Search

Abstract Background Little is known about patient-provider communication on gestational weight gain among women pregnant with twins, a growing population at high risk for adverse maternal and neonatal outcomes. We examined if women’s report of provider advice on gestational weight gain was consistent with the Institute of Medicine (IOM) weight gain guidelines for twin pregnancies, and the association of provider advice on weight gain with women’s weight gain during their twin pregnancy. Methods We conducted a cross-sectional survey of 276 women who delivered twins and received prenatal care in the United States. The 2009 IOM provisional weight gain guidelines for twin pregnancies defined whether provider advice on weight gain and women’s weight gain were below, within, or above guidelines. Multinomial logistic regression examined associations between provider advice on weight gain with women’s weight gain, after adjustment for maternal age, gestational age at delivery, education, parity, twin type, use of assisted reproductive technologies and pre-pregnancy BMI category. Results Approximately 30% of women described provider advice on weight gain below the IOM guidelines, 60% within, and 10% above guidelines. Compared to women who reported weight gain advice within guidelines, women who reported advice below guidelines or who reported no advice were 7.1 (95% CI: 3.2, 16.0) and 2.7 (95% CI: 1.3, 5.6) times more likely to gain less than recommended, respectively. Women who reported provider advice above guidelines were 4.6 (95% CI: 1.5, 14.2) times more likely to exceed guidelines. Conclusions Provider advice on gestational weight gain may be an important predictor of women’s weight gain during twin pregnancies, highlighting the critical need for accurate provider counseling to optimize health outcomes.

Abstract Background Sedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy. Methods This cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson’s r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods. Results Fifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54–0.66 and ICC = 0.52–0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r

Abstract Background Health care providers should counsel pregnant patients on physical activity and nutrition to improve pregnancy outcomes. However, little is known about provider advice on these lifestyle behaviors among women pregnant with twins, a growing population at high risk for pregnancy complications. We examined the prevalence and content of provider advice on physical activity and nutrition among women pregnant with twins. Methods A cross-sectional electronic survey was administered to 276 women who delivered twins in the past 3 years and received prenatal care in the United States. The proportion of women reporting provider advice on physical activity and nutrition during prenatal visits (yes/no) was assessed and open-ended questions examined the content of provider advice. Bivariate differences in participant characteristics, stratified by provider advice on physical activity and nutrition (yes/no), were assessed. Responses from open-ended questions were examined using a content analysis approach to identify commonly reported advice on physical activity and nutrition. Results Approximately 75 and 63% of women reported provider advice on physical activity and nutrition, respectively, during their twin pregnancy. Women who recalled advice on physical activity most commonly reported recommendations to walk at a light to moderate intensity level. However, few women reported physical activity recommendations consistent with current guidelines, and approximately 55% of women reported provider advice to limit or restrict activity during their pregnancy, including bedrest. Nutrition advice was focused on eating a healthy, balanced diet and increasing protein intake. More women reported self-initiating the conversation on physical activity with their provider (40%) compared to nutrition (21%). Despite limited advice, 70% of women reported being satisfied or very satisfied with the information they received from their provider on physical activity or nutrition. Conclusions The majority of women reported provider advice on physical activity and nutrition during their twin pregnancies. However, advice was limited in detail, and physical activity levels were commonly restricted, despite the lack of evidence that activity restriction is beneficial during pregnancy. More research is needed to determine the optimal physical activity and dietary patterns in twin pregnancies to facilitate clear and consistent provider counseling on these lifestyle behaviors.

Walking is the most commonly chosen type of physical activity (PA) during pregnancy and provides several health benefits to both mother and child. National initiatives have promoted the importance of walking in general, but little emphasis is directed toward pregnant women, the majority of whom are insufficiently active. Pregnant women face a variety of dynamic barriers to a physically active lifestyle, some of which are more commonly experienced during specific times throughout the pregnancy experience. Walking is unique in that it appears resistant to a number of these barriers that limit other types of PA participation, and it can be meaningfully integrated into some transportation and occupational activities when leisure-time options are unavailable. Preliminary intervention work suggests that walking programs can be effectively adopted into a typical pregnancy lifestyle. However, a great deal of work remains to administer successful pregnancy walking interventions, including developing and using validated methods of PA and walking assessment. This narrative review discusses the unique advantages of walking during pregnancy, provides recommendations for future intervention work, and outlines the need for pregnancy-focused community walking initiatives. Standard search procedures were followed to determine sources from the literature specific to walking during pregnancy for use in each section of this review. Keywords: Ambulatory activity, Exercise behavior, Maternal-fetal health, Pregnant women

Porcine hepatocytes are currently being investigated as a therapy for patients suffering from acute liver failure. Incorporating hepatocytes in an extracorporeal device that would stabilize a patient until transplantation or recovery could dramatically decrease the mortality rate associated with this disease. The ability to maximize hepatocyte function would contribute significantly to being able to provide the required cell mass in a device of reasonable size. Several approaches have been effective at increasing rat hepatocyte function in vitro, including coculture with nonparenchymal cells. In this study, we investigated the effect of the addition of 3T3 cells to porcine hepatocyte culture and found that while there was an increase in albumin secretion, there was little or no effect on urea synthesis or cytochrome P450 activity.

The clinical consequences of acute liver failure are associated with high mortality. Intensive medical intervention is required to treat the symptoms of liver failure, including coagulopathy, metabolic instability, and encephalopathy. Providing temporary liver support with an extracorporeal liver assist device could stabilize the patient until a donor liver became available or the patient's own liver was able to recover. The use of human hepatocytes as the biologic component of the assist device is precluded by the scarcity of available tissue and the limited proliferative potential of adult hepatocytes in vitro. Consequently, porcine hepatocytes are being evaluated as a cell source for liver assist devices. Maintaining differentiated function in isolated hepatocytes, however, remains a challenge in the development of this technology and is complicated by the fact that the key therapeutic functions for short-term survival have not been well defined. Several approaches have been effective in prolonging rodent hepatocyte function in vitro, including manipulation of extracellular matrix. Here, we have investigated porcine hepatocyte function in vitro with a specific emphasis on the response to exogenous collagen matrix. In control cultures, albumin secretion increased during the first 7–10 days of culture to an average of 50 ± 17 μg/day/10 6 cells and then decreased over the next 2 weeks. The pattern of urea synthesis was slightly different in that it was highest in the first 1–3 days postisolation (140 ± 19 μg/day/10 6 cells) and then decreased by about 50% to a plateau level that was stable during the next 3–4 weeks of culture. Cytochrome P450-mediated activities were the most labile with time in culture and were undetectable after the first week in the absence of pharmacological inducers. In contrast to results reported for rat cells, porcine hepatocytes exhibited differentiated function in the absence of any modification of the culture dish surface and function was not increased or prolonged in the presence of exogenous collagen.

Pregnant and postpartum women have reported a number of barriers that prevent them from being sufficiently physically active. Overcoming these barriers is critical to ensure the health benefits of physical activity to both mother and fetus. The primary focus of this review centers on the potential impact social support may have in overcoming each of the primary barriers to physical activity experienced during pregnancy and the postpartum period. A reasonable body of research exists regarding the relationships between social support and these barriers; however, few investigations have specifically attempted to mitigate the effects of these barriers via social support interventions. Within this review, the enabling influence of social support as it pertains to pregnant and postpartum women's physical activity is discussed. Recommendations are suggested for the application of social support in future research investigations involving physical activity during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Improving STEM education in schools is important to prepare students for the increasing number of STEM related jobs. As a STEM discipline, kinesiology, which includes the study of sport, exercise, movement and well-being, may be an effective link between science concepts and students’ everyday lives and thus may stimulate science engagement. Our university’s kinesiology programs developed a set of sport related kinesiology labs which were presented by faculty and students during one semester in local high school Freshmen and Senior science classes. Survey data included information about STEM engagement, scientific inquiry, and knowledge of kinesiology as a STEM field. Findings included improved understanding of kinesiology but no differences between treatment and control groups in science engagement or understanding. Implications and future directions for kinesiology and science engagement are discussed.