PEANUTS
New $3 million grant supports research on leading cause of maternal mortality worldwide
MU researcher Laura Schulz has dedicated her career to studying the intricacies of maternal health related to the placenta, research that advances knowledge on common diseases like preeclampsia
Grant and Award AnnouncementUniversity of Missouri researchers are striving to find solutions to the leading cause of maternal mortality in the world — preeclampsia. For Laura Schulz, an associate professor of obstetrics, gynecology and women’s health in the University of Missouri School of Medicine, understanding the root causes of preeclampsia and other complicated, life-threatening maternal conditions is pivotal in advancing women’s health care.
Supported by a renewed $3 million grant from the National Institute of Child Health and Human Development (NICHD), Schulz and her team will use trophoblast cells, which are cells that develop in the placenta and provide nutrients to the growing embryo, to understand how placental defects that cause preeclampsia function. The goal is to learn the disease’s tell-tale signs, which would enable doctors to diagnose, treat, and, ultimately, prevent preeclampsia.
Joining Schulz on the project is co-principal investigator R. Michael Roberts at MU and co-investigators Toshihiko Ezashi at the Colorado Center for Reproductive Medicine and Danny Schust at Duke University.
“Preeclampsia is characterized by high blood pressure and protein in the urine, and it can progress to multisystem organ failure,” Schulz said. “It can also cause stroke, postpartum hemorrhage or, commonly, premature birth, which has all kinds of consequences for the baby.”
While scientists can easily observe the placenta at birth, one of the challenges in studying this disease is that the remodeling of spiral arteries in the uterus — those that supply blood to the placenta — occurs in the first trimester, making it particularly difficult to study as it’s happening. Spiral artery remodeling appears to go wrong in preeclampsia. To study the early stages of pregnancy, without impacting the pregnancy, the researchers are examining umbilical cord cells after the birth occurs.
“What we do is take umbilical cord cells from either a normal pregnancy, or one complicated by preeclampsia after the baby’s been born,” Schulz said. “Then we re-program these cells to turn them into trophoblast cells. That way we can look at cells that resemble placental cells and try to figure out what might be going on in early pregnancy that can lead to the development of all these problems.”
In a prior study, the research team developed umbilical cord-based cell models to test whether they could recapitulate any of the features that are often seen in preeclampsia patients. This new funding will allow for an expansion of this work to make organoids — three-dimensional tissue cultures derived from trophoblast cells — so the researchers can understand the architecture of the tissues and to make specific kinds of trophoblast, the cells of the placenta, to learn more about how this organ works.
“I started off as a comparative reproductive biologist,” Schulz said. “I was mostly interested in how pregnancy happens in different kinds of animals and species-specific factors. And then I got more interested in human pregnancy when I joined an OB-GYN department and learned the implications for women's health and their babies. Now, I’m broadly interested in how we make healthier pregnancies and a more favorable maternal environment during pregnancy while optimizing fetal bone and muscle growth.”
Childbearing, infertility, and career trajectories among women in medicine
JAMA Network Open
Peer-Reviewed PublicationAbout The Study: In this survey study, women physicians reported that career-related pressures influenced the timing of childbearing and led to marked alterations to career trajectories to accommodate family building and parenthood. These findings suggest that fertility and family building concerns among women in medicine may contribute to ongoing gender disparities and attrition and represent a potentially critical area for policy reform and future change.
Authors: Jennifer B. Bakkensen, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2023.26192)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
JOURNAL
JAMA Network Open
Investigators identify translation gaps in instrument that measures nursing practice environment
IMAGE: EILEEN T. LAKE, PH.D. RN, FAAN, PROFESSOR OF NURSING, THE EDITH CLEMMER STEINBRIGHT PROFESSOR IN GERONTOLOGY, ASSOCIATE DIRECTOR OF THE CENTER FOR HEALTH OUTCOMES AND POLICY RESEARCH view more
CREDIT: UNIVERSITY COMMUNICATIONS
PHILADELPHIA (July 27, 2023) – Two decades ago, the Practice Environment Scale of the Nursing Work Index was published to measure the nursing practice environment. Although the instrument's use has resulted in advances in science and quality improvement efforts, its potential may be limited by the availability and quality of translations into different languages.
Researchers from the University of Pennsylvania School of Nursing (Penn Nursing) investigated published translations of the instrument and have identified translations into 24 languages and 15 language variants representing 35 countries. Languages in Europe, Southeast Asia, and the Middle East comprise most translations. Translation gaps are noted for countries in Africa, Asia, and South America. While most translations exhibited cross-cultural equivalence and sound psychometric properties, the gaps indicate an area of opportunity that, when addressed, could further support worldwide quality and safety of care, and improve patient health outcomes as well as nurse job outcomes.
“In countries and regions where a translation is available, managers can survey their registered nurses to assess the quality of their work environments and compare them with published referents,” suggests Penn Nursing’s Eileen T. Lake, Ph.D. RN, FAAN, Professor of Nursing, the Edith Clemmer Steinbright Professor in Gerontology, Associate Director of the Center for Health Outcomes and Policy Research, and lead author of the article. “In countries without published translations, healthcare managers should consider collaborating with regional schools of nursing to support translation efforts by permitting their staff nurses to volunteer as research participants.”
The research suggests that additional cultural equivalence or psychometric evaluation is warranted for half of the available translations. In addition, more robust reporting of the translation processes and results is needed. The article “Translations of the Practice Environment Scale of the Nursing Work Index: A Systematic Review” details the findings. It has been published in Nursing & Health Sciences and is available online.
Co-authors of the article include Kathleen E. Fitzpatrick Rosenbaum, BSN, RN, RNC-NIC, CCRN-K, Christina Sauveur, BSN, Catherine Buren, and Priscilla Cho, BSN, all of Penn Nursing. Kathleen E. Fitzpatrick Rosenbaum's predoctoral fellowship is supported by funding from the National Institute of Nursing Research, National Institutes of Health (Aiken, PI; T32NR007104).
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About the University of Pennsylvania School of Nursing
The University of Pennsylvania School of Nursing is one of the world’s leading schools of nursing. For the eighth year in a row, it is ranked the #1 nursing school in the world by QS University. For the second year in a row, our Bachelor of Science in Nursing (BSN) program is ranked # 1 in the 2023 U.S. News & World Report’s Best Colleges rankings. Penn Nursing is also consistently ranked highly in the U.S. News & World Report annual list of best graduate schools and is ranked as one of the top schools of nursing in funding from the National Institutes of Health. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook, Twitter, LinkedIn, & Instagram.
JOURNAL
Nursing and Health Sciences
ARTICLE TITLE
Translations of the Practice Environment Scale of the Nursing Work Index: A Systematic Review
ARTICLE PUBLICATION DATE
28-Jul-2023
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