Evaluation of a Patient Education Pamphlet for Women Considering Vaginal Birth After Cesarean.

We evaluated a patient education pamphlet on vaginal birth after cesarean (VBAC). Focus groups with 17 women in 4 communities involved a 5-item knowledge pretest and question on intention to plan VBAC, reading the pamphlet, a knowledge posttest, and a moderated discussion. Forming a preference for birth after cesarean was characterized by (a) consolidating information from social sources, (b) seeking certainty in your next birth, and (c) questioning your ability to have a vaginal birth. Participants preferred vaginal birth, but all feared the uncertainty of labor. Knowledge scores increased for all participants, but intentions to plan a VBAC did not change. Our findings may encourage the development of interventions to reduce women's fear of vaginal birth.

Intrauterine Adhesions Following Miscarriage: Look and Learn.

OBJECTIVE: To examine the incidence of intrauterine adhesions (IUA) following the management of miscarriage in women with previously documented normal uterine cavities. METHODS: We conducted a retrospective cohort study from two fertility clinics with standard practice protocols for evaluating the uterine cavity prior to infertility treatment and following clinical pregnancy loss. A database query and manual chart review identified 144 women with normal uterine cavities who experienced a miscarriage between January 2010 and November 2012 and returned to the clinic for follow-up hysteroscopy. Following documentation of a non-viable clinical pregnancy using transvaginal ultrasound, patients chose expectant, medical, or surgical management according to standardized clinical protocols. The primary outcome was the detection of IUA. Secondary outcomes included the presence of retained products of conception and various risk factors associated with the development of IUA. RESULTS: The incidence of IUA following early pregnancy loss was 6.3%. There were no significant differences in patient characteristics between those with and without IUA. There was a significant association between IUA and increasing uterine size, particularly in the presence of multiple gestation (P = 0.039). Mechanical suction dilatation and curettage (D&C) was a risk factor for IUA, but manual vacuum aspiration was not a risk factor (P = 0.003). Retained products of conception were found in 13.9% of study participants, and the incidence did not differ among management options. CONCLUSIONS: This appears to be the first documentation of IUA that were entirely attributable to the index miscarriage or its management. There appears to be an increased risk of IUA following D&C with larger uteri and multiple pregnancies and following mechanical suction D&C.

Breast Cancer and Mammography Screening: Knowledge, Beliefs and Predictors for Asian Immigrant Women Attending a Specialized Clinic in British Columbia, Canada.

Screening mammography (MMG) reduces breast cancer mortality; however, Asian immigrant women underutilize MMG. The Asian Women's Health Clinic (AWHC) was established to promote women's cancer screening amongst this population. This study evaluated the rate, and predictors, of MMG amongst women attending the AWHC. Women (N = 98) attending the AWHC completed a questionnaire. Descriptive statistics and multivariable logistic regression evaluated rate and predictors of MMG. Most participants (87 %, n = 85) reported having had a mammogram. Significant MMG predictors were: lower perceived MMG barriers [lifetime: OR (CI) 1.19 (1.01-1.49); past 2 years: OR (CI) 1.11 (1.01-1.25)], and knowing someone with breast cancer [past year: OR (CI) 3.42 (1.25-9.85); past 2 years: OR (CI) 4.91 (1.32-2.13)]. Even amongst women using preventive medicine, 13 % report never having had a mammogram. More research is needed into innovative interventions, e.g. the AWHC, and breast cancer-related outcomes amongst Asian immigrant women.

Induction, overhypothesis, and the origin of abstract knowledge. Evidence from 9-month-old infants.

Human cognition relies on the ability to extract generalizable knowledge from limited evidence. One type of inductive learning, overhypothesis formation, allows learners to make inferences that take them beyond the limits of direct experience, leading to the creation of abstract knowledge. The developmental roots of this ability have yet to be investigated. We report three experiments examining whether 9-month-old infants are capable of forming overhypotheses. Our results show that when given evidence about a few objects in some category, infants formed a second-order generalization about categories in general. These findings provide evidence that infants possess a powerful mechanism for inductive learning-a mechanism that may be applied to many domains and that can account for the development of many inductive biases later on.

Do early nouns refer to kinds or distinct shapes? Evidence from 10-month-old infants.

What is the nature of early words? Specifically, do infants expect words for objects to refer to kinds or to distinct shapes? The current study investigated this question by testing whether 10-month-olds expect internal object properties to be predicted by linguistic labels. A looking-time method was employed. Infants were familiarized with pairs of identical or different objects that made identical or different sounds. During test, before the sounds were demonstrated, paired objects were labeled with one repeated count-noun label or two distinct labels. Results showed that infants expected objects labeled with distinct labels to make different sounds and objects labeled with repeated labels to make identical sounds, regardless of the objects' appearance. These findings indicate that the 10-month-olds' expectations about internal properties of objects were driven by labeling and provide evidence that even at the beginning of word learning, infants expect distinct labels to refer to different kinds.

Do 9-month-old infants expect distinct words to refer to kinds?

In 3 experiments, 9-month-old infants' expectations for what distinct count noun labels refer to were investigated. In Experiment 1, a box was opened to reveal 2 objects inside during familiarization: either 2 identical objects or 2 different objects. Test trials followed the same procedure, except before the box was opened, the contents were described using 2 distinct labels ("I see a wug! I see a dak!") or the same label twice ("I see a zav! I see a zav!"). Infants who heard a label repeated twice looked longer at 2 different objects versus 2 identical objects, whereas infants who heard 2 distinct labels showed a different pattern of looking. Experiments 2 and 3 presented infants with object pairs that only differed in shape or color, and it was found that infants expected the different-shaped (but not the different-colored) objects to be labeled by distinct count nouns. Because the property of shape is a cue to kind membership and the property of color is not, these results suggest that even at the beginning of word learning, infants may expect distinct labels to refer to distinct kinds of objects.