The Rights of Physicians and Future Physicians Who Are Lactating, Breastfeeding, or Chestfeeding: An American Medical Women's Association Position Article.

Breastfeeding is a fundamental and biologically normal function with well-established benefits for both lactating parents and infants. Despite these benefits, physicians, particularly those in training, often face significant obstacles when attempting to meet their breastfeeding and pumping goals. In response to these challenges, the American Medical Women's Association (AMWA) and a diverse group of health care professionals have come together to advocate for comprehensive lactation support policies in medical learning environments and workplaces. This position article highlights the ethical necessity of comprehensive lactation support in medical educational and workplace settings, emphasizing the importance of not only providing physical accommodations but also fostering a cultural shift, educational initiatives, and policy reforms to empower lactating parents. It offers an examination of the difficulties encountered by lactating parents within medical environments and proposes guidelines for the formulation and enhancement of supportive policies. The position article envisions a future where medical professionals can thrive in both their careers and parenthood through collaborative efforts and a commitment to the key elements of Effective Lactation Support Programs in medical workplaces based on the following: (1) well-equipped lactation facilities, (2) customized work schedules, (3) mentorship and support networks, (4) lactation support in clinical settings, and (5) research and advocacy.

Epidemiological investigation of insulin dysregulation in Shetland and Welsh ponies in Australia.

BACKGROUND: Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies. OBJECTIVES: To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR). STUDY DESIGN: Cross-sectional. METHODS: Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an insulin tolerance test (ITT). Owners completed surveys reporting activity, laminitis history and perception of body condition using a (1-9) visual analogue scale (VASo). Ordinal scores were converted to binary outcomes for CNS (≤2/5 or ≥3/5), BCS and VASo (≤6/9 or ≥7/9). Variables associated with insulin concentrations, glucose reduction after the ITT and laminitis were evaluated with mixed effects regression models accounting for random effects of farms. RESULTS: Among 167 ponies tested, median (range) age was 9 (4-21) years and BCS was 6 (4-8). Prevalence (95% confidence interval [CI]) of ID was 61 (53-68)%. Factors associated with insulin concentrations (estimate [95% CI]; µIU/mL) 60 min post-OST were: age (1.07 [1.02-1.11]), CNS (≥3/5, 1.52 [1.04-2.23]) and VASo (≥7/9, 1.75 [1.09-2.79]); and 90 min post-OST were: age (1.08 [1.03-1.12]), CNS (≥3/5, 1.80 [1.22-2.64]), VASo (≥7/9, 2.49 [1.52-4.08]) and sex (male, 0.64 [0.45-0.91]). Factors associated with glucose reduction after the ITT (estimate [95% CI]; %) were: age (-1.34 [-2.01 to -0.67]), sex (female, -6.21 [-11.68 to -0.74]) and VASo (≥7/9, -1.74 [-18.89 to -4.78]). Factors associated with laminitis (odds ratio [95% CI]) were DHI (4.60 [1.68-12.58]), IR (3.66 [1.26-10.61]) and PPID (11.75 [1.54-89.40]). MAIN LIMITATIONS: Single time-point sampling, laminitis definition and diet analysis. CONCLUSIONS: Ageing, being female and owner-perceived obesity were associated with ID.

Evaluation of an HMGA2 variant contribution to height and basal insulin concentrations in ponies.

BACKGROUND: The HMGA2:c.83G>A variant was identified in Welsh ponies having pleiotropic effects on height and insulin concentration. OBJECTIVE: Determine whether the HMGA2:c.83G>A variant is associated with decreased height and higher basal insulin concentrations across pony breeds. ANIMALS: Two hundred thirty-six ponies across 6 breeds. METHODS: Cross-sectional study. Ponies were genotyped for the HMGA2:c.83G>A variant and phenotyped for height and basal insulin concentrations. Stepwise regression was performed for model analysis using a linear regression model for height and mixed linear model for insulin with farm as a random effect. Coefficient of determination, pairwise comparison of the estimated marginal means and partial correlation coefficients (parcor) were calculated to assess the relationship between HMGA2 genotype and height or insulin. RESULTS: Breed and genotype accounted for 90.5% of the variation in height across breeds, and genotype explained 21% to 44% of the variation within breeds. Breed, genotype, cresty neck score, sex, age, and farm accounted for 45.5% of the variation in insulin, with genotype accounting for 7.1%. The HMGA2 A allele frequency was 62% and correlated with both height (parcor = -0.39; P < .001) and insulin (parcor = 0.22; P = .02). Pairwise comparisons found A/A ponies were >10 cm shorter than other genotypes. Compared with G/G individuals, A/A and G/A individuals had 4.3 µIU/mL (95% confidence interval [CI]: 1.8-10.5) and 2.7 µIU/mL (95% CI: 1.4-5.3) higher basal insulin concentrations, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: These data demonstrate the pleiotropic effects of the HMGA2:c.83G>A variant and its role in identifying ponies at increased risk for insulin dysregulation.

Kainic Acid-Based Agonists of Glutamate Receptors: SAR Analysis and Guidelines for Analog Design.

A comprehensive survey of kainic acid analogs that have been tested for their biological activity is presented. Specifically, this review (1) gathers and compares over 100 kainoids according to a relative activity scale, (2) exposes structural features required to optimize affinity for kainate receptors, and (3) suggests design rules to create next-generation KA analogs. Literature SAR data are analyzed systematically and combined with the most recent crystallographic studies. In view of the renewed interest in neuroactive molecules, this review aims to help guide the efforts of organic synthesis laboratories, as well as to inform newcomers to KA/GluK research.

Outdoor-based play and reconnection to nature: a neglected pathway to positive youth development.

Throughout history, outdoor-based play and the connection to nature have been recognized as important contributors to a happy life and healthy development. At times, however, play and nature have been neglected and viewed as frivolous and wasteful. In the early twentieth century, the first play movement took place to get children out of the factories and back outdoors to play. Now, a century later, factors including twenty-four-hour media,stranger danger, and overscheduling of children's time have resulted in a level of play deprivation that is contributing to a host of social, emotional, and physical problems. This article draws on recent research that shows that as many as 40 percent of America's schools have eliminated or significantly reduced recess. Also, children and adolescents are spending an average of fifty-three hours each week in front of screen media, and only 31 percent of mothers report that their children play outside as frequently as they did as children. The deficits in outdoor-based play that arise from these lifestyles have resulted in significant increases in emotional and psychological disorders, decreased capacity to deal with stressors, and decreased physical fitness. This article describes specific organizations and programs that address the problem of play deprivation and reconnection to the outdoors.

Preadolescent female development through sport and physical activity: a case study of an urban after-school program.

Youth development research has found that children become more engaged and benefit more from being incorporated as decision makers. Thus participation helps promote development and encourages engagement. Based in theories of engagement and free-choice learning, the current research focused on a program combining sport/physical activity, life skills, and mentoring while promoting healthy life choices for preadolescent girls of color The co-investigators, all women, conducted two 2-hr visits per week for two 12-week periods with a group of 8 girls at a community recreation center in Hartford, Connecticut, including lessons in nutrition and life skills and participation in a sport/physical activity. Five of the girls completed every stage of data collection, including participant journals and four individual interviews with each participant and her parents, over the course of the 24 weeks. The co-investigators also kept journals throughout the program. The results reflected the following themes: self-esteem/self-worth, accountability/responsibility for self connections to community and a sense of belonging, knowledge and acquisition of health/life skills, application of those skills, and planning and recognizing one's own influence on self and others.