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"Why can't I have my postpartum care in the same room as my baby?" questioned Hilary, a neonatal intensive care unit (NICU) "alumni" parent, during a design event for the new British Columbia's Women's Hospital 70 single family room NICU. This simple yet provocative question was nearly dismissed and the idea of a combined care model lost, since most members of the team thought it was simply "not possible." Hilary did not give up and continued to raise this idea throughout every design event. It was Hilary's fortitude and sharing of her NICU experience that was the inspiration for the MotherBaby Care unit. The voice of one woman has improved the birth experiences of potentially thousands of mothers and their at-risk newborns. By honoring women's voices and values in health care, positive changes that matter to women, infants, and families can be made. Mothers also shared: "I knew what was best for me was to be with my baby," "If I could stand up after my C-section, I would drag my IV pole to be with my baby!", "Teach me how to take care of my premature baby before I am ready to go home!" MotherBaby Care is a combined care or "couplet" care where one NICU nurse provides care for a postpartum mother and her at-risk newborn in the Level 2 NICU. This review describes the journey from innovation and design to the implementation of the MotherBaby Care model.

Nutrition is an important source of exogenous AGEs and thermally processed foods present in western-style diets contain a large amount of these pro-inflammatory AGEs. Additionally, the intake of dietary AGEs could upregulate ovarian gene expression of inflammatory macrophage markers. The objective of this study was to investigate the effect of diet rich in AGEs on estrous cyclicity and ovarian function in a mouse model. Six-week old C57BL/6 J female mice were randomly subjected to either a diet low in AGEs (L-AGE) or a diet high in AGEs (H-AGE) for a total of 13 weeks. Experiments performed included daily vaginal smears to assess estrous cyclicity, ovarian superovulation with gonadotropins to assess the number of oocytes released, whole ovarian tissue mRNA quantification by RT-PCR to quantify genes involved in folliculogenesis, steroidogenesis, and macrophage markers, and ovarian morphology for follicle count. Outcome measures included estrous cyclicity, number of oocytes following superovulation, expression of genes involved in folliculogenesis, steroidogenesis, and macrophage infiltration as well as the number of primordial, primary, secondary, antral follicles and corpora lutea. Compared to mice on L-AGE diet, mice on H-AGE spent significantly longer time in the diestrus phase, had similar number of oocytes released following ovarian superovulation, and showed significant alterations in genes involved in steroidogenesis (increase in Star mRNA expression levels) and folliculogenesis (increase in Gdf-9 and Fshr mRNA expression levels). Mouse macrophage marker F4/80 mRNA expression was upregulated in mice on H-AGE diet compared to mice on L-AGE diet. Finally, mice on H-AGE diet had significantly fewer corpora lutea in their ovaries. These results indicate that the ingestion of high amounts of dietary AGEs could disrupt folliculogenesis and steroidogenesis that might lead to abnormal estrous cyclicity. Intake of dietary AGEs could also upregulate ovarian gene expression of inflammatory macrophage markers.

Interactions between brain IGF-I receptors and estrogen receptors regulate female reproductive physiology and behavior. The present study investigated potential mechanisms by which IGF-I receptors in the neuroendocrine hypothalamus regulate GnRH neuronal activation and LH release in young and middle-aged female rats under estradiol (E2) positive feedback conditions. We infused vehicle, IGF-I, or JB-1, a selective antagonist of IGF-I receptors, into the third ventricle of ovariectomized female rats primed with E2 and progesterone or vehicle. In young females, blockade of IGF-I receptors attenuated the steroid hormone-induced LH surge, reduced the percent of GnRH neurons expressing c-fos on the day of the LH surge, and decreased the total number of neurons expressing c-fos in the preoptic area. Middle-aged females had fewer GnRH neurons expressing c-fos during the LH surge than young females, and the LH surge amplitude was attenuated. Infusion of an IGF-I dose previously shown to increase LH surge amplitude did not increase the percent of GnRH neurons expressing c-fos in middle-aged females. Brain IGF-I receptor blockade did not modify E2 induction of progestin receptor-immunoreactive neurons in the preoptic area, arcuate, or ventromedial hypothalamus of young rats. These findings indicate that brain IGF-I receptors are required for E2 activation of GnRH neurons in young rats and for robust GnRH release from axon terminals in middle-aged females. IGF-I likely exerts its effects by actions on E2-sensitive neurons that are upstream of GnRH neurons and terminals.

The epoxidation of isoprene (2-methyl-1,3-butadiene) and piperylene (1,3-pentadiene), both conjugated olefins containing allylic methyl groups, has been conducted using conventional, CsCl-promoted, Ag/α-Al2O3 catalysts. Selectivities to the allylic olefin epoxide isomers are over 20% and are much higher than expected due to the presence of the conjugated olefin structure. The epoxidation of propylene over the same catalyst under the same conditions is only 2.5%. The epoxidation of propylene in the presence of butadiene also yields PO in much higher selectivities. The presence of as little as 1% C4H6 in the reaction feedstream increases the selectivity to PO from 2.5% to over 40% at the expense of overall activity for C3H6 conversion. The upper limit of selectivity to PO in the presence of C4H6 appears to be approximately 50%, suggesting an upper limit for the effectiveness of this methodology. Epoxidation of C4H6 alone on similar Ag catalysts indicates that the consecutive reaction of EpB to CO2/H2O is strongly limited by the presence of excess C4H6 in the feedstream. In addition, the selectivity to EpB is directly proportional to the amount of C4H6 in the reaction feed stream. Selectivities >90% are obtained only when there is sufficient C4H6 in the reaction feedstream to control the concentration of the reactive Ag–O surface. For C4H6 epoxidation, all CO2/H2O is formed by a consecutive reaction pathway from EpB; there is no parallel pathway for the direct formation of CO2/H2O from C4H6. Using the selective epoxidation of C4H6 as the model for understanding the enhancement in selectivity for allylic olefin epoxide formation, the most likely reason for improved selectivities is that strongly adsorbed C4H6 (or other conjugated olefins) limits the ensemble size of contiguous Ag–O surface sites. These ensembles are too small for PO combustion, but not too small for PO formation.