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Both low birthweight (4000 g) are considered adverse birth outcomes and are associated with later poor health conditions, yet the social determinants of macrosomia are understudied. In this study, we explore patterning of LBW, normal birthweight, and macrosomia by race/ethnicity and nativity. We examined data from all live births between 1999 and 2014 in New Jersey with a non-missing, plausible value of birthweight (n = 1,609,516). We compared the risk for LBW and macrosomia among non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian mothers, and between the US- and native-born. For Hispanics and Asians, we also examined differences by country of origin. The racial/ethnic patterns for macrosomia mirrored those of LBW, suggesting that the factors underlying LBW shift birthweight distributions. For example, non-Hispanic White mothers had the lowest risk for LBW and the highest risk for macrosomia. Nativity patterns differed by subgroup, however, with unique risks for macrosomia among some origin groups, such as foreign-born Cubans. The racial/ethnic and nativity patterns of macrosomia do not completely mirror those of LBW, suggesting some distinct social risk factors for macrosomia. Our findings raise questions about whether and how racial/ethnic and nativity patterning in both low and excess birthweight is retained in later conditions, such as childhood obesity.

Both low birthweight (4000 g) are considered adverse birth outcomes and are associated with later poor health conditions, yet the social determinants of macrosomia are understudied. In this study, we explore patterning of LBW, normal birthweight, and macrosomia by race/ethnicity and nativity. We examined data from all live births between 1999 and 2014 in New Jersey with a non-missing, plausible value of birthweight (n = 1,609,516). We compared the risk for LBW and macrosomia among non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian mothers, and between the US- and native-born. For Hispanics and Asians, we also examined differences by country of origin. The racial/ethnic patterns for macrosomia mirrored those of LBW, suggesting that the factors underlying LBW shift birthweight distributions. For example, non-Hispanic White mothers had the lowest risk for LBW and the highest risk for macrosomia. Nativity patterns differed by subgroup, however, with unique risks for macrosomia among some origin groups, such as foreign-born Cubans. The racial/ethnic and nativity patterns of macrosomia do not completely mirror those of LBW, suggesting some distinct social risk factors for macrosomia. Our findings raise questions about whether and how racial/ethnic and nativity patterning in both low and excess birthweight is retained in later conditions, such as childhood obesity.

•Neighborhood affluence protects against the risk of poor birth outcome. •The protective effect of affluence holds for Whites, Blacks, Hispanics and Asians. •Mediation of these pathways by prenatal smoking varies by racial group. •The discourse on neighborhoods and birth outcomes should include affluence.

Both community-based learning (CBL) and online learning are popular pedagogical practices, with distinct benefits and issues for teaching and learning. The integration of these practices may seem challenging, but they can be compatible. This article seeks to provide effective examples and support for conducting CBL projects in online courses while supporting the belief that criteria such as reinforcement, evaluation, feedback, and motivation (Berge, 2010) can be achieved through congruent CBL and online instruction. The theoretical basis for the projects identified in this work adhere to the tenets of quality online design, which are student-centered, and evoking principles of project-based learning (PBL), anchored instruction and situated learning.

BackgroundThe incidence of chronic diseases, including diabetes mellitus (DM), heart failure (HF) and chronic obstructive pulmonary disease (COPD) is on the rise. The existing health care system must evolve to meet the growing needs of patients with these chronic diseases and reduce the strain on both acute care and hospital-based health care resources. Paramedics are an allied health care resource consisting of highly-trained practitioners who are comfortable working independently and in collaboration with other resources in the out-of-hospital setting. Expanding the paramedic's scope of practice to include community-based care may decrease the utilization of acute care and hospital-based health care resources by patients with chronic disease.Methods/designThis will be a pragmatic, randomized controlled trial comparing a community paramedic intervention to standard of care for patients with one of three chronic diseases. The objective of the trial is to determine whether community paramedics conducting regular home visits, including health assessments and evidence-based treatments, in partnership with primary care physicians and other community based resources, will decrease the rate of hospitalization and emergency department use for patients with DM, HF and COPD. The primary outcome measure will be the rate of hospitalization at one year. Secondary outcomes will include measures of health system utilization, overall health status, and cost-effectiveness of the intervention over the same time period. Outcome measures will be assessed using both Poisson regression and negative binomial regression analyses to assess the primary outcome.DiscussionThe results of this study will be used to inform decisions around the implementation of community paramedic programs. If successful in preventing hospitalizations, it has the ability to be scaled up to other regions, both nationally and internationally. The methods described in this paper will serve as a basis for future work related to this study.Trial registrationClinicalTrials.gov: NCT02034045. Date: 9 January 2014.

Plant–microbe interactions in the rhizosphere shape carbon and nitrogen cycling in soil organic matter (SOM). However, there is conflicting evidence on whether these interactions lead to a net loss or increase of SOM. In part, this conflict is driven by uncertainty in how living roots and microbes alter SOM formation or loss in the field. To address these uncertainties, we traced the fate of isotopically labelled litter into SOM using root and fungal ingrowth cores incubated in a Miscanthus x giganteus field. Roots stimulated litter decomposition, but balanced this loss by transferring carbon into aggregate associated SOM. Further, roots selectively mobilized nitrogen from litter without additional carbon release. Overall, our findings suggest that roots mine litter nitrogen and protect soil carbon. [ABSTRACT FROM AUTHOR]

This article explores the opportunities and challenges that university instructors and students have when completing course assignments that merge community-based learning (CBL) and online learning (OL) in sport management and athletic administration pedagogy. As online instruction continues to increase, instructors and students need to be equipped to handle its challenges while at the same time seeking to maximize the opportunities that result from the flexibility and versatility of online instructional methods. While both OL and CBL are popular pedagogical activities, strategic efforts need to be utilized to make these methods can compatible. This article identifies two sample projects that show how online instruction and community-based learning can be "married" in a joint union that will be beneficial for all involved.

Objective To estimate the associations between neighborhood disadvantage and neighborhood affluence with breastfeeding practices at the time of hospital discharge, by race-ethnicity. Methods We geocoded and linked birth certificate data for 111,596 live births in New Jersey in 2006 to census tracts. We constructed indices of neighborhood disadvantage and neighborhood affluence and examined their associations with exclusive (EBF) and any breastfeeding in multilevel models, controlling for individual-level confounders. Results The associations of neighborhood disadvantage and affluence with breastfeeding practices differed by race-ethnicity. The odds of EBF decreased as neighborhood disadvantage increased for all but White women [Asian: Adjusted odds ratio (AOR) 0.82 (95% confidence interval (CI) 0.69-0.97); Black: AOR 0.77 (95% CI 0.70-0.86); Hispanic: AOR 0.78 (95% CI 0.70-0.86); White: AOR 0.99 (95% CI 0.91-1.08)]. The odds of EBF increased as neighborhood affluence increased for Hispanic [AOR 1.19 (95% CI 1.08-1.31)] and White [AOR 1.12 (95% CI 1.06-1.18)] women only. The odds of any breastfeeding decreased with increasing neighborhood disadvantage only for Hispanic women [AOR 0.85 (95% CI 0.79-0.92)], and increased for White women [AOR 1.16 (95% CI 1.07-1.26)]. The odds of any breastfeeding increased as neighborhood affluence increased for all except Hispanic women [Asian: AOR 1.31 (95% CI 1.13-1.51); Black: AOR 1.19 (95% CI 1.07-1.32); Hispanic: AOR 1.08 (95% CI 0.99-1.18); White: AOR 1.30 (95% CI 1.24-1.38)]. Conclusions Race-ethnic differences in associations between neighborhood disadvantage and affluence and breastfeeding practices at the time of hospital discharge indicate the need for specialized support to improve access to services., Author(s): Jennifer Yourkavitch [sup.1] , Jennifer B. Kane [sup.2] , Gandarvaka Miles [sup.1] Author Affiliations: (Aff1) 0000000122483208, grid.10698.36, Department of Epidemiology, Gillings School of Global Public Health, University of North [...]

Alterations in the apoptosis of immune cells have been associated with autoimmunity. Here, we have identified a homozygous missense mutation in the gene encoding the base excision repair enzyme Nei endonuclease VIII-like 3 (NEIL3) that abolished enzymatic activity in 3 siblings from a consanguineous family. The NEIL3 mutation was associated with fatal recurrent infections, severe autoimmunity, hypogammaglobulinemia, and impaired B cell function in these individuals. The same homozygous NEIL3 mutation was also identified in an asymptomatic individual who exhibited elevated levels of serum autoantibodies and defective peripheral B cell tolerance, but normal B cell function. Further analysis of the patients revealed an absence of LPS-responsive beige-like anchor (LRBA) protein expression, a known cause of immunodeficiency. We next examined the contribution of NEIL3 to the maintenance of self-tolerance in [Neil3.sup.-/-] mice. Although [Neil3.sup.-/-] mice displayed normal B cell function, they exhibited elevated serum levels of autoantibodies and developed nephritis following treatment with poly(hC) to mimic microbial stimulation. In [Neil3.sup.-/-] mice, splenic T and B cells as well as germinal center B cells from Peyer's patches showed marked increases in apoptosis and cell death, indicating the potential release of self-antigens that favor autoimmunity. These findings demonstrate that deficiency in NEIL3 is associated with increased lymphocyte apoptosis, autoantibodies, and predisposition to autoimmunity., Introduction The clearance of apoptotic cells is initiated by the recognition of their modified surface molecules and subsequent engulfment by phagocytes (1). An imbalance between the rates of cell death [...]

Extinction and recovery of the discriminative stimulus effects of nicotine (0.3 mg/kg) was investigated with a devalued food reinforcer (rats sated). Sixteen rats were trained in a counterbalanced one manipulandum (nose-poke) drug discrimination procedure with the roles of nicotine and saline counterbalanced as S[superscript D] and S[superscript [delta]]. Discrimination training was maintained and then extinguished with the devalued reinforcer. Devaluation of the reinforcer diminished S[superscript D] response rates during discrimination training but not discriminative control. Following delays after extinction, recovery of responding occurred with the revalued but not devalued reinforcer. These data demonstrate that (a) discriminative control by nicotine is temporally stable with a devalued reinforcer following acquisition and extinction, (b) revaluation of the reinforcer promotes recovery of discriminative control, and (c) recovery of interoceptive discriminative control by nicotine following extinction is affected by changes in motivation. Theoretical implications regarding drug replacement therapy and cue-exposure therapy are discussed. (Contains 2 figures.)

This study attempted to assess the notion that a "good divorce" protects children from the potential negative consequences of marital dissolution. A cluster analysis of data on postdivorce parenting from 944 families resulted in three groups: cooperative coparenting, parallel parenting, and single parenting. Children in the cooperative coparenting (good divorce) cluster had the smallest number of behavior problems and the closest ties to their fathers. Nevertheless, children in this cluster did not score significantly better than other children on 10 additional outcomes. These findings provide only modest support for the good divorce hypothesis.

The authors used data from the Add Health study to estimate the effects of parents' marital status and relationship distress on daughters' early family formation transitions. Outcomes included traditional transitions (marriage and marital births) and nontraditional transitions (cohabitation and nonmarital births). Relationship distress among continuously married parents was not related to any outcome. Offspring with single parents and remarried parents had an elevated risk of nonmarital births and nonmarital cohabitation. Offspring with remarried parents with a high-distress relationship had an elevated risk of early marriages and marital births. These results, combined with analyses of mediating variables, provide the strongest support for a modeling perspective, although some support also was found for a perspective based on escape from stress. (Contains 5 tables.)

We examined 7 life-course pathways from adolescence through the early adult years and their links with general health and psychosocial adjustment among 2,290 women from the National Longitudinal Study of Adolescent Health. Young women who followed a pathway involving college attendance to full-time employment with no family-formation transitions were functioning comparatively well with respect to general health, depression, and self-esteem. In contrast, young women who followed pathways involving early motherhood were functioning less well. Fixed-effects models suggested that the differences were due to selection factors. Young women who followed the pathway of college to full-time employment exhibited an increase in heavy drinking, whereas women who became married mothers exhibited a decrease in the same. Involvement in illegal behavior declined for all groups but least so for women who attended college. (Contains 5 tables.)