhra Pradesh. Our goal is to determine the utility and acc...

Background Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. Yet, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. Objectives The purpose of this study was to solicit perspectives of homeless drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Methods Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica. Results The findings revealed support for a myriad of delivery styles, including in person communication, flyers, music, documentary film and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. Conclusions The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real and truthful. . Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

Concerns about time efficiency and patient and learner satisfaction during exam room staffing were not supported. This approach may allow attending physicians to maximize billing levels while increasing learner/patient involvement.

BACKGROUND: It is hypothesized that pregnancy causes time-limited physiologic adaptations of the reproductive system, such as increased blood flow to the uterus. With long interpregnancy intervals, those adaptations may regress, and maternal physiologic characteristics may revert to those of primigravid women. Therefore, it is plausible that long interpregnancy interval is associated with cesarean delivery, especially due to arrest disorders (failed induction of labor, arrest of dilation, or arrest of descent). OBJECTIVE: To examine the association between interpregnancy interval and cesarean delivery due to arrest disorders in multiparous women without a history of cesarean delivery. MATERIALS AND METHODS: This was a retrospective cohort study of all women who had more than 1 singleton pregnancy at 23 weeks' gestation or greater at MedStar Washington Hospital Center from January 2009 to June 2018. We defined the interpregnancy interval as the duration from the birth of the preceding offspring to the date of conception of the index offspring. We a priori decided to categorize women based on the interpregnancy interval (less than 18 months, 18À59 months, and 60 months or greater). Our primary outcome was cesarean delivery due to arrest disorders. We also examined overall cesarean delivery and cesarean delivery due to nonreassuring fetal heart tracing. Multivariable logistic regression was performed to calculate adjusted odds ratios and 95% confidence intervals, controlling for predefined covariates. RESULTS: Of 2741 women, 1143 (41.7%), 1369 (49.9%), and 229 (8.4%) had an interpregnancy interval of less than 18 months, 18À59 months, and 60 months or more, respectively. After adjusting for confounders, an interpregnancy interval of 60 months or more compared to an interpregnancy interval of 18À59 months was associated with increased odds of cesarean delivery due to arrest disorders (4.8% vs 1.3%; adjusted odds ratio, 3.06; 95% confidence interval, 1.34À6.97) and cesarean delivery due to arrest of dilation (3.1% vs 0.7%; adjusted odds ratio, 3.24; 95% confidence interval, 1.10À9.59). An interpregnancy interval of less than 18 months compared to an interpregnancy interval of 18À59 months was associated with decreased odds of cesarean delivery due to nonreassuring fetal heart tracing (2.4% vs 4.1%; adjusted odds ratio, 0.55; 95% confidence interval, 0.32À0.92). CONCLUSION: An interpregnancy interval of 60 months or greater compared to an interpregnancy interval of 18À59 months was associated with increased odds of cesarean delivery due to arrest disorders. Beneficial effects on postpartum adaptations in the reproductive system may regress as interpregnancy interval increases.