Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model

Background

Stress can lead to excessive weight gain. Mindfulness-based stress reduction that incorporates mindful eating shows promise for reducing stress, overeating, and improving glucose control. No interventions have tested mindfulness training with a focus on healthy eating and weight gain during pregnancy, a period of common excessive weight gain. Here, we test the effectiveness of such an intervention, the Mindful Moms Training (MMT), on perceived stress, eating behaviors, and gestational weight gain in a high-risk sample of low income women with overweight/obesity.

Method

We conducted a quasi-experimental study assigning 115 pregnant women to MMT for 8 weeks and comparing them to 105 sociodemographically and weight equivalent pregnant women receiving treatment as usual. Our main outcomes included weight gain (primary outcome), perceived stress, and depression.

Results

Women in MMT showed significant reductions in perceived stress (β = − 0.16) and depressive symptoms (β = − 0.21) compared to the treatment as usual (TAU) control group. Consistent with national norms, the majority of women (68%) gained excessive weight according to Institute of Medicine weight-gain categories, regardless of group. Slightly more women in the MMT group gained below the recommendation. Among secondary outcomes, women in MMT reported increased physical activity (β = 0.26) and had lower glucose post-oral glucose tolerance test (β = − 0.23), being 66% less likely to have impaired glucose tolerance, compared to the TAU group.

Conclusion

A short-term intervention led to significant improvements in stress, and showed promise for preventing glucose intolerance. However, the majority of women gained excessive weight. A longer more intensive intervention may be needed for this high-risk population.

Clinical Trials.gov #NCT01307683.

c-myc amplifications in primary breast carcinomas and their local recurrences

OBJECTIVE

To evaluate the role of c-myc oncogene amplifications in the progression of invasive breast carcinomas.

METHODS

c-myc gene copy number was evaluated in a series of 49 primary breast carcinomas and the corresponding local recurrences using fluorescence in situ hybridisation.

RESULTS

11 of the primary carcinomas (22%) harboured c-myc amplifications; these tumours typically were hormone receptor negative and occurred in younger patients (43 v 53 years). At the time of relapse, six additional tumours had acquired a c-myc amplification. The mean recurrence-free survival was 24 months; c-myc amplified tumours relapsed significantly earlier than carcinomas without amplification (18 v 27 months). Univariate analysis showed a worse overall survival in these patients.

CONCLUSIONS

While c-myc amplifications can be observed in early stage breast cancer, especially in younger patients, they often occur later in tumour development and appear to be associated with disease progression.

Steady-state and transient-state performance of a biotrickling filter treating chlorobenzene-containing waste gas

Biotrickling filter (BTF) technology was applied for the treatment of waste gas containing a mixture of chlorobenzene and 1,2-dichlorobenzene. An adapted microbial community was immobilised on a structured packing material. The strategy followed was to reach high removal efficiencies at initially low mass loading rates followed by an increase of the latter. This procedure was successful and resulted in a short start-up period of only 2 weeks. A 3-month operation under steady-state conditions showed good performance, with >95% removal efficiency at a mass loading rate of 1,800 g m(-3) day(-1). Dimensionless concentration profiles showed that the chlorobenzenes were simultaneously degraded. Low dissolved organic carbon of 15 mg l(-1) and stoichiometric chloride concentrations in the trickling liquid indicated complete mineralisation of the pollutant. Transient-state experiments with five times higher mass loading rates caused a decrease in the removal efficiency that recovered rapidly once the mass loading rate returned to its original steady-state level. A progressive increase of the mass loading rate in a long-term performance experiment showed that the removal efficiency could be kept stable between 95 and 99% at loads of up to 5,200 g m(-3) day(-1) over several days. Above this mass loading rate, the elimination capacity did not increase any further. These results demonstrated that with a well-adapted inoculum and optimal operation parameters, a BTF system with excellent performance and stability that efficiently removes a mixture of chlorobenzene vapours from air can be obtained.

Morphometry of the adult human earlobe: a study of 547 subjects and clinical application

The purpose of this study was to define the factors that influence earlobe length and to establish a standard for adult earlobe length by sex and age. The study sample consisted of 547 adult subjects older than 20 years of age. A randomized, prospective design was used. Patients with malignancies, previous surgery or trauma to the earlobe, or congenital earlobe anomalies were excluded. The following variables were studied: sex; age; ethnic origin; skin complexion; height, weight, and body mass index; and piercing. Pearson's correlation, analysis of variance, t test, and multiple regression analysis were used for the statistical analysis. There were 383 women (70 percent) and 164 men (30 percent) aged 20 to 80 years. The average length of the left earlobe was 1.97 cm (SD, 0.42 cm), and that of the right earlobe, 2.01 cm (SD, 0.42 cm) (p < 0.0001). A post hoc test revealed a statistically significant difference among the three age groups (20 to 40 years, 40 to 60 years, and >60 years) in both men and women. Pendulous earlobes were significantly longer and less symmetrical than nonpendulous ones by t test. In men, nonpierced left earlobes were longer than pierced lobes; in women, there was no significant difference between pierced and nonpierced ears. Pearson's correlation tests for weight, height, and body mass index showed that only weight had a significant effect on earlobe length, and only in women. Analysis of variance for ethnic origin and skin color revealed a longer left earlobe in Ashkenazi and Sephardic Jews compared with Ethiopian, Asian, and American Jews and Arabs and a short earlobe in blacks compared with dark and fair-skinned people. On multiple regression analysis, sex and age were the only factors that contributed to earlobe length. A table of average earlobe length by age was formulated on the basis of the authors' findings. These data, together with the knowledge that earlobe length changes little in women over 40, that earlobes are not symmetrical, and that right and left nonpendulous earlobes are symmetrical in individual patients and shorter than pendulous earlobes, can assist the plastic surgeon in deciding on the proper time for loboplasty. The preferable technique is creating a nonpendulous earlobe to minimize the chances of further elongation with time.

Exploding microwaved eggs--revisited

Different types of injuries are described as caused by the use of microwave ovens. Four of 41 burns from microwave ovens, presented by an international survey in 1986, were due to exploding microwave-heated eggs. Careful review of the English language literature through a Medline search from 1966 to 2000 was performed, in search of burns caused by exploding eggs. Clinical information from the published articles was reviewed and missing information was completed by e-mail correspondence with authors. Our own case was added to the collected data, and a total of 13 cases were analyzed. The average age of patients was 24.3 years (range, 7-49 years). All patients suffered from superficial burns of the mid and upper face, namely the forehead, periorbital region, dorsum of nose and malar areas. All patients with information available complained of ocular disturbances, and three suffered long-term decrease in visual acuity. Long-term skin complications were not reported. In summary, the clinical presentation of a facial injury from an exploding microwave-heated egg is relatively constant and mild. Favorable outcome can be expected but a meticulous ophthalmologic evaluation and a close follow-up are mandatory for prevention of long-term sequelae.

A procedure for production of adapted bacteria to degrade chlorinated aromatics

Production of biomass adapted to the degradation of a mixture of chlorobenzene (CB) and 1,2-dichlorobenzene (DCB) was investigated in a batch culture with substrates supplied by pulses. CB and o-DCB concentrations which gave the best adapted biomass productivity were determined and found to be 150 and 30 microl l(-1), respectively. The biomass productivity was 51 mg l(-1) h(-1). The biomass yield was 0.38 g of biomass dry weight per gram of substrate. The pulses of 200 microl CB and 40 microl o-DCB, were inhibitory to the bacterial culture. Among the metabolites, muconic acid was found in large quantities in the medium and in the cells. At a time between two pulses of 60 min, adding 150 microl CB and 30 microl o-DCB per each pulse, 7.6g l(-1) of biomass was obtained. The produced biomass served as an inoculum for the biotrickling filter which treated industrial waste gases contaminated by CBs. The method of adapted biomass production was described using CBs, but the degradation of any other toxic volatile pollutant can be improved using this technique.

Growth inhibition of biomass adapted to the degradation of toluene and xylenes in mixture in a batch reactor with substrates supplied by pulses

A biomass adapted to degrade toluene and xylenes in mixture was grown in a batch reactor with substrates supplied by pulses. The inhibition of biomass growth in the course of substrate degradation was investigated. The maximal biomass concentration of 7 g l-1 was obtained using 150 microliters of toluene and 15 microliters of a mixture of xylenes in one litre of liquid medium, and the maximal biomass productivity and yield were 53 mg l-1 h-1 and 0.32 gDW gs-1, respectively. Higher quantities of substrate added by pulses, that is 200 microliters of toluene with 20 microliters of xylenes and 300 microliters of toluene with 30 microliters of xylenes, caused an accumulation of metabolites. These higher quantities of substrates caused inhibition of microbial growth. Among the metabolites produced, 4-methyl catechol was found in large quantities in the culture medium and in the cells.

Concurrent sex partners and risk for sexually transmitted diseases among adolescents

BACKGROUND/OBJECTIVES

A large percentage of sexually active adolescents have multiple sex partners and are at high risk of acquiring sexually transmitted diseases (STDs). Little is known about adolescents' patterns of sexual partnerships (e.g., concurrent versus serial) and how these patterns influence STD risk.

GOAL OF THE STUDY

To determine the frequency with which adolescents have concurrent partners during a main relationship and the association between having concurrent partners and STD risk.

STUDY DESIGN

Adolescents seeking care at a public STD clinic were recruited from March, 1996, to May, 1998. Demographic and behavioral data were obtained during an interviewer-administered questionnaire. Sexually transmitted disease testing and physical exams were performed by clinicians.

RESULTS

Of those adolescents who reported having at least one main partner during the previous 6 months (n = 245), 110 (44.9%) had multiple partners, and 76 (31%) had at least one concurrent partner during a main relationship. Greater number of concurrent partners was associated with STD diagnosis/exposure after controlling for number of sex partners (OR = 1.6; 95% CI, 1.1-2.4).

CONCLUSIONS

A significant percentage of adolescents have concurrent partners during a main relationship, and having concurrent partners increases STD risk.

Biomass growth monitoring using pressure drop in a cocurrent biofilter

The possibility of following the biomass growth by pressure drop measurement was investigated in an aerated cocurrent upflow fixed-bed bioreactor continuously fed with wastewater containing industrial organic pollutants. The experiments were carried out in a biological filtration oxygenated reactor (Biofor) pilot plant packed with expanded clay balls (Biolite) of 2.7-mm diameter, which served as biomass carriers. The column was equipped for on-line pressure drop measurements. Correlation between pressure drop measurements and Reynolds numbers of air and water were determined in experiments carried out without biomass. Under operating conditions with biomass, it was demonstrated that column clogging and the operating time between washing cycles can be predicted depending on the volumetric organic load for a given total organic carbon inlet concentration. The biological activity of the fixed biomass was estimated from the oxygen consumption rate per unit time and carrier area. The oxygen consumption rate measurements demonstrated that the biological activity depends on the inlet substrate concentration, and that the Biofor column was most efficient between 75 and 100 g m-3 of total organic carbon inlet concentration. In the course of the wastewater treatment, using pressure drop measurements, the equivalent diameter of the Biolite particles, the reduced column macroporosity, and the biofilm thickness were calculated. An expression correlating biofilm density and biofilm thickness, as determined from the pressure drop measurements, was proposed. Good agreement was found between the fixed biomass in the reactor, determined as volatile suspended solids, and the biologically active biomass, estimated by respirometry. Copyright 1998 John Wiley & Sons, Inc.

Aerobic and anaerobic biodegradability of 1-anthraquinone sulphonate

The present work investigates 1-anthraquinone sulphonate (1-AS) biodegradation under (i) aerobic conditions using domestic activated sludge as inoculum, (ii) anaerobic conditions using sludge from an anaerobic domestic wastewater treatment digester in a sulphate-containing or methanogenic environment, (iii) a combination of anaerobic followed by aerobic conditions. The process was evaluated in terms of primary degradation, i.e. 1-AS elimination and ultimate degradation, as total dissolved organic carbon removal. It was shown that aerobic conditions lead to the complete primary and ultimate degradation, of 1-AS. By contrast, neither under sulphato-reductive nor methanogenic conditions does anaerobic digestion lead to the significant degradation of 1-AS. The use of anaerobic treatment followed by aerobic treatment did not improve degradation. Indeed aerobic post-treatment resulted in the re-appearance of pollutant in the medium even though this had been partly degraded under anaerobic conditions.

Soviet special psychiatric hospitals. Where the system was criminal and the inmates were sane

The subversion of psychiatric intervention for political purposes in the USSR during the 1970s and 1980s resulted in both intra-psychic and subsequent adaptational dysfunction in those dissidents who physically survived it. Incarceration in special psychiatric hospitals subjected the inmates to a sense of helplessness under the control of a malevolent power, futility, despair, danger from close and contentious contact with hardened criminals and the violently insane, overdosage with mind-altering and body-distorting neuroleptic drugs, and a Kafkaesque ambiguity concerning the specific terms of instutionalisation. Discharge did not bring release from continued threats and the eroded social networks to which the inmates returned subjected them to a new set of stressors. While some families remained intact and provided necessary support during the re-entry period, many families had been destroyed either by the circumstances of the family member's incarceration or by the length of the victim's stay in the psychiatric hospital. Wives left, people died, friends deserted, jobs evaporated, and often there was not even a home to accept them. Social agencies were either hostile or indifferent to their plight. Many felt like they had been thrown overboard from a prison ship without a life preserver. It was the proverbial transition from the frying pan into the fire.

Do adolescents understand what physicians say about sexuality and health?

The high rates of adolescent sexual activity, often with adverse medical and social outcomes among minority females, prompted us to survey 160 girls between the ages of 13 and 18 concerning their knowledge of reproductive health terms, anatomy, and body functions. All were patients in a clinic in an inner-city hospital. We hypothesized that adolescents who were older, sexually active, and/or had received formal sex education would be better informed. We used a two-part, self-administered questionnaire. The first part focused on definitions of nine common medical and reproductive health terms; the second focused on definitions of unlabeled anatomic drawings of male and female genitourinary systems. The subjects' responses revealed their lack of information as well as a great deal of misinformation. No statistical differences in knowledge were found related to age, sexual activity status, or formal sex education. Many patients knew only nontechnical and slang terms and did not understand medical terms used by physicians in the clinic. Clinicians should not assume similar patients (minority and poor) know or understand their terminology and should use simple and, if necessary, explicit vocabulary.

Gait electromyograms and surgical decisions for paralytic deformities of the foot

Twenty-one patients who had 23 gait electromyographic (EMG) examinations for paralytic deformities of the foot had surgical procedures performed. Outcome of the surgery was analysed with respect to the value of the pre-operative gait studies in deciding on appropriate surgical procedures. When outcome at follow-up (mean 3.6 years) was satisfactory and surgery had been in accordance with the EMG findings, or when outcome was unsatisfactory when the EMG had been disregarded, the value was deemed positive. Conversely, if the EMG data had been disregarded but outcome was satisfactory, the value was negative. Using these criteria, 70 per cent of the EMGs of the four muscles tested (tibialis anterior and posterior, peroneal and gastrocnemius) were a positive contribution to the evaluation and decision for the particular surgical procedure.

A scale for measuring the occurrence of positive states of mind: a preliminary report

It may be as important to measure a failure to achieve desirable states of mind as it is to measure negative moods. The proposed measure of positive states of mind was found to be internally consistent, sensitive to degrees of life stress, well accepted, quick to administer, and amenable to use as a repeated measure in longitudinal studies. Data from 187 men and women in a college student sample are reported.

Stimulation of the paraventricular nucleus area of the hypothalamus elevates urinary 6-hydroxymelatonin during daytime

The paraventricular nucleus of the hypothalamus (PVN) is thought to be a part of the neural circuit comprising the melatonin rhythm generating system (MRGS). Electrical stimulation of the PVN during the early lights-on period significantly elevated urinary 6-hydroxymelatonin content to nearly 50% of night levels; stimulation during the lights-off period did not produce significant changes. In contrast to the effects of PVN stimulation, stimulation of surrounding brain areas was without effect at either time. This observation confirms the participation of the PVN in the MRGS.

Parental reactions to the onset of adolescence

This paper documents the common changes associated with the onset of puberty and examines parents' reactions to these changes. Nine hundred questionnaires were sent to the parents of sixth and seventh graders (11-13 years old) in four communities. The questionnaire requested information on the perception of recent behavioral changes and the parents' emotional responses to them. Four hundred parents responded. Parents reported significant changes, both positive and negative, in their children in the year prior to the study. Reported changes were not significantly related to community locations, demographic or education variables, and, with one exception, to the sex of the child. First-born children were perceived more negatively and generated more negative feelings in parents. Younger parents (less than or equal to 38 years of age) perceived more negative changes and experienced more negative and anxious feelings toward their children than did older parents (greater than or equal to 39 years). These findings suggest that a primary cause of stress for parents with children in this age group may be a lack of knowledge about the developmental process. Physicians may be able to reduce the stress by providing anticipatory guidance to parents about the physical growth and psychologic aspects of early adolescence.

Balance reactions and eye-hand coordination in idiopathic scoliosis

We undertook this study to determine if subclinical postural control mechanisms were abnormal in idiopathic scoliosis. Ninety-one female patients and fifty-seven age-matched female controls were examined. We used a force plate ataxiometer to quantitate postural sway in the standing position and recorded the displacement and acceleration of the center of pressure during static stance and under perturbation with eyes opened and closed. A joystick-controlled video system was used to measure reaction time and eye-hand motor coordination. The scoliosis group demonstrated significantly less sway during two of the eight standing balance conditions and on the remaining balance tests there was a similar trend, albeit nonsignificant. The reaction time for the scoliosis group was also significantly slower, but the accuracy was not significantly worse. We noted no statistical differences between progressive and nonprogressive or between braced and unbraced patients. The subgroup of patients whose curves progressed despite bracing had a tendency to demonstrate greater stability on all standing tests. They also exhibited faster reaction times and less error in eye-hand coordination than other patient groups. No correlation existed between severity of curve and test performance. We found no indication of deficient balance in idiopathic scoliosis, and the tests could not predict curve progression.

Electromyography of idiopathic toe walking

Eighteen idiopathic toe walkers were evaluated by gait electromyography to define muscle timing abnormalities. This group was compared with a matched group of normal children walking on their toes and to a group of patients with cerebral palsy and equinus deformities. Although timing in all three groups differed from normal timing, the two patient groups showed some statistically significant differences in phasic timing from the control group. However, no significant differences existed between toe walking and spastic children. Historical data (family history, male predominance, and learning disabilities) suggest that idiopathic toe walking is a true entity, although the gait electromyograms were not diagnostic.

Rat model for acute myocardial infarction: application to technetium-labeled glucoheptonate, tetracycline, and polyphosphate

Cauterization of rat myocardium serves as a quick (2 min) inexpensive technique to create an animal model of acute myocardial infarction useful in evaluating radiopharmaceuticals as potential clinical imaging agents. Preliminary evidence indicates that is correlates well with behavior in man. Application of the model led to the discovery, confirmed by later investigators, that chelating agents such as glucoheptonate and polyphosphate show significant uptake in recent myocardial lesions.

Modulation of the copulatory sequence of the male rat by a schedule of reinforcement

Copulating male rats were permitted a maximum of seven intromissions in which to ejaculate. This experimental constraint of the male rat's sexual behavior produced an increase in the number of sessions in which the male ejaculated before the seventh intromrission. This species-specific behavior pattern is therefore susceptible to environmental conditioning.