Seeking solitude skills: Do memories of intrinsic goals enhance enjoyment of alone time?

OBJECTIVE: Further investigate the application of self-determination theory (SDT) to experiences of solitude by examining the effects of recalling intrinsic versus non-intrinsic memories. BACKGROUND: SDT research indicates that recalling memories associated with intrinsic goals (e.g., personal growth, relationships, altruism) enhances present moment wellness by satisfying basic psychological needs. METHOD: Two studies were conducted with American adults. Study 1 included 465 participants (age = 49.49 [SD = 19.01], 49.46% female) and Study 2 comprised 490 participants (age = 54.16 [SD = 18.89], 51.84% female). Both studies assessed the impact of recalling intrinsic versus non-intrinsic memories prior to a five-minute solitude session. RESULTS: Study 1 found intrinsic memories were linked to more basic psychological need satisfaction than non-intrinsic memories, but both memory types resulted in similar wellness improvements. Contrary to expectations, Study 2 revealed extrinsic memories (e.g., wealth, fame, image) led to the highest basic psychological need satisfaction and least need frustration compared to intrinsic and neutral memories, with all memory conditions showing similar wellness gains. CONCLUSIONS: Solitude appears beneficial regardless of memory content. While different memories vary in need satisfying quality, this does not seem to impact the benefits of solitude. These findings suggest further exploration is needed before developing a "solitude skill set" for use during inevitable periods of solitude.

A Quantitative Meta-Analysis and Qualitative Meta-Synthesis of Aged Care Residents' Experiences of Autonomy, Being Controlled, and Optimal Functioning.

BACKGROUND AND OBJECTIVES: The poor mental health of adults living in aged care needs addressing. Improvements to nutrition and exercise are important, but mental health requires a psychological approach. Self-determination theory finds that autonomy is essential to wellbeing while experiences of being controlled undermine it. A review of existing quantitative data could underscore the importance of autonomy in aged care, and a review of the qualitative literature could inform ways to promote autonomy and avoid control. Testing these possibilities was the objective of this research. RESEARCH DESIGN AND METHODS: We conducted a mixed-methods systematic review of studies investigating autonomy, control, and indices of optimal functioning in aged care settings. The search identified 30 eligible reports (19 quantitative, 11 qualitative), including 141 quantitative effect sizes, 84 qualitative data items, and N = 2,668. Quantitative effects were pooled using three-level meta-analytic structural equation models, and the qualitative data were meta-synthesized using a grounded theory approach. RESULTS: As predicted, the meta-analysis showed a positive effect of aged care residents' autonomy and their wellness, r = 0.33 [95% CI: 0.27, 0.39], and a negative effect of control, r = -0.16 [95% CI: -0.27, -0.06]. The meta-synthesis revealed seven primary and three sub-themes describing the nuanced ways autonomy, control, and help seeking are manifest in residential aged care settings. DISCUSSION AND IMPLICATIONS: The results suggest that autonomy should be supported, and unnecessary external control should be minimized in residential aged care, and we discuss ways the sector could strive for both aims.

Improving communication and patient information recall via a question prompt list: randomized clinical trial.

BACKGROUND: Patient-surgeon communication is an important component of the success of a consultation and is known to impact patient outcomes. The aim of this study was to investigate whether a document called a question prompt list, containing suggested questions that a patient may like to ask their doctor, improved communication. METHODS: A prospective RCT was conducted from October 2021 to October 2022 at The Queen Elizabeth Hospital, Adelaide, Australia. Patients 16 years or older, seeing a general surgeon for a pre-surgical consultation, not requiring a translator, were randomized to receive a question prompt list (intervention) or standard care without a question prompt list (control). The primary outcomes were number of questions asked, talk time, and mutual eye gaze. Secondary outcomes were patient recall of information, anxiety, and consultation duration. Randomization was achieved using a computer program, with allocation concealment by opaque sequentially numbered envelopes. Patients were blinded to study group; surgeons were aware of study group, but blinded to outcomes. RESULTS: Patients (59) were randomly allocated to receive the question prompt list (31) or to the control group (28). A patient from the intervention group withdrew before consultation, resulting in 58 patients being included in the analysis. In the question prompt list consultations, 24 per cent more questions were asked (incidence rate ratio = 1.25, 95 per cent c.i. 1.10 to 1.42; P = 0.001). The intervention group recalled 9 per cent more items than the control group (incidence rate ratio = 1.09, 95 per cent c.i. 1.02 to 1.17; P = 0.012). The control group were 26 per cent less likely to correctly recall information about surgical treatment (OR = 0.26, 95 per cent c.i. 0.10 to 0.68; P = 0.006). No statistically significant differences between study arms for talk time, mutual eye gaze, anxiety, or consultation duration were demonstrated. CONCLUSION: The question prompt list was associated with increased question asking and greater patient recall of medical information. It did not increase patient anxiety or consultation duration. REGISTRATION NUMBER: ACTRN12623000089639 (http://www.ANZCTR.org.au).

Socioeconomic position as a predictor of youth's movement trajectory profiles between ages 10 and 14 years.

BACKGROUND: Combinations of movement behaviors (i.e., physical activity, sedentary behavior, sleep) are associated with health and developmental outcomes in youth. Youth vary in how they accumulate these behaviors, both in volume and specific domains (e.g., sedentary time spent on recreational screen activities vs homework). The aim of this study was to examine how youth's combined general and domain-specific movement trajectories differ by socioeconomic position. METHODS: We conducted a longitudinal, group-based multi-trajectory analysis to identify general and domain-specific movement trajectory profiles for 2457 youth from age 10 to 14 years from the Longitudinal Study of Australian Children from 2014-2018. We used multinomial logistic regression to test if socioeconomic position predicted profile membership. RESULTS: We identified three general movement trajectory profiles for both sexes, four domain-specific profiles for males, and five for females. For general movement trajectories, females from lower socioeconomic positions were more likely to be a combination of less active and more sedentary than females from higher socioeconomic positions. Males across socioeconomic positions spend similar amounts of time in physical activity, sedentary time, and sleep. For domain-specific movement trajectories, youth from lower socioeconomic positions were likely to spend a combination of less time in education-based sedentary behavior and more time in recreational screen activities than their higher socioeconomic position peers. CONCLUSION: Our results indicate that socioeconomic position predicted in which domains youth accumulate their movements. Future observational research and interventions targeting different socioeconomic groups should therefore consider domain-specific movement trajectories.

Understanding unplanned return to theatre in rural South Australia general surgery: review of four major hospitals over a six-year period.

BACKGROUND: Unplanned return to theatre (URTT) is associated with longer hospital stay and higher mortality rates, placing extra burden on hospital resources. There is a lack of literature analysing causes of URTT in a rural general surgery department. This knowledge may be important to help identify patients at risk of URTT. This study aims to identify causes of URTT in rural general surgical patients. METHODS: This is a retrospective multicenter cohort involving four rural South Australian (SA) hospitals: Mount Gambier (MGH), Whyalla (WH), Port Augusta (PAH), and Port Lincoln (PLH). All general surgical inpatients admitted from February 2014 to March 2020 were analysed to identify all-cause of URTT. RESULTS: Of the 44 191 surgical procedures performed, there were 67 (0.15%) URTT. The most common surgical subspecialty cases that resulted in URTT were Colorectal (47.1%), General surgery (33.2%) Plastics (9.8%), and Hepatopancreatico-biliary (3.9%). The three commonest operations during URTT were washouts 22 (32.8%), interventions for haemostasis 11 (16.4%) and bowel resections 9 (13.4%). Sixteen (24%) of URTT followed emergency surgery. When comparing between elective and emergency admissions needing URTT, there were no statistical difference in age, gender, speciality type, types of surgery performed, and median number of days until URTT. CONCLUSION: Rates of URTT are low in South Australian rural hospitals when compared to our overseas counterpart. A wide range of surgery is being performed in rural centres, further supporting the need for rural surgical trainees to have a tailored curriculum encompassing subspecialities and being competent in managing any potential complications.

Patient focused interventions and communication in the surgical clinic: a systematic review and meta-analysis.

Background: Communication is the foundation of a strong doctor-patient relationship. Holistic care of the patient involves good communication and empathy. There are various tools and interventions aimed at increasing the Surgeon's performance, but these have the drawback of heavy cost and time commitments. In contrast, patient focused interventions are often simple and cheap. In surgery this is an evolving field, and little is known about the impact these interventions have on clinical encounters. The aim of this review is to determine how patient focussed interventions impact communication in the Surgical Outpatient Consultation. Methods: In this systematic review and meta-analysis, two reviewers independently searched MEDLINE (incl. PubMed), EMBASE, EMCARE, CINAHL, and the Cochrane Library for the period starting 01 February 1990 to 01 February 2022. Filtration and screening was performed in accordance with PRISMA guidelines. Conflicts were resolved by discussion. Risk of Bias was assessed using the RoB 2 tool. Meta-analyses were conducted by an independent statistician using Stata Statistical Software. This systematic review was prospectively registered with PROSPERO (ID CRD42022311112). Findings: After screening, 38 papers were included in the final analysis. These involved 6392 patients consisting of 32 randomised controlled trials (RCT), one crossover RCT, three non-randomised experimental studies, and three cohort studies. All articles were published between 1999 and 2022. Four types of intervention were identified: Patient Decision Aids, Educational Materials, Question Prompt Lists and Patient Reported Outcome Measures. There was much heterogeneity in the reported results but ultimately four recurring domains for assessing quality of communication were identified: Patient knowledge; decisional conflict; satisfaction; and anxiety. Meta-analyses showed that patient focussed interventions increased patient knowledge and reduced decisional conflict. Meta-regression demonstrated significant knowledge increases in females compared with males. Results regarding satisfaction and anxiety were not statistically significant. Interpretation: Our study suggested that patient focused interventions demonstrate promising results for increasing patient engagement and improving communication. Further multicentre randomised controlled trials with consistent validated endpoints should be conducted to evaluate this evolving field. Funding: There was no funding source for this study.

A meta-analysis of the dark side of the American dream: Evidence for the universal wellness costs of prioritizing extrinsic over intrinsic goals.

Self-determination theory holds that the intrinsic and extrinsic content of people's aspirations differentially affect their wellness. An evidence base spanning nearly 30 years indicates that focusing on intrinsic goals (such as for growth, relationships, community giving, and health) promotes well-being, whereas a focus on extrinsic goals (such as for wealth, fame, and beauty) deters well-being. Yet, the evidence base contains exceptions, and some authors have argued that focusing on extrinsic goals may not be universally detrimental. We conducted a systematic review and used multilevel meta-analytic structural equation modeling to evaluate the links between intrinsic and extrinsic aspirations with indices of well-being and ill-being. Across 92 reports (105 studies), 1,808 effects, and a total sample of N = 70,110, we found that intrinsic aspirations were linked positively with well-being, r = 0.24 [95% CI 0.22, 0.27], and negatively with ill-being, r = -0.11 [-0.14, -0.08]. When the variety of extrinsic aspiration scoring methods were combined, the link with well-being was not statistically significant, r = 0.02 [-0.02, 0.06]. However, when extrinsic aspirations were evaluated in terms of their predominance in the overall pattern of aspiring the effect was universally detrimental, linking negatively to well-being, r = -0.22 [-0.32, -0.11], and positively to ill-being, r = 0.23 [0.17, 0.30]. Meta-analytic conclusions about the associations between goal types and wellness are important because they inform how individuals could shape aspirations to support their own happiness and how groups and institutions can frame goals such that their pursuit is for the common good. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient prompts in surgical consultations: A systematic review.

BACKGROUND: Quality communication has been found to improve patient outcomes. Despite good communication, information may still be forgotten or misunderstood by patients. A question prompt list is a document to help patients ask questions. Question prompt lists are well perceived by various stakeholders and have been found of benefit to patients. This systematic review evaluated the effectiveness of patient question prompting documents in surgical outpatient consultations. METHODS: MEDLINE, EMBASE, and PsychINFO were searched on September 13, 2021. Study selection, data extraction, and risk of bias assessment were performed in duplicate. We included English studies that investigated the use of question prompt lists and their influence on patient outcomes. We excluded studies that did not have a comparator group. Because of heterogeneity of outcome measures, meta-analysis was precluded. This study was registered with PROSPERO (identification number: CRD42021279058). RESULTS: Searches identified 107 suitable studies; however, only 7 studies met eligibility criteria. All included studies were randomized controlled trials, but the designs of studies were heterogenous. Three out of 7 included studies were at a high risk of bias. The included studies investigated different outcomes that could be broadly categorized into 5 themes: consultation characteristics, patient engagement, patient well-being, information exchange, and patient satisfaction. None of the studies looked at patient recall of information. Aside from length of consultation, the overall results for each category were mixed. CONCLUSION: Current literature has suggested that question prompt lists are a low-risk intervention that could improve patient engagement and patient-doctor communication; however, there is limited evidence at present to conclusively promote their usage in perioperative surgical consultations.

Motivations for personal financial management: A Self-Determination Theory perspective.

Financial knowledge and sound financial decision making are now broadly recognized to be important determinants of both personal and societal prosperity, but research has yet to examine how distinct qualities of motivation may be associated with the way people manage their money. In two studies we applied the framework of Self-Determination Theory (SDT) to examine people's autonomous (volitional) and controlled (pressured) motivation for understanding and managing their finances, as well as their amotivation (lack of motivation) for doing so, and the differential associations these motives have with financial knowledge and financial well-being. American participants (Study 1, N = 516; Study 2, N = 534) completed detailed demographic surveys and questionnaires assessing the financial variables of interest. As hypothesized, SDT's motivational constructs were associated with financial outcomes over and above participants' age, gender, income, household wealth, and educational attainment. Autonomous motivation was positively associated with a host of positive financial behaviors and characteristics (e.g., saving/investing and financial self-efficacy, well-being, and self-awareness). Controlled motivation was negatively associated with financial well-being. Amotivation was positively associated with overspending and negatively associated with financial self-efficacy and well-being. These findings support the relevance of SDT's framework in this domain and suggest that interventions aimed at promoting financial knowledge and wellness may benefit by adopting evidence-supported strategies for optimizing more autonomous motivations and addressing amotivations.

Hepatic cytochrome P450 function is reduced by life-long Western diet consumption in guinea pig independent of birth weight.

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is characterised by accumulation of triglycerides and cholesterol within the liver and dysregulation of specific hepatic cytochrome P450 (CYPs) activity. CYPs are involved in the metabolism of endogenous and exogenous chemicals. Hepatic CYP activity is dysregulated in human studies and animal models of a Western diet (WD) or low birth weight (LBW) independently, but the additive effects of LBW and postnatal WD consumption are unknown. As such, the aim of this study was to determine the independent and combined effect of birthweight and postnatal diet on hepatic CYP activity in a guinea pig model. METHODS: LBW was generated via uterine artery ablation at mid gestation (term = 70 days gestation). Normal birthweight (NBW) and LBW pups were allocated either a control diet (CD) or WD at weaning. After 4 months of dietary intervention, guinea pigs were humanely killed, and liver tissue collected for biochemical and functional hepatic CYP activity analyses. RESULTS: Independent of birthweight, functional activity of CYP3A was significantly reduced in female and male WD compared to CD animals (female, P < 0.0001; male, P = 0.004). Likewise, CYP1A2 activity was significantly reduced in male WD compared to CD animals (P = 0.020) but this same reduction was not observed in females. CONCLUSION: Diet, but not birthweight, significantly altered hepatic CYP activity in both sexes, and the effect of diet appeared to be greater in males. These findings may have clinical implications for the management of NAFLD and associated co-morbidities between the sexes.

Intrauterine growth restriction alters the activity of drug metabolising enzymes in the maternal-placental-fetal unit.

PURPOSE: Ten percent of pregnancies are affected by intrauterine growth restriction (IUGR), and evidence suggests that affected neonates have reduced activity of hepatic cytochrome P450 (CYP) drug metabolising enzymes. Given that almost all pregnant individuals take medications and additional medications are often required during an IUGR pregnancy, we aimed to determine the impact of IUGR on hepatic CYP activity in sheep fetuses and pregnant ewes. METHODS: Specific probes were used to determine the impact of IUGR on the activity of several CYP isoenzymes (CYP1A2, CYP2C19, CYP2D6 and CYP3A) in sheep fetuses and pregnant ewes. Probes were administered intravenously to the ewe at 132 days (d) gestation (term 150 d), followed by blood sampling from the maternal and fetal circulation over 24 h. Maternal and fetal liver tissue was collected at 139-140 d gestation, from which microsomes were isolated and incubated with probes. Metabolite and maternal plasma cortisol concentrations were measured using Liquid Chromatography - tandem mass spectrometry (LC-MS/MS). RESULTS: Maternal plasma cortisol concentration and maternal hepatic CYP1A2 and CYP3A activity was significantly higher in IUGR pregnancies. Maternal hepatic CYP activity was higher than fetal hepatic CYP activity for all CYPs tested, and there was minimal CYP1A2 or CYP3A activity in the late gestation fetus when assessed using in vitro methods. CONCLUSIONS: The physiological changes to the maternal-placental-fetal unit in an IUGR pregnancy have significant effects on maternal drug metabolism, suggesting changes in medications and/or doses may be required to optimise maternal and fetal health.

Impact of maternal late gestation undernutrition on surfactant maturation, pulmonary blood flow and oxygen delivery measured by magnetic resonance imaging in the sheep fetus.

Restriction of fetal substrate supply has an adverse effect on surfactant maturation in the lung and thus affects the transition from in utero placental oxygenation to pulmonary ventilation ex utero. The effects on surfactant maturation are mediated by alteration in mechanisms regulating surfactant protein and phospholipid synthesis. This study aimed to determine the effects of late gestation maternal undernutrition (LGUN) and LGUN plus fetal glucose infusion (LGUN+G) compared to Control on surfactant maturation and lung development, and the relationship with pulmonary blood flow and oxygen delivery ( DO2 ) measured by magnetic resonance imaging (MRI) with molecules that regulate lung development. LGUN from 115 to 140 days' gestation significantly decreased fetal body weight, which was normalized by glucose infusion. LGUN and LGUN+G resulted in decreased fetal plasma glucose concentration, with no change in fetal arterial PO2 compared to control. There was no effect of LGUN and LGUN+G on the mRNA expression of surfactant proteins (SFTP) and genes regulating surfactant maturation in the fetal lung. However, blood flow in the main pulmonary artery was significantly increased in LGUN, despite no change in blood flow in the left or right pulmonary artery and DO2 to the fetal lung. There was a negative relationship between left pulmonary artery flow and DO2 to the left lung with SFTP-B and GLUT1 mRNA expression, while their relationship with VEGFR2 was positive. These results suggest that increased pulmonary blood flow measured by MRI may have an adverse effect on surfactant maturation during fetal lung development. KEY POINTS: Maternal undernutrition during gestation alters fetal lung development by impacting surfactant maturation. However, the direction of change remains controversial. We examined the effects of maternal late gestation maternal undernutrition (LGUN) on maternal and fetal outcomes, signalling pathways involved in fetal lung development, pulmonary haemodynamics and oxygen delivery in sheep using a combination of molecular and magnetic resonance imaging (MRI) techniques. LGUN decreased fetal plasma glucose concentration without affecting arterial PO2 . Surfactant maturation was not affected; however, main pulmonary artery blood flow was significantly increased in the LGUN fetuses. This is the first study to explore the relationship between in utero MRI measures of pulmonary haemodynamics and lung development. Across all treatment groups, left pulmonary artery blood flow and oxygen delivery were negatively correlated with surfactant protein B mRNA and protein expression in late gestation.

Open or closed: Changes in ductus arteriosus flow patterns at birth using 4D flow MRI in newborn piglets.

The ductus arteriosus (DA) functionally closes during the transition from fetal to postnatal life because of lung aeration and corresponding cardiovascular changes. The thorough and explicit measurement and visualization of the right and left heart output during this transition has not been previously accomplished. We combined 4D flow MRI (dynamic volumetric blood flow measurements) and T2 relaxometry (oxygen delivery quantification) in surgically instrumented newborn piglets to assess the DA. This was performed in Large White-Landrace-Duroc piglets (n = 34) spanning four age groups: term-9 days, term-3, term+1, and term+5. Subject's DA status was classified using 4D flow: closed DA, forward DA flow, reversed DA flow, and bidirectional DA flow. Over all states, vessel diameters and flows normalized to body weight increased with age (for example in the ascending aorta flow-term-9: 126.6 ± 45.4; term+5: 260.2 ± 80.0 ml/min per kg; p = 0.0005; ascending aorta diameter-term-9: 5.2 ± 0.8; term+5: 7.7 ± 0.4 mm; p = 0.0004). In subjects with reversed DA blood flow there was lower common carotid artery blood flow (forward: 37.5 ± 9.0; reversed: 20.0 ± 7.4 ml/min per kg; p = 0.032). Linear regression revealed that as net DA flow decreases, common carotid artery flow decreases (R2  = 0.32, p = 0.004), and left (R2  = 0.33, p = 0.003) and right (R2  = 0.34, p = 0.003) pulmonary artery flow increases. Bidirectional DA blood flow changed oxygen saturation as determined by MRI between the ascending and descending aorta (ascending aorta: 90.1% ± 8.4%; descending aorta: 75.6% ± 14.2%; p < 0.05). Expanded use of these techniques in preterm animal models will aid in providing new understandings of normal versus abnormal DA transition, as well as to test the effectiveness of related clinical interventions.

Alcohol consumption and dependence is linked to the extent that people experience need satisfaction while drinking alcohol in two Aboriginal and Torres Strait Islander communities.

BACKGROUND: Unhealthy alcohol use is a key concern for Aboriginal and Torres Strait Islander ('Indigenous Australian') communities. Due to systematic disadvantage and inter-generational trauma, Indigenous Australians may be less likely to have satisfied basic psychological needs (autonomy, competence, and relatedness). When people are need-thwarted, they may engage in compensatory behaviours to feel better in the short-term. We explore the relationship between perceived basic psychological needs satisfaction and alcohol consumption use among Indigenous Australians. Better understanding the functions that alcohol may play for some Indigenous Australian drinkers may aid communities, clinicians, and policy makers in improving programs for reducing drinking-related harms. METHODS: We performed a cross-sectional survey of Indigenous Australians (aged 16 years or older) living in two South Australian communities. Participants were eligible if they had consumed any alcohol in the past 12 months. Spearman correlations and linear regressions were used to determine if feeling more autonomous, competent, and related to others (need satisfied) while drinking, was linked to alcohol consumption and dependence. RESULTS: Controlling for participant demographics, reporting feeling need satisfied while drinking was linked to drinking more alcohol per day, reporting more frequent symptoms of alcohol dependence, spending more money on alcohol, and scoring higher on the AUDIT-C. CONCLUSIONS: Unhealthy drinking may partly stem from attempts to satisfy basic psychological needs. Programs which support Indigenous Australians to meet basic psychological needs could reduce attempts to meet psychological needs through alcohol consumption.

Haemodynamics and cerebral oxygenation of neonatal piglets in the immediate ex utero period supported by mechanical ventilation or ex utero oxygenator.

KEY POINTS: The margin of human viability has extended to the extremes of gestational age (<24 weeks) when the lungs are immature and ventilator-induced lung injury is common. Artificial placenta technology aims to extend gestation ex utero in order to allow the lungs additional time to develop prior to entering an air-breathing environment. We compared the haemodynamics and cerebral oxygenation of piglets in the immediate period post-oxygenator (OXY) transition against both paired in utero measures and uniquely against piglets transitioned onto mechanical ventilation (VENT). Post-transition, OXY piglets became hypotensive with reduced carotid blood flow in comparison with both paired in utero measures and VENT piglets. The addition of a pump to the oxygenator circuit may be required to ensure haemodynamic stability in the immediate post-transition period. ABSTRACT: Gestational age at birth is a major predictor of wellbeing; the lower the gestational age, the greater the risk of mortality and morbidity. At the margins of human viability (<24 weeks gestation) immature lungs combined with the need for early ventilatory support means lung injury and respiratory morbidity is common. The abrupt haemodynamic changes consequent on birth may also contribute to preterm-associated brain injury, including intraventricular haemorrhage. Artificial placenta technology aims to support oxygenation, haemodynamic stability and ongoing fetal development ex utero until mature enough to safely transition to a true ex utero environment. We aimed to characterize the impact of birth transition onto either an oxygenator circuit or positive pressure ventilation on haemodynamic and cerebral oxygenation of the neonatal piglet. At 112 days gestation (term = 115 days), fetal pigs underwent instrumentation surgery and transitioned onto either an oxygenator (OXY, n = 5) or ventilatory support (VENT, n = 8). Blood pressure (BP), carotid blood flow and cerebral oxygenation in VENT piglets rose from in utero levels to be significantly higher than OXY piglets post-transition. OXY piglet BP, carotid blood flow and carotid oxygen delivery (DO2 ) decreased from in utero levels post-transition; however, cerebral regional oxygen saturation (rSO2 ) was maintained at fetal-like levels. OXY piglets became hypoxaemic and retained CO2 . Whether OXY piglets are able to maintain cerebral rSO2 under these conditions for a prolonged period is yet to be determined. Improvements to OXY piglet oxygenation may lie in maintaining piglet BP at in utero levels and enhancing oxygenator circuit flow.

Impact of resveratrol-mediated increase in uterine artery blood flow on fetal haemodynamics, blood pressure and oxygenation in sheep.

NEW FINDINGS: What is the central question of this study? Uterine artery blood flow helps to maintain fetal oxygen and nutrient delivery. We investigated the effects of increased uterine artery blood flow mediated by resveratrol on fetal growth, haemodynamics, blood pressure regulation and oxygenation in pregnant sheep. What is the main finding and its importance? Fetuses from resveratrol-treated ewes were significantly larger and exhibited a haemodynamic profile that might promote peripheral growth. Absolute uterine artery blood flow was positively correlated with umbilical vein oxygen saturation, absolute fetal oxygen delivery and fetal growth. Increasing uterine artery blood flow with compounds such as resveratrol might have clinical significance for pregnancy conditions in which fetal growth and oxygenation are compromised. ABSTRACT: High placental vascular resistance hinders uterine artery (UtA) blood flow and fetal substrate delivery. In the same group of animals as the present study, we have previously shown that resveratrol (RSV) increases UtA blood flow, fetal weight and oxygenation in an ovine model of human pregnancy. However, the mechanisms behind changes in growth and the effects of increases in UtA blood flow on fetal circulatory physiology have yet to be investigated. Twin-bearing ewes received s.c. vehicle (VEH, n = 5) or RSV (n = 6) delivery systems at 113 days of gestation (term = 150 days). Magnetic resonance imaging was performed at 123-124 days to quantify fetal volume, blood flow and oxygen saturation of major fetal vessels. At 128 days, i.v. infusions of sodium nitroprusside and phenylephrine were administered to study the vascular tone of the fetal descending aorta. Maternal RSV increased fetal body volume (P = 0.0075) and weight (P = 0.0358), with no change in brain volume or brain weight. There was a positive relationship between absolute UtA blood flow and umbilical vein oxygen saturation, absolute fetal oxygen delivery and combined fetal twin volume (all P ≤ 0.05). There were no differences between groups in fetal haemodynamics or blood pressure regulation except for higher blood flow to the lower body in RSV fetuses (P = 0.0170). The observed increase in fetal weight might be helpful in pregnancy conditions in which fetal growth and oxygen delivery are compromised. Further preclinical investigations on the mechanism(s) accounting for these changes and the potential to improve growth in complicated pregnancies are warranted.

Identification of placental androgen receptor isoforms in a sheep model of maternal allergic asthma.

Maternal asthma is known to impact intrauterine growth outcomes, which may be mediated, in part, by altered androgen signalling. Our aim was to explore whether the sheep placenta expresses androgen receptor (AR) isoforms and determine if the differential expression of AR protein isoforms is altered by maternal asthma. Four known AR isoforms were detected (AR-FL, AR-v1, AR-v7, and AR-45), and their expression and subcellular distribution was altered in the presence of maternal allergic asthma. These findings underscore the importance for in vivo models of maternal asthma to delineate molecular patterns that may contribute to feto-placental growth and development.

A configural approach to aspirations: The social breadth of aspiration profiles predicts well-being over and above the intrinsic and extrinsic aspirations that comprise the profiles.

We conducted a person-centered analysis of the Aspiration Index to identify subgroups that differ in the levels of their specific (wealth, fame and image, personal growth, relationships, community giving, and health) and global intrinsic and extrinsic aspirations. In a Hungarian (N = 3,370; 77% female; age: M = 23.57), an Australian (N = 1,632; 51% female; age: M = 16.6), and an American sample (N = 6,063; 82.2% female; age: M = 21.86), we conducted separate bifactor exploratory structural equation models to disentangle the level of higher-order intrinsic and extrinsic aspirations from the shape of specific aspirations by using the resultant factor scores as indicators in latent profile analyses. The analyses yielded 3 replicable latent profiles: Disengaged from relationships and health (Profile 1); Aspiring for interpersonal relationships more than community relationships (Profile 2); and Aspiring for community relationships more than interpersonal relationships (Profile 3), with Profile 3 reliably experiencing the highest well-being. To demonstrate the incremental value of our approach to more traditional variable-centered methods, we used profile membership to predict well-being while controlling for the aspirations that comprise the profiles. Even in these conservative tests, profile membership explained additional variance in well-being. However, the real-life significance of the size of the incremental value appeared quite small. These studies make a unique contribution to the literature by identifying replicable latent profiles of aspiring, membership to which uniquely predicted well-being, over and above the constituent variables. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Fetal cardiovascular response to acute hypoxia during maternal anesthesia.

Preclinical imaging studies of fetal hemodynamics require anesthesia to immobilize the animal. This may induce cardiovascular depression and confound measures under investigation. We compared the impact of four anesthetic regimes upon maternal and fetal blood gas and hemodynamics during baseline periods of normoxia, and in response to an acute hypoxic challenge in pregnant sheep. Merino ewes were surgically prepared with maternal and fetal vascular catheters and a fetal femoral artery flow probe at 105-109 days gestation. At 110-120 days gestation, ewes were anesthetized with either isoflurane (1.6%), isoflurane (0.8%) plus ketamine (3.6 mg·kg-1 ·h-1 ), ketamine (12.6 mg·kg-1 ·h-1 ) plus midazolam (0.78 mg·kg-1 ·h-1 ), propofol (30 mg·kg-1 ·h-1 ), or remained conscious. Following 60 min of baseline recording, nitrogen was administered directly into the maternal trachea to displace oxygen and induce maternal and thus fetal hypoxemia. During normoxia, maternal PaO2 was ~30 mmHg lower in anesthetized ewes compared to conscious controls, regardless of the type of anesthesia (p < .001). There was no effect of anesthesia on fetal mean arterial blood pressure (MAP; p > .05), but heart rate was 32 ± 8 bpm lower in fetuses from ewes administered isoflurane (p = .044). During maternal hypoxia, fetal MAP increased, and peripheral blood flow decreased in all fetuses except those administered propofol (p < .05). Unexpectedly, hypoxemia also induced fetal tachycardia regardless of the anesthetic regime (p < .05). These results indicate that despite maternal anesthesia, the fetus can mount a cardiovascular response to acute hypoxia by increasing blood pressure and reducing peripheral blood flow, although the heart rate response may differ from when no anesthesia is present.

Information Safety Assurances Increase Intentions to Use COVID-19 Contact Tracing Applications, Regardless of Autonomy-Supportive or Controlling Message Framing.

Promoting the use of contact tracing technology will be an important step in global recovery from the COVID-19 pandemic. Across two studies, we assessed two messaging strategies as motivators of intended contact tracing uptake. In one sample of 1117 Australian adults and one sample of 888 American adults, we examined autonomy-supportive and controlling message framing and the presence or absence of information safety as predictors of intended contact tracing application uptake, using an online randomized 2 × 2 experimental design. The results suggested that the provision of data safety assurances may be key in affecting people's intentions to use contact tracing technology, an effect we found in both samples regardless of whether messages were framed as autonomy-supportive or controlling. Those in high information safety conditions consistently reported higher intended uptake and more positive perceptions of the application than those in low information safety conditions. In Study 2, we also found that perceptions of government legitimacy related positively to intended application uptake, as did political affiliation. In sum, individuals appeared more willing to assent to authority regarding contact tracing insofar as their data safety can be assured. Yet, public messaging strategies alone may be insufficient to initiate intentions to change behavior, even in these unprecedented circumstances.