scholarly journals Sonographic Evaluation of Fetal Cardiac Anatomy in the Late First Trimester

2019 ◽  
Vol 36 (2) ◽  
pp. 140-150
Author(s):  
Emily Hildebrand
Keyword(s):  
Heart Defects ◽  
Color Doppler ◽  
First Trimester ◽  
Nuchal Translucency ◽  
The United States ◽  
Image Correlation ◽  
Future Research ◽  
Early Screening ◽  
Screening Protocol ◽  
The Impact

Objective: Congenital heart defects (CHDs) are the most common cause of infant death in the United States. Severe, complex cardiac anomalies make up approximately half of the cases and carry significant morbidity and mortality. The purpose of this literature review was to define a CHD screening protocol to be used in the first trimester. Methods: Literature was pulled that discussed the impact of color Doppler and spatiotemportal image correlation on image quality, explored the benefits and limitations of early screening, and analyzed the risk of bioeffects to the developing fetus. Results: A simplified cardiac screening protocol has been shown to be a feasible addition to the first trimester nuchal translucency scan. Conclusion: Color Doppler and three-dimensional sonography can be utilized during the first trimester to evaluate the fetal heart for major anomalies between 11 weeks and 13 weeks 6 days. Recommendations for future research and guidance from accrediting bodies are provided.

First-trimester presentation of ultrasound findings in trisomy 13 and validation of multiparameter ultrasound-based risk calculation models to detect trisomy 13 in the late first trimester

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Bartosz Rajs ◽  
Agnieszka Nocuń ◽  
Anna Matyszkiewicz ◽  
Marcin Pasternok ◽  
Michał Kołodziejski ◽  
...  
Keyword(s):  
Heart Defects ◽  
False Positive Rate ◽  
Nasal Bone ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Trisomy 13 ◽  
Ductus Venosus ◽  
Patau Syndrome ◽  
A Prospective Study ◽  
Cns Anomalies

AbstractObjectivesTo identify the most common ultrasound patterns of markers and anomalies associated with Patau syndrome (PS), to explore the efficacy of multiparameter sonographic protocols in detecting trisomy 13 (T13) and to analyze the influence of maternal age (MA) on screening performance. Methods: The project was a prospective study based on singleton pregnancies referred for a first-trimester screening examination. The scan protocol included nuchal translucency (NT), fetal heart rate (FHR), secondary ultrasound markers [nasal bone (NB), tricuspid regurgitation (TR), ductus venosus reversed a-wave (revDV)] and major anomaly findings. Results: The study population comprised 6133 pregnancies: 6077 cases of euploidy and 56 cases of T13. Statistically significant differences were found in MA, FHR, NT, absence of NB, presence of revDV, TR and single umbilical artery. Fourteen cases of T13 (25%) demonstrated no markers of aneuploidy. The best general detection rate (DR) (DR of 78.6% with an false positive rate (FPR) of 1.2%) was obtained for a cutoff of 1/300 utilizing the “NT+T13” algorithm. The logistic regression model revealed that the central nervous system (CNS) anomalies had the greatest odds ratio (of 205.4) for T13. Conclusions: The effectiveness of the multiparameter sonographic protocol used for T13 screening showed promising results in patients older than 36 years and suboptimal results in patients between 26 and 36 years old. When screening for T13 left heart defects, CNS anomalies, abdominal anomalies, FHR above the 95th percentile, increased NT, revDV and lack of NB should receive specific attention.

scholarly journals Plasma mineral (selenium, zinc or copper) concentrations in the general pregnant population, adjusted for supplement intake, in relation to thyroid function

2020 ◽  
Vol 125 (1) ◽  
pp. 71-78
Author(s):  
Victor Pop ◽  
Johannes Krabbe ◽  
Wolfgang Maret ◽  
Margaret Rayman
Keyword(s):  
Thyroid Function ◽  
Reference Range ◽  
First Trimester ◽  
Future Research ◽  
Thyroid Peroxidase ◽  
Reference Ranges ◽  
Lower Plasma ◽  
The Mean ◽  
The Impact ◽  
Supplement Intake

AbstractThe present study reports on first-trimester reference ranges of plasma mineral Se/Zn/Cu concentration in relation to free thyroxine (FT4), thyrotropin (TSH) and thyroid peroxidase antibodies (TPO-Ab), assessed at 12 weeks’ gestation in 2041 pregnant women, including 544 women not taking supplements containing Se/Zn/Cu. The reference range (2·5th–97·5th percentiles) in these 544 women was 0·72–1·25 µmol/l for Se, 17·15–35·98 µmol/l for Cu and 9·57–16·41 µmol/l for Zn. These women had significantly lower mean plasma Se concentration (0·94 (sd 0·12) µmol/l) than those (n 1479) taking Se/Zn/Cu supplements (1·03 (sd 0·14) µmol/l; P < 0·001), while the mean Cu (26·25 µmol/l) and Zn (12·55 µmol/l) concentrations were almost identical in these sub-groups. Women with hypothyroxinaemia (FT4 below reference range with normal TSH) had significantly lower plasma Zn concentrations than euthyroid women. After adjusting for covariates including supplement intake, plasma Se (negatively), Zn and Cu (positively) concentrations were significantly related to logFT4; Se and Cu (but not Zn) were positively and significantly related to logTSH. Women taking additional Se/Zn/Cu supplements were 1·46 (95 % CI 1·09, 2·04) times less likely to have elevated titres of TPO-Ab at 12 weeks of gestation. We conclude that first-trimester Se reference ranges are influenced by Se-supplement intake, while Cu and Zn ranges are not. Plasma mineral Se/Zn/Cu concentrations are associated with thyroid FT4 and TSH concentrations. Se/Zn/Cu supplement intake affects TPO-Ab status. Future research should focus on the impact of trace mineral status during gestation on thyroid function.

scholarly journals Training Preservice Mental Health Counselors for Suicide Assessment: A Multiple Baseline Study

2019 ◽  
Author(s):  
Teal Bohrer ◽  
Cass Dykeman
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Self Efficacy ◽  
The United States ◽  
Multiple Baseline ◽  
Future Research ◽  
Probe Design ◽  
Mental Health Clinicians ◽  
Suicide Assessment ◽  
The Impact

Rates of death by suicide continue to increase across the United States. Mental health clinicians often have contact with individuals expressing suicidal ideation, but research suggests clinicians may not be appropriately prepared to assess a client’s suicide risk. Numerous models and theories explain and assess suicidal ideation. In 2009, Thomas Joiner and his colleagues proposed the interpersonal-psychological theory of suicide (IPT), which focused on three main factors strongly supported by research over the preceding decade. The present study utilized a nonconcurrent, multiple-baseline, multiple-probe design as well as a one-group pretest–posttest design to examine the impact of an IPT-based training model. Participants were preservice mental health clinicians currently enrolled in Master’s degree programs. Participants completed assessments on IPT knowledge and suicide-assessment self-efficacy, and results from this study indicated a significant increase in knowledge after completion of the training, as well as a slight decrease in self-efficacy. This study suggests that suicide-assessment training, even when done remotely, can increase suicide-assessment knowledge. Future research should explore preservice mental health clinicians’ self-efficacy as well as those factors influencing the confidence these professionals feel in their assessments of risk.

Adolescent Birth Rates and Rural–Urban Differences by Levels of Deprivation and Health Professional Shortage Areas in the United States, 2017–2018

2021 ◽  
Vol 111 (1) ◽  
pp. 136-144
Author(s):  
Sylvester O. Orimaye ◽  
Nathan Hale ◽  
Edward Leinaar ◽  
Michael G. Smith ◽  
Amal Khoury
Keyword(s):  
United States ◽  
Rural Communities ◽  
Health Professional ◽  
Health Resources ◽  
The United States ◽  
Future Research ◽  
Birth Rates ◽  
Rural Counties ◽  
Adolescent Birth ◽  
The Impact

Objectives. To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. Methods. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Results. Rural counties had an additional 7.8 births per 1000 females aged 15 to 19 years (b = 7.84; 95% confidence interval [CI] = 7.13, 8.55) compared with urban counties. Counties with the highest deprivation had an additional 23.1 births per 1000 females aged 15 to 19 years (b = 23.12; 95% CI = 22.30, 23.93), compared with less deprived counties. Rural counties with whole shortage designation had an additional 8.3 births per 1000 females aged 15 to 19 years (b = 8.27; 95% CI = 6.86, 9.67) compared with their urban counterparts. Conclusions. Rural communities across deprivation and HPSA categories showed disproportionately high adolescent birth rates. Future research should examine the extent to which contraceptive access differs among deprived and HPSA-designated rural communities and the impact of policies that may create barriers for rural communities.

Self-Management of Arthritis

2017 ◽  
pp. 171-196
Author(s):  
Jessica M. Brooks ◽  
Kanako Iwanaga ◽  
Fong Chan
Keyword(s):  
Scientific Evidence ◽  
The United States ◽  
Self Management ◽  
Future Research ◽  
Counseling Services ◽  
Evidence Based ◽  
Physical Conditions ◽  
Current State ◽  
The Individual ◽  
The Impact

Arthritis is ranked among the top causes of disability in the United States and worldwide. Despite recent improvements in medications and medical treatment, there is no known cure for arthritis. Providing evidence-based psychoeducation and counseling services to people with arthritis lessens the impact of pain-related symptoms and disability on the individual and society. The purpose of this chapter is to provide an overview of the most common arthritic conditions, co-occurring physical conditions, and psychosocial factors associated with arthritis. Barriers to self-management and existing self-management programs are also discussed along with the current state of scientific evidence. The chapter concludes with some questions for future research.

scholarly journals Federal, State, and Local Nutrition Policies for Cancer Prevention: Perceived Impact and Feasibility, United States, 2018

2020 ◽  
Vol 110 (7) ◽  
pp. 1006-1008
Author(s):  
Lauren Lizewski ◽  
Grace Flaherty ◽  
Parke Wilde ◽  
Ross Brownson ◽  
Claire Wang ◽  
...  
Keyword(s):  
United States ◽  
Cancer Prevention ◽  
The United States ◽  
Federal State ◽  
Future Research ◽  
Assistance Program ◽  
Nutrition Policies ◽  
Perceived Impact ◽  
State And Local ◽  
The Impact

Objectives. To assess stakeholder perceptions of the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention across 5 domains in the United States. Methods. We conducted an online survey from October through December 2018. Participants were invited to take the survey via direct e-mail contact or an organizational e-newsletter. Results. Federal or state Medicare/Medicaid coverage of nutrition counseling and federal or state subsidies on fruits, vegetables, and whole grains for participants in the Supplemental Nutrition Assistance Program were the policies rated as having the highest perceived impact and feasibility. Overall, the 170 respondents rated policy impact higher than policy feasibility. Polices at the federal or state level had a higher perceived impact, whereas local policies had higher perceived feasibility. Conclusions. Our findings might guide future research and advocacy that can ultimately motivate and target policy actions to reduce cancer burdens and disparities in the United States.

Men’s Adjustment to Spinal Cord Injury: The Unique Contributions of Conformity to Masculine Gender Norms

2009 ◽  
Vol 4 (2) ◽  
pp. 157-166 ◽  
Author(s):  
Shaun Michael Burns ◽  
Sigmund Hough ◽  
Briana L. Boyd ◽  
Justin Hill
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Gender Norms ◽  
The United States ◽  
Future Research ◽  
Masculine Norms ◽  
Cord Injury ◽  
Future Research Directions ◽  
The Impact

Men constitute 82% of the approximately 250,000 people in the United States living with a spinal cord injury. Unfortunately, however, little is known about the impact of men’s adherence to gender norms on their adjustment to such injuries. The present investigation examined the utility of masculine norms in explaining variance in depression beyond that accounted for by commonly identified predictors of men’s adjustment following spinal cord injury. As hypothesized, results suggested that men’s adherence to masculine norms accounted for unique variance in their depression scores beyond that contributed by social support, environmental barriers/access, and erectile functioning. Respondents who adhered to norms stressing the primacy of men’s work demonstrated lower rates of depression, whereas those who conformed to norms for self-reliance demonstrated higher depression scores. The authors discuss future research directions and potential psychotherapeutic strategies for working with men with spinal cord injuries.

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