Theresa H. M. Kim

Obstetrical and Neonatal Outcomes of Methadone-Maintained Pregnant Women: A Canadian Multisite Cohort Study

OBJECTIVE To describe obstetrical and neonatal outcomes including neonatal abstinence syndrome (NAS) in a Canadian cohort of methadone-maintained pregnant women. METHODS We conducted a retrospective chart review at three integrated care programs in Vancouver, Toronto, and Montreal. Pregnant women on methadone maintenance treatment (MMT) who attended for care between 1997 and 2009 were included in this multisite study. Maternal and neonatal outcomes in each of the three contributing centres were compared. RESULTS A total of 94 pregnant methadone-maintained women were included in the final analysis: 36 from Toronto, 36 from Vancouver, and 22 from Montreal. Maternal demographics showed inter-site differences in ethnicity and marital status. Obstetrical complications were not frequent; the most frequent was antenatal hemorrhage, which occurred in 14% of the total cohort. The incidence of premature labour was significantly higher in Vancouver and Montreal than in Toronto. The mean gestational age at delivery for the entire cohort was 38 weeks; mean birth weight was 2856 grams. The average length of hospital stay for babies with NAS was 19 days, with 27% of neonates requiring pharmacological treatment for NAS. Approximately 60% of neonates were discharged from hospital to the care of their mother. CONCLUSION Integrated care programs resulted in satisfactory obstetrical and neonatal outcomes for pregnant women on MMT. Policies promoting maternal-newborn contact, rooming-in, and breastfeeding may help to decrease the severity of NAS and the need for pharmacological treatment of NAS. We strongly recommend the development of similar programs across Canada to address gaps in services.

The mental-attention Tai Chi effect with older adults.

BackgroundTai Chi practice has some fitness, wellness, and general cognitive effects in older adults. However, benefits of Tai Chi on specific mental-attentional executive processes have not been investigated previously. We studied older Canadian adults of Chinese and non-Chinese origin and from low socioeconomic areas.MethodsSixty-four adults (51–87 years old) took part in a 16-week Tai Chi program. There were two groups: Chinese-background (n = 35) and Non-Chinese-background (n = 29). They received four mental-attention executive tasks before and after the 16-week period. These tasks measured visuospatial reasoning, mental-attentional activation (working memory), attentional inhibition, and balance between these attention factors (field-dependence-independence).ResultsChinese participants showed significant gain on Figural Intersections Task (mental-attentional capacity), Antisaccade (attentional inhibition), and Matrix Reasoning (fluid intelligence measure). Both groups evidenced gain on the Water Level Task (attentional balance).ConclusionsThese gains suggest that Tai Chi can improve mental-attentional vigilance and executive control, when practitioners are sufficiently motivated to pursue this practice, and apply themselves (as our Chinese participants seem to have done). We found that Tai Chi enhanced mental attentional executives in the Chinese sample. The largely negative results with Non-Chinese participants might be explained by less strong motivation and by the relatively short Tai Chi practice period, which contrasts with the prior familiarity with Tai Chi of the Chinese participants.

Quantification of adipose volume reduction with a prospective study analyzing the application of external radiofrequency energy and high voltage ultrashort pulse duration electrical fields

To date, there have been no objective measurements of subcutaneous volume loss following treatments with a noninvasive radiofrequency (RF)-based device. Twenty female patients were treated with a suction-coupled bipolar RF device using external RF energy combined with pulsed electromagnetic RF energy for subcutaneous fat reduction. Parameters followed included weight, Vectra measurements of abdominal circumference and torso volume, and high-definition ultrasound measurements of fat thickness. Measurements were taken before treatment and three times following treatment. Analysis of the measured parameters showed that mean circumference reduction of 2.30 cm was noted at three months post-treatment. Independent volumetric analysis showed a mean subcutaneous volume reduction of 428 cc three months following RF treatment. High-resolution ultrasound fat thickness was reduced by a mean of 39.6% three months following the final BodyFX treatment. Independent and paired-sample t-tests showed a p value of < 0.05. Repeated measures of analysis of covariance (ANCOVA) adjusted for differences in age, as well as height and weight (proxy for body mass index) to minimize individual differences and control for extraneous variables that may affect the pre- and post-treatment results were analyzed. No confounding variables were found. All analyses were conducted using IBM SPSS 21.0.