Parental distress around supplementing breastfed babies using nasogastric tubes on the post-natal ward: a theme from an ethnographic study

‘The definitive version is available at: www3.interscience.wiley.com ' Copyright Blackwell Publishing. DOI: 10.1111/j.1740-8709.2008.00165.xThere is abundant evidence of the benefits of breastfeeding. In the UK, supplementation in hospital has consistently been shown to be associated with shortened duration of breastfeeding. This paper reports on a subset of the data from an ethnographic study that explored the expectations, beliefs and experiences of mothers and health professionals concerning supplementation, using a variety of methods, of breastfed babies in an English maternity unit in 2002. This paper aims to describe the expectations, beliefs and experiences of mothers and health professionals concerning supplementation by nasogastric (NG) tube on the post-natal ward. Participant observation was carried out on day and night shifts and at weekends over 9 months. Mothers, midwives, neonatal nurses, health care assistants and senior paediatricians were interviewed. Categories and themes were generated. The researchers' constructs of 'the essential method', when the tube was the method needed for medical reasons, and 'the chosen method', when other methods of oral feeding should have been possible, emerged. The latter included time pressures and the avoidance of any form of oral activity that might perhaps make return to the breast more difficult. The data concerning the use of NG tubes for supplementation yielded the specific theme of parental distress. In the absence of evidence that supplementation by NG tube on the post-natal ward is associated with greater breastfeeding success than other methods, the use of the tube to avoid any form of 'oral confusion' should be discontinued. Its use primarily to save time should not be considered acceptable.Peer reviewe

Overexpression of Parkinson's Disease-Associated Mutation LRRK2 G2019S in Mouse Forebrain Induces Behavioral Deficits and alpha-Synuclein Pathology

Citation: Xiong, Y. L., Neifert, S., Karuppagounder, S. S., Stankowski, J. N., Lee, B. D., Grima, J. C., . . . Dawson, V. L. (2017). Overexpression of Parkinson's Disease-Associated Mutation LRRK2 G2019S in Mouse Forebrain Induces Behavioral Deficits and alpha-Synuclein Pathology. Eneuro, 4(2), 10. https://doi.org/10.1523/eneuro.0004-17.2017Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene have been identified as an unambiguous cause of late-onset, autosomal-dominant familial Parkinson's disease (PD) and LRRK2 mutations are the strongest genetic risk factor for sporadic PD known to date. A number of transgenic mice expressing wild-type or mutant LRRK2 have been described with varying degrees of LRRK2-related abnormalities and modest pathologies. None of these studies directly addressed the role of the kinase domain in the changes observed and none of the mice present with robust features of the human disease. In an attempt to address these issues, we created a conditional LRRK2 G2019S (LRRK2 GS) mutant and a functionally negative control, LRRK2 G2019S/D1994A (LRRK2 GS/DA). Expression of LRRK2 GS or LRRK2 GS/DA was conditionally controlled using the tet-off system in which the presence of tetracycline-transactivator protein (tTA) with a CAMKII alpha promoter (CAMKII alpha-tTA) induced expression of TetP-LRRK2 GS or TetP-LRRK2 GS/DA in the mouse forebrain. Overexpression of LRRK2 GS in mouse forebrain induced behavioral deficits and alpha-synuclein pathology in a kinase-dependent manner. Similar to other genetically engineered LRRK2 GS mice, there was no significant loss of dopaminergic neurons. These mice provide an important new tool to study neurobiological changes associated with the increased kinase activity from the LRRK2 G2019S mutation, which may ultimately lead to a better understanding of not only the physiologic actions of LRRK2, but also potential pathologic actions that underlie LRRK2 GS-associated PD

Cardiac Cell-to-Cell Communication Using Exosomes and Cytokines Regulated By Spectrin-Based Pathways

1st Place Undergraduate Award, DHLRI Research Day 20202nd Place Overall Award, BMES Engineering in Healthcare and Industry Research SymposiumIncreased levels of cardiac fibrosis are characteristic remodeling responses to stress-induced conditions in cardiovascular diseases associated with cardiac dysfunction and arrhythmias. The stress-induced transition of resident/quiescent cardiac fibroblasts (CF) to an activated myofibroblast state displays increased proliferation, contractility, and deposition of extracellular matrix, all crucial steps in the fibrotic pathway. While the precise mechanism associated with this process remains unclear, our group has identified a novel βIV-spectrin/STAT3 complex in the heart crucial for the regulation of normal gene transcription and maintenance of the quiescent CF phenotype. Further, the complex plays a key role in regulating the cardiac-cell response to acute and chronic stress, however the upstream extracellular stress signals that lead to stress-induced βIV-spectrin dysfunction and successive CF activation remain unknown. This study explores the upstream extracellular stress signals associated with CF activation, using βIV-spectrin deficient mice. Specifically, primary mouse CFs from WT (control) and βIV-spectrin deficient (qv4J) species were isolated and cultured. Extracellular stress signals (i.e. exosomes and cytokines/chemokines) were examined. Finally, in-vitro assays (e.g. proliferation and collagen gel contractility) were performed to evaluate CF activity in response to the extracellular stress signals. We reported that WT CFs treated with qv4J conditioned media displayed higher rates of proliferation and contraction than CFs treated with control media. We also identified several cytokine/chemokine candidates that are involved in the CF activation pathway. The knowledge gained from this study will provide new insight into understanding the overall fibroblast biology, mechanisms of cardiac cell cross-talk, and for developing therapeutic strategies to target cardiac fibrosis.The Ohio State University- College of EngineeringThe Ohio State University- Undergraduate Research OfficeA one-year embargo was granted for this item.Academic Major: Biomedical Engineerin

Differences in the emotional and practical experiences of exclusively breastfeeding and combination feeding mothers

The majority of research examining the barriers to breastfeeding focuses on the physical challenges faced by mothers rather than the risks of encountering negative emotional and practical feeding experiences. We aimed to quantify the emotional and practical experiences of the overall sample of breastfeeding mothers and identify the differences in the emotional and practical experiences of exclusively breastfeeding mothers and combination feeding mothers, by feeding type and intention. Eight hundred forty‐five mothers with infants up to 26 weeks of age and who had initiated breastfeeding were recruited through relevant social media via advertisements providing a link to an online survey. Predictors of emotional experiences included guilt, stigma, satisfaction with feeding method, and the need to defend themselves due to infant feeding choices. Practical predictors included perceived support from health professionals, main sources of infant feeding information, and respect from their everyday environment, workplace, and when breastfeeding in public. Current feeding type and prenatal feeding intention. In the overall sample, 15% of the mothers reported feeling guilty, 38% stigmatized, and 55% felt the need to defend their feeding choice. Binary logit models revealed that guilt and dissatisfaction were directly associated with feeding type, being higher when supplementing with formula. No associations with feeding intention were identified. This study demonstrates a link between current breastfeeding promotion strategies and the emotional state of breastfeeding mothers who supplement with formula to any extent. To minimize the negative impact on maternal well‐being, it is important that future recommendations recognize the challenges that exclusive breastfeeding brings and provide a more balanced and realistic target for mothers

Using hoops structures for early weaning and farrowing

Tom Frantzen is a farrow-to-finish swine producer from northeast Iowa. He has three 30 x 72-ft. Cover All hoops. He first learned about hoop house farrowing two years ago on an ISU tour, and began farrowing in hoops in March and April, 1998. Most of his hogs had been pasturefarrowed, something he has done for 25 years, then finished inside the hoop facilities. During the colder months, December and January, he farrows in a controlled temperature facility. Jim Van Der Pol and his son Josh have a farrow-to-finish swine operation in western Minnesota where they raise a DurocBerkshire cross sold in specialty markets. They decided to use hoops to get the most return out of a low capital investment (hoops). Before they built the hoop facilities, they had decided to quit work in traditional hog confinement facilities. Homer Showman has a wean-to-finish operation, which includes eight hooped structures and a nine-year-old grow-to-finish confinement facility. He began using hoops five years ago, when he built three 30 x 72 ft. hoops with a 16-ft. concrete pad on the south end. In the past, he had done pasture and confinement farrowing, but does not farrow pigs at the current time. His last three hooped structures were built on a concrete pad 2 ft. above the dirt pad

Construcción y Validación de una Escala para evaluar Indicadores Físicos y Psicoemocionales de Estrés

El propósito de este trabajo es presentar el proceso de construcción y validación del cuestionario de indicadores físicos y psicoemocionales de estrés el cual permite realizar un examen rápido de la sintomatología que experimenta una persona que es expuesta a situación de tensión psicológica. La versión preliminar fue sometida a una prueba piloto con el fin de estudiar sus propiedades psicométricas y, luego de ser modificada, fue administrada a una muestra de 356 sujetos de ambos sexos de la provincia de Entre Ríos. Se obtuvieron buenos indicadores de fiabilidad, validez factorial, validez constructiva y poder discriminativo de los ítem. La escala resultante es de tipo Likert y consta de 22 síntomas que el sujeto debe valorar según el grado de aparición (Nunca, Rara vez, A veces si - A veces no,  recuentemente, Siempre). De acuerdo a los resultados del análisis factorial, existen tres dimensiones subyacentes a este conjunto de ítems: a) déficit cognitivo y estado anímico, b) nerviosismo y dificultad para la relajación, y c) síntomas físicos

Tactile mechanisms and afferents underlying the rat pup transport response

Juvenile rodents and other altricial mammals react with calming, immobility and postural modifications to parental pickup, a set of behaviors referred to as the transport response 1–5. Here we investigate sensory mechanisms underlying the rat transport response. Grasping rat pups in anterior neck positions evokes strong immobility and folding up of feet, whereas more posterior grasping have lesser effects on immobility and foot position. Transport responses are enhanced by slow (1Hz) and even more so by fast (4Hz) gentle shaking and translation, features consistent with parental transport. With lateral grasping, the forepaw below the grasping position points downwards and the forepaw lateral to the grasping position points upwards and medially. Such forepaw adjustments put the pup’s center of gravity below the grasping point, optimizing pup transportability. Tactile stimuli on the back, belly, tail, whisker, dorsal forepaws and dorsal hind-paws do not significantly affect behavior of anterior-neck-held pups. Instead, ground contact or paw stimulation, consistent with ground contact disrupts transport responses. We identify afferents mediating transport response by examining membrane labelling with FM1-43 following anterior neck grasping. We observe a dense innervation of the anterior neck skin region (~30 terminals/ mm2). We find an age-related decrease of cytochrome oxidase reactivity in the rat somatosensory cortical neck representation, a possible correlate to developmental decrease in pup transport response. We conclude anterior neck grasping and loss of ground contact trigger calming and postural adjustments for parental transport in rat pups, responses putatively driven from the densely innervated anterior neck skin