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1.
In this editorial, a board member of Lamaze International describes the “Push for Your Baby” campaign to urge women to advocate for more evidence-based practice for better births. She also reflects on her hopes and worries about the “Push for Your Baby” campaign launched by Lamaze in May 2012. Discussing the realities of current maternity care practice, she asks how we can work with obstetric nurses and providers to have them support what most women value—vaginal birth.  相似文献   

2.
All women should be allowed and encouraged to bring a loved one, friend, or doula to their birth without financial or cultural barriers. Continuous labor support offers benefits to mothers and their babies with no known harm. This article is an updated evidence-based review of the “Lamaze International Care Practices that Promote Normal Birth, Care Practice #3: Continuous Labor Support,” published in The Journal of Perinatal Education, 16(3), 2007.  相似文献   

3.
A standard genetic/bioinformatic activity in the genomics era is the identification within DNA sequences of an "open reading frame" (ORF) that encodes a polypeptide sequence. As an educational introduction to such a search, we provide a webapp that composes, displays for solution, and then solves short DNA exemplars with a single ORFTo the Editor: We wish to bring a new Web resource to the attention of CBE—Life Sciences Education readers.When being introduced to the central dogma of nucleic acid transactions, students are often required to identify the 5′→3′ DNA template strand in a double-stranded DNA (dsDNA) molecule; transcribe an antiparallel, complementary 5′→3′ mRNA; and then translate the mRNA codons 5′→3′ into an amino acid polypeptide by means of the genetic code table. Although this algorithm replicates the molecular genetic process of protein synthesis, experience shows that the series of left/right, antiparallel, and/or 5′→3′ reversals is confusing to many students when worked by hand. Students may also obtain the “right” answer for the “wrong” reasons, as when the “wrong” DNA strand is transcribed in the “wrong” 3′→5′ direction, so as to produce a string of letters that “translates correctly.”In genetics and bioinformatics education, we have found it more intuitively appealing to demonstrate and emphasize the equivalence of the mRNA to the DNA sense strand complement of the template strand. The sense strand is oriented in the same 5′→3′ direction and has a sequence identical to the mRNA, except for substitution of thymidine in the DNA for uracil in the mRNA. It is thus more computationally efficient to “read” the polypeptide sequence directly from this strand, with mental substitution of thymidine in the triplets of the genetic code table. (By definition, “codons” occur only in mRNA: the equivalent three-letter words in the DNA sense strand may be designated “triplets.”) This is the same logic used in DNA “translation” software programs.A further constraint often imposed on dsDNA teaching exemplars is that five of the six possible reading frames are “closed” by the occurrence of one or more “stop” triplets, and only one is an open reading frame (ORF) that encodes an uninterrupted polypeptide. We designate this the “5&1” condition. The task for the student is to identify the ORF and “translate” it correctly. Other considerations include correct labeling of the sense and template DNA strands, their 5′ and 3′ ends (and of the mRNA as required), and the amino (N) and carboxyl (C) termini of the polypeptide.Thus, instructors face the logistical challenge of creating dsDNA sequences that satisfy the “5&1” condition for homework and exam questions. Instructors must compose sequences with one or more “stops” in the three overlapping read frames of one strand, while simultaneously creating two “stopped” frames and one ORF in the other. We have explored these constraints as an algorithmic and computational challenge (Carr et al., 2014 ). There are no “5&1” exemplars of length L ≤ 10, and the proportion of exemplars of length L ≥ 11 is very small relative to the 4L possible sequences (e.g., 0.0023% for L = 11, 0.048% for L = 15, 0.89% for L = 25). This makes random exploration for such exemplars inefficient.We therefore developed a two-stage recursive search algorithm that samples 4L space randomly to generate “5&1” exemplars of any specified length L from 11 ≤ L ≤ 100. The algorithm has been implemented as a Web application (“RandomORF,” available at www.ucs.mun.ca/~donald/orf/randomorf). Figure 1 shows a screen capture of the successive stages of the presentation. The application requires JavaScript on the computer used to run the Web browser.Open in a separate windowFigure 1.Successive screen captures of the webapp RandomORF. First panel: the Length parameter is the desired number of base pairs. Second panel: Clicking the “Generate dsDNA” button shows the dsDNA sequence to be solved, with labeled 5′ and 3′ ends. The button changes to “Show ORF.” Third panel: A second click shows the six reading frames, with the ORF highlighted. Here, the ORF is in the sixth reading frame on the bottom (sense) strand. The polypeptide sequence, read right to left, is N–EITHLRL–C, where N and C are the amino and carboxyl termini, respectively. The conventional IUPAC single-letter abbreviations for amino acids are centered over the middle base of the triplet; stop triplets are indicated by asterisks (*).The webapp provides a means for students to practice identifying ORFs by efficiently generating many examples with unique solutions (Supplemental Material); this can take the place of the more standard offering of a small number of set examples with an answer key. The two-stage display makes it possible for problems to be worked “cold,” with the correct ORF identified only afterward. For examinations, any exemplar may be presented in any of four ways, by transposing the top and bottom strands and/or reversing the direction of the strands left to right. Presentation of the 5′ end of the sense strand at the lower left or upper or lower right tests student recognition that sense strands are always read in the 5′→3′ direction, irrespective of the “natural” left-to-right and/or top-then-bottom order. We intend to modify the webapp to include other features of pedagogical value, including constraints on [G+C] composition and the type, number, and distribution of stop triplets. We welcome suggestions from readers.  相似文献   

4.
In the United States, obstetric care is intervention intensive, resulting in 1 in 3 women undergoing cesarean surgery wherein mobility is treated as an intervention rather than supporting the natural physiologic process for optimal birth. Women who use upright positions and are mobile during labor have shorter labors, receive less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #2: Freedom of Movement Throughout Labor,” published in The Journal of Perinatal Education, 16(3), 2007.  相似文献   

5.
Maternity care in the United States is intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy is far from restrictive. These interventions disturb the normal physiology of labor and birth and restrict women’s ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #4: No Routine Interventions,” published in The Journal of Perinatal Education, 16(3), 2007.  相似文献   

6.
In January 2010, Women’s Health Issues published two direction-setting reports from the Transforming Maternity Care (TMC) Project: “2020 Vision for a High-Quality, High-Value Maternity Care System” and “Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System.” This guest editorial summarizes highlights of the implementation phase of what is now known as the TMC Partnership. Major progress has been made in elevating maternity care quality to a national policy priority, increasing the availability and use of maternity care performance measures, and developing shared decision making tools for childbearing women.  相似文献   

7.
The aim of this research was to explore the experiences of a group of first-time mothers who had given birth at home or in hospital in Australia. Data were generated from in-depth interviews with 19 women and analyzed using a grounded theory approach. One of the categories to emerge from the analysis, “Preparing for Birth,” is discussed in this article. Preparing for Birth consisted of two subcategories, “Finding a Childbirth Setting” and “Setting Up Birth Expectations,” which were mediated by beliefs, convenience, finances, reputation, imagination, education and knowledge, birth stories, and previous life experiences. Overall, the women who had planned home births felt more prepared for birth and were better supported by their midwives compared with women who had planned hospital births.  相似文献   

8.
Objective: Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductive-aged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features. Methods: This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSISSFSE), and placental relative apparent diffusion coefficient value (rADC). Data on height and weight of offspring were collected through telephone follow-up. Results: Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSISSFSE or rADC were observed between the groups (all P>0.05). No significant differences in height and weight of offspring during childhood existed between the groups (all P>0.05). Conclusions: There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.  相似文献   

9.
This article reports original research that describes new mothers'' experiences of birth and maternity care. Qualitative data were collected through a survey on birth satisfaction, which included space for women to provide comments about their birth and experience of care. Thirty-nine women provided comments that were analyzed using the thematic analysis method. Two themes emerged from the women''s experiences: “Unexpected birth processes: expectations and reality” and “Coping with birth: the role of health-care staff.” Participants described unexpected birthing processes, their experiences of care, and maternity care staff''s contributions to coping with birth. Implications for practice for childbirth professionals include promotion of physiologic birth, respectful person-centered care during all phases of perinatal care, and the value of childbirth preparation.  相似文献   

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12.
This edited volume of essays presents a countermainstream view against genetic underpinnings for cancer, behavior, and psychiatric conditions.This edited volume is a project from the Council of Responsible Genetics, a private organization based in Cambridge, Massachusetts, whose mission, as stated on its website, includes as one of several goals to “expose oversimplified and distorted scientific claims regarding the role of genetics in human disease, development and behavior.” This book represents such an effort. Editors Krimsky and Gruber are chair and president/executive director, respectively, of the organization and appear to have solicited contributions to the book from affiliates and other colleagues. Fewer than half of the 16 chapters are written by active laboratory scientists, however, and as a result, the book suffers from arguments clouded by imprecise use of terminology and preconceptions about genes and their functions. One might consider this book, or parts thereof, for an advanced undergraduate genetics class in which positions counter to the mainstream scientific view are presented and evaluated, and in which students are challenged to critically assess the quality of support for all arguments.The general theme of this book is to question the role of genes (and reproducible molecular mechanisms, more broadly) in cancer, behavior, psychiatric disorders, evolution, and other phenomena. One chapter promotes the tissue organization field theory (TOFT) against the somatic mutation theory of cancer. TOFT was proposed by the chapter authors in 2011 (Soto and Sonnenschein, 2011 ) but has not found traction and has garnered little attention beyond an initial refutation (Vaux, 2011 ). The authors assert that cancer is a disease of development and tissue repair primarily from environmental exposures and independent of genetic changes. Most cancer researchers agree that environmental factors can trigger cell growth but that ensuing mutations complete the picture in the genesis of malignancies. This chapter would be a good starting point from which one could assign students to explore papers cited in the Cancer Genome Atlas database, a growing resource compiling cancer genome data and subsequent validation in other systems of the effects of mutations found. In another chapter, a nonscientist author asserts that “in only a small percentage of cases are genes notable contributors to breast cancer,” implying imprecisely that only rare inherited cancer predisposition is genetic, when in fact cancer stemming from somatic mutations is also gene based. To assert that cancer stems only from environmental effects, to the exclusion of genes, overlooks the intertwining of the two arenas—radiation induces somatic mutations, for example, and estrogen mimics trigger cell division, which sets the stage for additional new mutations during DNA replication. Open in a separate windowOther sections of the book argue a lack of evidence for genetic influence on behaviors and psychiatric conditions. One chapter centers on several refuted ideas of biology and behavior (for example XYY and monoamine oxidase genotypes associated with aggression), with the intended implication that all other biological connections to behavior must be suspect. A chapter on autism accepts but downplays a partial role of genetics in the disorder, while emphasizing environmental exposures. Students exploring this topic could examine the growing literature on de novo mutations found in autism patients (Huguet et al., 2013 ), among other autism studies, to see how interlocking causes of the disorder might best explained by the available data. In the context of disorders such as schizophrenia, the book does not acknowledge or address the literature reporting genetic associations with psychiatric predispositions. In a troubling instance, a cited reference is misrepresented as refuting a genetic connection to schizophrenia; the reference in question (Collins et al., 2012 ) actually reports genome-wide association studies showing linkage of schizophrenia to particular loci (just not to the genes originally suspected). The same research group the previous month reported copy number variations associated with schizophrenia (Kirov et al., 2012 ), but this finding was not cited. Psychiatric genetics is a rich area for students to explore, and the contrarian viewpoint of the book can provide a starting point to trigger students’ delving into the literature.Genetic Explanations: Sense and Nonsense includes two chapters with assertions counter to the neo-Darwinian synthesis of evolution. One claims, fairly misleadingly, that “a growing number of evolutionary biologists … believe that macroevolution was the result of mechanisms other than natural selection.” Another states that “not genomic DNA but epigenetic environmental influences … overwhelmingly affect our health and well being.” The idea that gene regulation via environmental and epigenetic effects is somehow not reducible to genes (and that genes are therefore not central to evolution) would be an interesting subject for students to explore in the literature to see what the data actually support.This book is recommended only for use in advanced classes centered on weighing evidence and dissecting arguments in scientific controversies. The book''s countermainstream assertion of a lack of significant genetic connection to cancer, autism, schizophrenia, and other phenomena provides multiple opportunities for students to explore the scientific literature surrounding such genetic connections.  相似文献   

13.
Successful learning outcomes require the integration of content and meaningful assessment with effective pedagogy. However, development of coherent and cohesive curriculum is seemingly overwhelming even to experienced teachers. Obviously this creates a barrier to successful student learning. Understanding by Design (UbD) overcomes this impasse by providing concise and practical guidance for experienced and inexperienced teachers. In programs sponsored by the National Science Foundation and the National Institutes of Health, teams composed of University of Wyoming graduate students and science teachers from grades 6 to 9 designed motivating, inquiry-based lesson plans intended to get students to think and act like scientists. In this process, teams utilized principles outlined in UbD with great success. UbD describes a practical and useful “backward” design process in which anticipated results are first identified; acceptable evidence for learning outcomes is established and, only then, are specific learning experiences and instruction planned. Additionally, UbD provides procedures to avoid content overload by focusing on “enduring principles.” WHERE, the UbD sieve for activities, was used effectively to develop tasks that are engaging, that are consistent with state educational standards, and that promote self-directed, life-long learning.  相似文献   

14.
In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses a new study that demonstrates the “First, do no harm” principle in a different way. New research on the potentially harmful effects of intravenous lines demonstrates that refraining from routine interventions in labor protects the safety of women and babies. A new systematic review of movement and position changes in labor shows that eliminating unfounded restrictions also protects maternal and infant health and well-being. Finally, a study of patterns of use of neonatal intensive care units reveals how the organization of the maternity care system itself can affect the health outcomes of its beneficiaries.  相似文献   

15.
Genetics instruction in introductory biology is often confined to Mendelian genetics and avoids the complexities of variation in quantitative traits. Given the driving question “What determines variation in phenotype (Pv)? (Pv=Genotypic variation Gv + environmental variation Ev),” we developed a 4-wk unit for an inquiry-based laboratory course focused on the inheritance and expression of a quantitative trait in varying environments. We utilized Brassica rapa Fast Plants as a model organism to study variation in the phenotype anthocyanin pigment intensity. As an initial curriculum assessment, we used free word association to examine students’ cognitive structures before and after the unit and explanations in students’ final research posters with particular focus on variation (Pv = Gv + Ev). Comparison of pre- and postunit word frequency revealed a shift in words and a pattern of co-occurring concepts indicative of change in cognitive structure, with particular focus on “variation” as a proposed threshold concept and primary goal for students’ explanations. Given review of 53 posters, we found ∼50% of students capable of intermediate to high-level explanations combining both Gv and Ev influence on expression of anthocyanin intensity (Pv). While far from “plug and play,” this conceptually rich, inquiry-based unit holds promise for effective integration of quantitative and Mendelian genetics.  相似文献   

16.
Doulas have fundamentally improved the health-care experience of pregnant women internationally. Women who recognize the importance of not being alone during pregnancy have embraced this role for centuries. However, less is known about doulas practicing in countries experiencing health inequities like Colombia. Miller''s methodology and Atkinson''s interview domain was used to answer the question “What life experiences led a Colombian woman to become a doula?” A central theme emerged, “A calling from within: Growing up to accompany the transition from woman to mother.” The path to becoming a doula evolved from life experiences involving health inequities, and a sense of femininity, maternity, and the women''s role in rural Colombia.  相似文献   

17.
Instructors attempting new teaching methods may have concerns that students will resist nontraditional teaching methods. The authors provide an overview of research characterizing the nature of student resistance and exploring its origins. Additionally, they provide potential strategies for avoiding or addressing resistance and pose questions about resistance that may be ripe for research study.
“What if the students revolt?” “What if I ask them to talk to a neighbor, and they simply refuse?” “What if they do not see active learning as teaching?” “What if they just want me to lecture?” “What if my teaching evaluation scores plummet?” “Even if I am excited about innovative teaching and learning, what if I encounter student resistance?”
These are genuine concerns of committed and thoughtful instructors who aspire to respond to the repeated national calls to fundamentally change the way biology is taught in colleges and universities across the United States. No doubt most individuals involved in promoting innovative teaching in undergraduate biology education have heard these or variations on these fears and concerns. While some biology instructors may be at a point where they are still skeptical of innovative teaching from more theoretical perspectives (“Is it really any better than lecturing?”), the concerns expressed by the individuals above come from a deeply committed and practical place. These are instructors who have already passed the point where they have become dissatisfied with traditional teaching methods. They have already internally decided to try new approaches and have perhaps been learning new teaching techniques themselves. They are on the precipice of actually implementing formerly theoretical ideas in the real, messy space that is a classroom, with dozens, if not hundreds, of students watching them. Potential rejection by students as they are practicing these new pedagogical skills represents a real and significant roadblock. A change may be even more difficult for those earning high marks from their students for their lectures. If we were to think about a learning progression for faculty moving toward requiring more active class participation on the part of students, the voices above are from those individuals who are progressing along this continuum and who could easily become stuck or turn back in the face of student resistance.Unfortunately, it appears that little systematic attention or research effort has been focused on understanding the origins of student resistance in biology classrooms or the options for preventing and addressing such resistance. As always, this Feature aims to gather research evidence from a variety of fields to support innovations in undergraduate biology education. Below, we attempt to provide an overview of the types of student resistance one might encounter in a classroom, as well as share hypotheses from other disciplines about the potential origins of student resistance. In addition, we offer examples of classroom strategies that have been proposed as potentially useful for either preventing student resistance from happening altogether or addressing student resistance after it occurs, some of which align well with findings from research on the origins of student resistance. Finally, we explore how ready the field of student resistance may be for research study, particularly in undergraduate biology education.  相似文献   

18.
As cesarean rates have climbed to almost one-third of all births in the United States, current research and professional organizations have identified letting labor begin on its own as one of the most important strategies for reducing the primary cesarean rate. At least equally important, letting labor begin on its own supports normal physiology, prevents iatrogenic prematurity, and prevents the cascade of interventions caused by labor induction. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #1: Let Labor Begin on Its Own,” published in The Journal of Perinatal Education, 16(3), 2007.  相似文献   

19.
At the close of the Society for the Advancement of Biology Education Research conference in July 2012, one of the organizers made the comment: “Misconceptions are so yesterday.” Within the community of learning sciences, misconceptions are yesterday''s news, because the term has been aligned with eradication and/or replacement of conceptions, and our knowledge about how people learn has progressed past this idea. This essay provides an overview of the discussion within the learning sciences community surrounding the term “misconceptions” and how the education community''s thinking has evolved with respect to students’ conceptions. Using examples of students’ incorrect ideas about evolution and ecology, we show that students’ naïve ideas can provide the resources from which to build scientific understanding. We conclude by advocating that biology education researchers use one or more appropriate alternatives in place of the term misconception whenever possible.  相似文献   

20.
Women in the United States are still giving birth in the supine position and are restricted in how long they can push and encouraged to push forcefully by their caregivers. Research does not support these activities. There is discussion about current research and suggestions on how to improve the quality of the birth experience. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions,” published in The Journal of Perinatal Education, 16(3), 2007.  相似文献   

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