The Impact of a Population-Based System of Care Intervention on Enhanced Prenatal Care and Service Utilization Among Medicaid-Insured Pregnant Women.

Introduction: Enhanced prenatal/postnatal care home visiting programs for Medicaid-insured women have significant positive impacts on care and health outcomes. However, enhanced prenatal care participation rates are typically low, enrolling <30% of eligible women. This study investigates the impacts of a population-based systems approach on timely enhanced prenatal care participation and other healthcare utilization.

A Novel Online Curriculum and Coaching Strategy to Expand the Addiction Medicine Workforce: The Michigan Collaborative Addiction Resources and Education System.

Problem: There is a shortage of addiction medicine (AM) physicians and a 9-year period (2017-2025) in which to build the workforce via a practice pathway enabling physicians to combine experiential hours with passing a board exam to become board-certified AM physicians. Afterward, AM specialists will need to complete the traditional fellowship pathway, requiring additional training.

Approach: The Michigan Collaborative Addiction Resources and Education System (MI CARES) was developed from February to June 2019 to support physicians in obtaining AM certification via the practice pathway.

Determining County-Level Counterfactuals for Evaluation of Population Health Interventions: A Novel Application of -Means Cluster Analysis.

Objectives: Evaluating population health initiatives at the community level necessitates valid counterfactual communities, which includes having similar population composition, health care access, and health determinants. Estimating appropriate county counterfactuals is challenging in states with large intercounty variation. We describe an application of -means cluster analysis for determining county-level counterfactuals in an evaluation of an intervention, a county perinatal system of care for Medicaid-insured pregnant women.

Clinical-Community Linkages: The Impact of Standard Care Processes that Engage Medicaid-Eligible Pregnant Women in Home Visiting.

Background: To better address physical, emotional, and social needs of Medicaid-insured pregnant women, a Federally Qualified Health Center and a hospital-based obstetrics and gynecology residency practice collaborated with their agency-based state Medicaid-sponsored home visiting program, the Maternal Infant Health Program (MIHP). In partnership, both practice sites created patient standards of care to identify and engage eligible pregnant women into underutilized home visiting services for enhanced prenatal care coordination. The purpose of this study was to describe how each practice operationalized clinical-community linkage strategies that best suited their setting and to determine if efforts resulted in improved MIHP participation and other service use.

Delay Discounting Interacts with Distress Tolerance to Predict Depression and Alcohol Use Disorders among Individuals Receiving Inpatient Substance Use Services.

Personality-linked psychological factors including distress tolerance and delay discounting have been shown to underlie both Alcohol Use and Major Depressive Disorders. Although these disorders commonly co-occur, especially among individuals seeking in-patient treatment, no study has examined the association between distress tolerance, delay discounting and dual diagnoses. This project evaluated these relations in a sample of 79 low-income adults receiving in-patient substance use treatment.

Maternal risk of hypertension 7-15 years after pregnancy: clues from the placenta.

Objective: To assess whether pre-eclampsia (PE)-related placental/extraplacental membrane findings are linked to moderately elevated blood pressure (BP) in pregnancy and later-life hypertension.

Design: Prospective cohort.

Setting: 52 prenatal clinics, 5 Michigan communities.

Life Course Adversity and Prior Miscarriage in a Pregnancy Cohort.

Background: Prior studies indicate associations between preconception adversities and risk of miscarriage, but few have considered type (e.g., financial, substance use, abuse) or timing (e.

Moderately elevated blood pressure during pregnancy and odds of hypertension later in life: the POUCHmoms longitudinal study.

Objective: Hypertensive disorders in pregnancy signal an increased risk of cardiovascular disease for women. However, future hypertension risk among pregnant women with moderately elevated blood pressure (BP) is unknown. We examined associations among moderately elevated BP or hypertensive disorders during pregnancy and later prehypertension or hypertension.

Stressors Across the Life-Course and Preterm Delivery: Evidence From a Pregnancy Cohort.

Objectives Growing evidence suggests that pre-conception stressors are associated with increased risk of preterm delivery (PTD). Our study assesses stressors in multiple domains at multiple points in the life course (i.e.

Developmental origins of chronic inflammation: a review of the relationship between birth weight and C-reactive protein.

Purpose: The developmental origins of adult disease hypothesis suggests that the intrauterine environment may program postnatal health outcomes through mechanisms such as chronic inflammation. The purpose of this article was to review the literature on the association between infant birth weight and C-reactive protein (CRP), markers of the fetal environment and inflammation, respectively.

Methods: We used PubMed, Google Scholar, Web of Science, ScienceDirect, the citation lists of the reviewed literature, and recommendations from experts in the field to identify potential articles.

Health disparities among young adult sexual minorities in the U.S.

Background: Emerging research suggests that young adult sexual minorities (identifying as lesbian, gay, or bisexual or engaging in same-sex attractions or behaviors) experience poorer health than their majority counterparts, but many measures of health inequity remain unexamined in population-based research.

Purpose: To describe a wide range of health status and healthcare access characteristics of sexual minorities in comparison with those of the majority population in a national sample of U.S.

Preconception stress, birth weight, and birth weight disparities among US women.

Objectives: We examined the impact of preconception acute and chronic stressors on offspring birth weight and racial/ethnic birth weight disparities.

Methods: We included birth weights for singleton live first (n = 3512) and second (n = 1901) births to White, Mexican-origin Latina, other-origin Latina, and Black women reported at wave IV of the National Longitudinal Study of Adolescent Health (2007-2008; ages 24-32 years). We generated factor scores for preconception acute and chronic stressors from wave I (1994-1995; ages 11-19 years) or wave III (2001-2002; ages 18-26 years) for the same cohort of women.

Selected preconception health indicators and birth weight disparities in a national study.

Background: This analysis explored the effect of timing, sequencing, and change in preconception health across adolescence and young adulthood on racial/ethnic disparities in birth weight in a diverse national cohort of young adult women.

Methods: Data came from Waves I (1994-1995), III (2001-2002), and IV (2007-2008) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all singleton live births to female non-Hispanic White, non-Hispanic Black, Mexican-origin Latina, or Asian/Pacific Islander participants (n = 3,014) occurring between the Wave III (ages 18-26 years) and IV (ages 24-32 years) interviews.

Risk of substance abuse and dependence among young adult sexual minority groups using a multidimensional measure of sexual orientation.

Objective: We examined associations between two definitions of sexual minority status (SMS) and substance abuse and/or dependence among young adults in a national population.

Methods: A total of 14,152 respondents (7,529 women and 6,623 men) interviewed during wave four of the National Longitudinal Study of Adolescent Health were included in the study (age range: 24-32 years). We used two definitions of SMS based on self-reported attraction, behavior, and identity: 1-indicator SMS (endorsing any dimension) and 3-indicator SMS (endorsing all dimensions).

Preconception health trajectories and birth weight in a national prospective cohort.

Purpose: This study was designed to assess the relationship between birth weight and prospectively measured trajectories of preconception health across adolescence and young adulthood in a diverse national cohort of young adult women.

Methods: Data came from Waves I (1994-1995), III (2001-2002), and IV (2007-2008) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all the singleton live births (n = 3,436) to female participants occurring between the Wave III (ages 18-26 years) and Wave IV (ages 24-32 years) interviews.

Birth outcomes across three rural-urban typologies in the Finger Lakes region of New York.

Purpose: The study is a descriptive, population-based analysis of birth outcomes in the New York State Finger Lakes region designed to determine whether perinatal outcomes differed across 3 rural typologies.

Methods: Hospital birth data for the Finger Lakes region from 2006 to 2007 were used to identify births classified as low birthweight (LBW), small for gestational age (SGA), and preterm delivery (PTD). Maternal residences were defined using 3 existing ZIP code-level rural-urban typologies: Census Bureau ZIP codes, Rural-Urban Commuting Area codes, and Primary Service Areas.

Origins of disparities in cardiovascular disease: birth weight, body mass index, and young adult systolic blood pressure in the national longitudinal study of adolescent health.

Purpose: We evaluated the contributions of birth weight and current body mass index (BMI) to racial/ethnic disparities in systolic blood pressure (SBP) in the United States.

Methods: Participants were 10,046 young adults (ages 24-32) in the National Longitudinal Study of Adolescent Health. SBP, BMI, and other contemporaneous factors were assessed at Wave IV (2007-2008); birth weight and other early life factors were reported at Wave I (1994-1995).

Thiosulfate reduces calcium phosphate nephrolithiasis.

An uncontrolled trial reported that sodium thiosulfate reduces formation of calcium kidney stones in humans, but this has not been established in a controlled human study or animal model. Using the genetic hypercalciuric rat, an animal model of calcium phosphate stone formation, we studied the effect of sodium thiosulfate on urine chemistries and stone formation. We fed genetic hypercalciuric rats normal food with or without sodium thiosulfate for 18 wk and measured urine chemistries, supersaturation, and the upper limit of metastability of urine.

Effect of bolus and divided feeding on urine ions and supersaturation in genetic hypercalciuric stone-forming rats.

Because urine ion excretion varies throughout the day, clinicians monitor 24 h urine samples to measure ion excretion and supersaturation in kidney stone patients. However, these results are averages and may not reflect maximal supersaturation which drives stone formation. We measured ion excretion and saturation in genetic hypercalciuric stone-forming rats on both a normal or low calcium diet over 0-3, 3-6 and 6-24 h using two feeding protocols, where the daily food allotment was fed either as a bolus or divided into three portions.

Intraoperative assessment and quantification of coronary artery graft patency performed on or off cardiopulmonary bypass.

Within the last 10 years, the incorporation of off-pump coronary artery bypass grafting (OPCAB) into many surgical practices has grown. OPCAB requires the surgeon to operate on a beating heart, and it is generally accepted that OPCAB procedures are more technically demanding. Concerns of possible incomplete revascularizations and decreased graft patency have been noted in the literature.

Do DNA gel electrophoretic mobilities extrapolate to the free-solution mobility of DNA at zero gel concentration?

The electrophoresis of small DNA fragments has been measured in dilute agarose and polyacrylamide gels cast and run in Tris-acetate-EDTA (TAE) and Tris-borate-EDTA (TBE) buffers. Ferguson plots were constructed to extrapolate the mobilities to zero gel concentration and estimate the free solution mobility of DNA. In polyacrylamide gels, in both TAE and TBE buffers, the extrapolated mobilities at zero gel concentration increased gradually with decreasing DNA molecular weight, went through a maximum at approximately 60 bp, and then decreased again.

Intrinsic curvature of plasmid DNAs analyzed by polyacrylamide gel electrophoresis.

The electrophoretic mobility of two small DNA plasmids, pUC19 and Litmus 28, linerarized by digestion with a variety of single-cut restriction enzymes, has been studied. The permuted sequence isomers migrate with identical mobilities in agarose gels, as expected, but exhibit different mobilities in large-pore polyacrylamide gels, suggesting that the parent plasmids contain sequence-specific sites of curvature and/or anisotropic flexibility. Both plasmids contain apparent bend centers near their origin(s) of replication; pUC19 also has a major apparent bend center near the promoter of the ampicillin resistance gene.