Knowledge, attitudes, and behaviors of low-income women considered high priority for receiving the novel influenza A (H1N1) vaccine.

The primary purpose of this qualitative study was to explore the knowledge, attitudes, and behaviors of low-income women considered high priority for receiving the novel influenza A (H1N1) vaccine to improve communication in emergency preparedness and response. Researchers sought to identify the factors that affect this high priority population's ability to successfully comply with vaccination recommendations. By utilizing an existing communication framework through the special supplemental nutrition program for women, infants, and children (WIC) they were able to document the systems and infrastructure needed to foster constructive responses in a sustainable manner in the future. Six focus group discussions with WIC clients (n = 56) and 10 individual interviews with staff members were conducted at two WIC clinics in Georgia (1 urban and 1 rural). Data were collected after the 2009-2010 influenza season and analyzed using thematic analysis. Knowledge and attitudes regarding H1N1 differed among participants with regard to perceived severity and perceived risk of influenza illness. Participants identified several barriers and motivators to receiving the vaccination, as well as information needs, sources, and information-seeking behaviors. Similarities emerged among both WIC clients and staff members regarding impressions of H1N1 and the vaccine's use, suggesting that while the information may be provided, it is not effectively understood or accepted. Comprehensive education, policy and planning development regarding pandemic influenza and vaccine acceptance among low-income women is necessary, including improvements in risk communication messages and identifying effective methods to disseminate trusted information to these high priority groups.

Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis.

OBJECTIVES: To compare the effect of donor breast milk with infant formula in preterm infants. Separate comparisons with formula were made for donor breast milk that was: (1) given as a sole diet; (2) given as a supplement to mother's own breast milk; and (3) fortified with macronutrients and micronutrients. The main outcomes were death, necrotising enterocolitis (NEC), infection, growth and development. DATA SOURCES: Electronic databases-Cochrane, CENTRAL, MEDLINE, EMBASE, CINAHL, and HMIC: DH. REVIEW METHODS: Systematic review and meta-analysis of trials and observational studies of preterm or low birthweight infants. RESULTS: Seven studies (including five randomised controlled trials), all from the 1970s and 1980s, fulfilled the inclusion criteria. All studies compared the effect of sole donor breast milk with formula (combined n = 471). One of these also compared the effect of donor breast milk with formula given as a supplement to mother's own milk (n = 343). No studies examined fortified donor breast milk. A meta-analysis based on three studies found a lower risk of NEC in infants receiving donor breast milk compared with formula (combined RR 0.21, 95% CI 0.06 to 0.76). Donor breast milk was associated with slower growth in the early postnatal period, but its long-term effect is unclear. CONCLUSION: Donor breast milk is associated with a lower risk of NEC and slower growth in the early postnatal period, but the quality of the evidence is limited. Further research is needed to confirm these findings and measure the effect of fortified or supplemented donor breast milk.

Developmentally restricted actin-regulatory molecules control morphogenetic cell movements in the zebrafish gastrula.

Although our understanding of the regulation of cellular actin and its control during the development of invertebrates is increasing, the question as to how such actin dynamics are regulated differentially across the vertebrate embryo to effect its relatively complex morphogenetic cell movements remains poorly understood. Intercellular signaling that provides spatial and temporal cues to modulate the subcellular localization and activity of actin regulatory molecules represents one important mechanism. Here we explore whether the localized gene expression of specific actin regulatory molecules represents another developmental mechanism. We have identified a cap1 homolog and a novel guanine nucleotide exchange factor (GEF), quattro (quo), that share a restricted gene expression domain in the anterior mesendoderm of the zebrafish gastrula. Each gene is required for specific cellular behaviors during the anterior migration of this tissue; furthermore, cap1 regulates cortical actin distribution specifically in these cells. Finally, although cap1 and quo are autonomously required for the normal behaviors of these cells, they are also nonautonomously required for convergence and extension movements of posterior tissues. Our results provide direct evidence for the deployment of developmentally restricted actin-regulatory molecules in the control of morphogenetic cell movements during vertebrate development.

Randomized controlled study of human zona pellucida dissection using the zona infrared laser optical system: evaluation of blastomere damage, embryo development, and subsequent hatching.

OBJECTIVE: To assess the effect of laser hatching on human embryo damage and subsequent development using the Zona Infrared Laser Optical System (ZILOS). DESIGN: Randomized controlled study. SETTING: Tertiary care fertility clinic. PATIENT(S): One hundred fourteen donated and discarded frozen human embryos. INTERVENTION(S): Embryos were thawed, cultured with cleavage and morphology evaluated periodically, and randomized into control, partial hatching, or complete hatching groups. The laser hatching procedure was performed by ZILOS. Zona thickness and embryo diameter were recorded. Complete hatching involved the production of a full-thickness defect in the zona and partial hatching, a defect in the outer half of the zona. No laser treatment was administered to the control group. MAIN OUTCOME MEASURE(S): Blastocyst development and completion of hatching process. RESULT(S): No significant difference was noted between the three study groups for their baseline characteristics. There was no significant difference in blastocyst development among the three groups. However, the complete hatching group showed a significant increase in hatching compared to the control group. CONCLUSION(S): Complete laser hatching of human embryos using the ZILOS does not have an adverse effect on subsequent development and increases the rate of completion of hatching.