The selenium content of milk samples from rural Gambian women (n = 55) was evaluated as a function of parity, stage of lactation, and maternal nutrition. Samples were collected during periods of relative food abundance (dry season) and food scarcity (rainy season). Milk selenium was lower (p less than 0.01) in the rainy than in the dry season (208 vs 256 nmol/L, respectively). Milk selenium was similar in samples from women in early (1-6 mo postpartum) and late (13-19 mo postpartum) lactation. During late lactation, parity, which ranged from 1 to 11, was negatively correlated with milk selenium regardless of plane of maternal nutrition (p less than 0.02). Measures of protein, glutathione peroxidase, and total peroxidase were not affected by stage of lactation or parity. Glutathione peroxidase activity accounted for 38% of the peroxidase activity in milk. Results show that although length of lactation alone had little impact, milk selenium secretion was influenced by both maternal nutritional adequacy and parity of rural Gambian women.

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In the United States, pelvic floor disorders affect 25% of women. Despite facing unique occupational risk factors that may increase the risk of pelvic floor disorders, there is little research on the prevalence of these disorders in active-duty service women.Objectives: This study sought to identify the prevalence of and risk factors for pelvic floor disorders in active-duty service women in the United States from diagnostic codes through service utilization.

This study examined whether the closure of several inpatient obstetric units in rural New Hampshire affected birth outcomes. It is a secondary analysis of birth certificate data from 2005 through 2012 and includes 5881 births. There were no changes in perinatal outcomes. When examining outcomes based on distance travelled to place of birth, controlling for closures, women who traveled greater than 30 miles had fewer prenatal visits and lower birth weight and gestational age infants. Community services that provide prenatal care and/or home visiting are even more important when obstetric units are not available in the community.

Objective Limited research of how to best taper opioids brings about an ethical and clinical dilemma. Experiments using overt and concealed administration of opioids have demonstrated the benefits of a concealed reduction to eliminate negative expectations and prolong analgesic benefits. This may allow for opioid tapering without significant increases in pain. Based on this, we investigated patient and provider acceptance of a concealed opioid reduction for chronic pain. Methods We conducted a cross-sectional survey via REDcap with 74 patients, who are currently taking or have taken high dose opioids, and 49 providers using a validated questionnaire based on two hypothetical clinical trials comparing a patient preauthorized concealed opioid reduction vs standard tapering. Results We found that patients and providers have positive attitudes toward a concealed reduction of opioid dosages. More than 60% of providers and patients surveyed viewed the hypothetical clinical trial as helpful to reduce pain, side effects, and withdrawal symptoms. Sixty-one percent of patients and 77.6% of providers recognized that there would be differences in pain relief depending upon which group the hypothetical participants would be enrolled in. Conclusions Patients and providers appear to understand the benefits of a concealed opioid reduction. Our findings support future randomized controlled trials that compare concealed and overt opioid tapering in patients with chronic pain. More research is needed to understand the difference in attitudes between research and clinical practice and to test the acceptability of a concealed reduction following a participation in an active clinical trial.