Biomedical subjects

S L Martin

Publications and source records attributed to S L Martin.

135 records · Page 8Linked to original sources

PubMedDate not supplied

Social support and psychological functioning among high-risk mothers: the impact of the Baby Love Maternal Outreach Worker Program.

This study compared two groups of high-risk Medicaid-eligible mothers, 221 who participated in a maternal home visitation program and 198 who did not, to determine whether program participation was associated with improvements in the mothers' psychological functioning 1 year after delivery, and whether these improvements were associated with the type and intensity of support provided by home visitors. The results suggest that, compared to nonparticipants, participants provided with more intensive home visitor support had significantly higher self-esteem (p = 0.039) and were less depressed (p = 0.015). Participants with less intensive home visitor support, however, did not differ significantly from nonparticipants in their self-esteem or depression levels. No significant differences were observed in the perceived stress levels of participants as compared with nonparticipants, regardless of the intensity of home visitor support. Mothers who had support from the baby's father, however, had significantly lower perceived stress levels than mothers with no support from the baby's father (p = 0.046). Moreover, the type of support provided by home visitors (emotional, instrumental, informational) did not appear to be related to the mothers' psychological functioning. This study suggests that the intensity of support is an important component of maternal home visitation programs that aim to improve women's psychological functioning.

Adaptation, Psychological↗

PubMedDate not supplied

Reversible depression of oxygen consumption in isolated liver mitochondria during hibernation.

The biochemical mechanisms by which hibernators cool as they enter torpor are not fully understood. In order to examine whether rates of substrate oxidation vary as a function of hibernation, liver mitochondria were isolated from telemetered ground squirrels (Spermophilus lateralis) in five phases of their annual hibernation cycle: summer active, and torpid, interbout aroused, entrance, and arousing hibernators. Rates of state 3 and state 4 respiration were measured in vitro at 25 degrees C. Relative to mitochondria from summer-active animals, rates of state 3 respiration were significantly depressed in mitochondria from torpid animals yet fully restored during interbout arousals. These findings indicate that a depression of ADP-dependent respiration in liver mitochondria occurs during torpor and is reversed during the interbout arousals to euthermia. Because this inhibition was determined to be temporally independent of entrance and arousal, it is unlikely that active suppression of state 3 respiration causes entrance into torpor by facilitating metabolic depression. In contrast to the observed depression of state 3 respiration in torpid animals, state 4 respiration did not differ significantly among any of the five groups, suggesting that alterations in proton leak are not contributing appreciably to downregulation of respiration in hibernation.

Animals↗

PubMedDate not supplied

Domestic violence and sexually transmitted diseases: the experience of prenatal care patients.

OBJECTIVES: The authors analyzed interview responses of patients at a prenatal care clinic to explore whether women who had been victims of sexual and physical abuse were more likely than non-victimized women to have experienced a sexually transmitted disease (STD). METHODS: A consecutive sample of 774 prenatal patients of a large health department in North Carolina were interviewed concerning a variety of health issues, including violence and STDs. Logistic regression analysis was used to model the women's STD status as a function of their experiences of sexual and physical abuse, controlling for several potentially confounding factors. RESULTS: Thirty percent of the women reported having experienced at least one STD, with the most common infections being chlamydia and gonorrhea. Twenty-eight percent of the women reported having been victims of abuse; 16% reported physical abuse only, while 12% reported both physical and sexual abuse. The majority of violence was domestic in nature, perpetrated by the victims' husbands, boyfriends, male friends, and relatives. After controlling for confounding variables, the authors found that women who reported both physical and sexual abuse were significantly more likely to have experienced STDs than non-victims (odds ratio [OR] = 2.25; 95% confidence interval [CI] 1.37, 3.69). The logistic regression analysis also showed a relationship of borderline statistical significance between non-sexual physical abuse and STDs. CONCLUSIONS: Health care providers should routinely screen patients for both abuse and STDs, and they should assist identified women in accessing appropriate health, social, and legal services.

Adult↗

PubMedDate not supplied

School-based programs for obesity prevention: what do adolescents recommend?

Twenty-five focus groups conducted with 203 adolescent boys and girls from junior high and high schools in St. Paul, Minnesota, showed that students want weight control programs that are fun, interactive, accessible, convenient, low in cost, sensitive to the needs of adolescents, include multiple physical activity options, and are offered to all students, regardless of their weight.

Adolescent↗

PubMedDate not supplied

Contemporary medical management of left ventricular dysfunction and congestive heart failure.

OBJECTIVE: The primary purpose of this review was to address the following question: based on the best available evidence, what should be the current medical management of congestive heart failure (CHF)? DATA SOURCES: The major sources for this review were from searches of the English language literature, including computer and bibliography reviews, of all randomized, controlled clinical trials and overview analyses of positive inotropic agents, preload/afterload reduction agents and beta-blocker medications in CHF. STUDY SELECTION: The number of studies reviewed was approximately 40. The major criterion for selection was that the studies be of CHF patients in randomized controlled clinical trials, particularly with a mortality/survival endpoint. Additional clinical trials of nonmortality endpoints in CHF patients and mortality trials in non-CHF patients were also selected to support possible pathophysiological insights for future CHF trials. DATA EXTRACTION: The data, particularly for the accompanying tables, were initially extracted by a single reviewer using common qualitative guidelines as far as was possible within the different temporal, etiological and geographic frameworks of the original component studies. Conclusions are drawn from this data synthesis and from published overviews. DATA SYNTHESIS: Angiotensin converting enzyme (ACE) inhibition therapy is effective in reducing mortality and morbidity in severe left ventricular dysfunction and CHF. Other systemic vasodilators may also be beneficial. The effects of digitalis on survival and morbidity in CHF are presently uncertain, but should be resolved in the near future. Other inotropic agents, at least in the long term, are clinically detrimental. Diuretics decrease morbidity, but their effect on mortality in CHF remains unknown. Beta-blocker and magnesium therapy offer promise in CHF, but await definitive clinical trials evaluation. CONCLUSIONS: The current medical therapy of CHF should definitely include ACE inhibitors, probably diuretics and possibly other vasodilators. Further viable trials of promising new, and older heretofore under-evaluated, CHF therapies are needed. Additionally, innovative strategies are needed to deal with this disease which has an increasing prevalence. Two strategies, primary prevention of CHF and a 'Heart Function Clinic', are discussed.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Morgentaler v. The Queen in the Supreme Court of Canada.

In Morgentaler v. R., the Supreme Court of Canada struck down the abortion provisions in the Criminal Code. In a five to two split, a majority of the Supreme Court judges found that section 251 offended a pregnant woman's constitutionally protected right not to be deprived of her "life, liberty, and security of the person." Sheilah Martin reviews the three majority judgments and focuses on the decision written by Madame Justice Wilson. She believes that Madame Justice Wilson's opinion merits special attention in several regards: her conclusions on the constitutional rights of pregnant women; her recognition and validation of women's perspectives on abortion; and her approach to balancing women's interests in reproductive self-determination against the state's interest in regulating reproduction. Sheilah Martin concludes that this decision will reverberate far into the future. Even though it fails to establish clear guidelines concerning governmental power to control access to abortion, its principles outline the legal framework in which future litigation will occur, and it will limit and shape the terms of any ensuing political debate. In addition, Madame Justice Wilson's judgment holds great promise for those looking to the Court to promote the rights of women and other historically disadvantaged groups.

Abortion, Induced↗

PubMedDate not supplied

Survey of exposure to violence among the children of migrant and seasonal farm workers.

Numerous children of migrant and seasonal farm workers live in rural areas of our country. The lifestyles and living conditions of farm workers place the children of these families at high risk for many health problems. However, few studies have focused on the emotional and behavioral well-being of these children. This study extends past research by examining the emotional and behavioral health of the children of farm workers in relation to a potentially risky environmental exposure, namely, exposure to violence. In this descriptive study, the extent of violence exposure, including being a witness to and a victim of violence, is examined among 8-11-year-old children of migrant and seasonal farm workers. Potential relationships between sociodemographic factors and violence exposure are examined, and associations between violence exposure and children's emotional and behavioral problems, and weapon carrying behavior are investigated. The results show that more than half of the study children had been exposed to violence, with 46 percent having witnessed violence among others and 19 percent having been the direct victims of violence. There was a fair degree of overlap between having witnessed violence and having been a victim of violence; 13 percent of all study children both witnessed and had been victims of violence, 33 percent only had witnessed violence, and 6 percent only had been victims of violence. Violence exposure was positively related to children's emotional problems, behavioral problems, and weapon carrying behavior. Compared to non exposed children, violence exposed children were eight times more likely to evidence internalizing problems, were six times more likely to evidence externalizing problems, and were four times more likely to carry weapons (specifically, knives or guns).These findings suggest that there is a need for further research on this high-risk population, as well as the need to develop and implement innovative public health interventions for rural children.

Black or African American↗

PubMedDate not supplied

The effect of incarceration during pregnancy on birth outcomes.

OBJECTIVE: This study examined the effect of incarceration during pregnancy on infant birth weight. METHODS: North Carolina prison records were matched to North Carolina birth certificates and health services records to identify 94 women who were incarcerated during one pregnancy but not incarcerated during another pregnancy. Paired analyses examined differences between the pregnancies in terms of the women's characteristics and use of health services. A generalized estimating equations analysis modeled infant birth weight as a function of the number of days that a woman was incarcerated during pregnancy, accounting for the correlation between the birth weights of two infants born to the same mother and several potentially confounding variables. RESULTS: Since the women were significantly more likely to have been incarcerated during the second of the pair of pregnancies, as a group they were significantly older and had more children at the time of the incarcerated pregnancy than at the time of the home pregnancy. After controlling for important covariates, a higher number of pregnancy days spent incarcerated was found to be associated with higher infant birth weight. CONCLUSION: These findings suggest that aspects of the prison environment such as shelter and regular meals may enhance pregnancy outcomes among very high risk women. Health professionals should join others in efforts to assure that health-promoting resources such as adequate shelter, nutritional support, and substance abuse treatment programs are available to all pregnant women.

Adult↗

PubMedDate not supplied

[Epidemiologic surveillance of early neonatal mortality at the university hospital center in Dakar (Sénégal)].

Neonatal precocious mortality (PNM) is a major public health problem in developing countries: the PNM rate is 57 per 1,000 live births, as compared to 11 per 1,000 in industrialized countries. In Senegal the rate is 35 per 1,000. A continuous epidemiological survey was started in 1987 in the Obstetrics and Gynecology Clinic of the Dakar University Teaching Hospital (Neonatology and Prematurity Unit) (Senegal). The aim was to identify the main risk factors for PNM, and thereby define the actions required to reduce the incidence. In 1995, there were 177 cases of PNM, which was 12.19% of admissions to the Neonatology and Prematurity Unit, and 41 per thousand live births. The most frequent causes were premature birth (62.71%) acute fetal suffering (27.20%) and neonatal infection (6.22%). The rate of PNM could be reduced by: improved organization of prenatal advice to identify pregnancies at risk (of premature delivery and obstetric disease); improved quality of neonatal resuscitation; improved practice for prevention of infectious disease.

Apgar Score↗