Group Workshops Research Articles

Placental pathology as a marker of brain injury in infants with hypoxic ischemic encephalopathy

BackgroundHypoxic Ischemic Encephalopathy (HIE) can lead to devastating consequences for the affected infant. Although therapeutic cooling benefits infants with moderate and severe HIE, differentiating mild from moderate-severe HIE may be challenging. The placenta reflects the fetal intrauterine environment and may reveal underlying processes that affect brain injury. AimTo describe placental histopathology using the Amsterdam Placental Workshop Group Criteria in different grades of HIE. Study designRetrospective cohort. SubjectsInfants admitted to a tertiary care neonatal intensive care unit with a diagnosis of HIE between 2011 and 2016. Outcome measureMaternal and neonatal clinical variables and placental histopathology using the Amsterdam Placental Workshop Group Criteria were compared between mild and moderate-severe HIE. Mann-Whitney or t-test or ꭓ2 were performed for bivariate associations as appropriate. To explain the relationship between placental pathology and severity of HIE odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using logistic regression models. ResultsOf the 73 infants in the study, 23 had mild and 50 moderate-sever HIE. There was no difference in maternal and neonatal characteristics except for sentinel events which were higher in the moderate- severe group. On placental histopathology, acute inflammation, including fetal inflammatory reaction (FIR) were significantly higher in the moderate-severe group. After adjusting for confounders, FIR remained significantly associated with moderate-severe HIE, ORs 6.29, 95 % CI 1.5–25. ConclusionOur study demonstrates FIR in the placenta is associated with severity of HIE.

Paternal Perinatal Depression in Modern-Day Fatherhood.

Postpartum depression in new mothers has become a widely recognized public health concern. Paternal perinatal depression (PPND) and the mental health of fathers in the perinatal period continues to receive significantly less public attention. Overall prevalence rates of up to 25% have been documented in first-time fathers. The presence of maternal depression, unsatisfactory couple relationships, and certain psychosocial and biological risk factors are associated with poor paternal bonding and increased depression risk. Depressed fathers experience excessive self-criticism, restlessness, irritability, and aggression rather than low mood. Depression in new fathers can lead to drug and alcohol abuse, food behavior disorders, and lack of impulse control. PPND leads to developmental delay, mental health disorders, and emotional or behavioral problems in the offspring. PPND may also adversely affect a child's ability to learn new information, with lasting intellectual and scholastic consequences. There currently are no official criteria to diagnose PPND, and neither are there validated screening tools available to fathers. A family-focused approach should be considered in place of the historically gender-focused mood assessment. Nontraditional interventions such as Internet communities, e-therapy, or group workshops are shown to combat a father's contextual understanding of therapy. Group therapy with integrated cognitive behavioral therapy can address masculine norms surrounding the parenting roles of fathers and can help cultivate support networks that are otherwise absent among new dads. PPND is ideally addressed by the adoption of a father-inclusive model of care that shifts the parenting paradigm and provides emotional and parenting support to men as they experience their new role as dad.

On-site communication skills education increases appointment-specific client satisfaction in four companion animal practices in Texas.

To assess the impact of a 15-month, in-practice communication skills intervention on client visit satisfaction. 4 purposely selected veterinary clinics, 9 veterinarians, and 930 appointment-specific client satisfaction surveys. The study was designed as a multipractice, preintervention-postintervention study. Practice teams participated in a 15-month communication skills intervention that included interactive group workshops and one-on-one communication coaching with the entire practice. Client Satisfaction Questionnaires were completed 3 months before (mean, 55 questionnaires/veterinarian) and after (mean, 48 questionnaires/veterinarian) the intervention. The impact of the intervention and factors associated with client visit satisfaction were evaluated with mixed logistic regression. Client satisfaction scores were dichotomized owing to extreme negative skewness. In total, 57% (284/496) of clients were completely satisfied on pretest questionnaires, and 67% (290/434) were completely satisfied on postintervention questionnaires. The odds of clients being completely satisfied were significantly higher after the communication skills intervention (OR = 1.56; P = .002). When controlling for the intervention, predictors of client visit satisfaction included appointment type (odds of being completely satisfied were significantly higher for recheck appointments than for preventative care appointments [OR = 1.71; P = .02] and health problem appointments [OR = 1.99; P = .003]) and duration of the veterinarian-client relationship (probability increased by 0.52 with each 1-year increase in relationship duration; P = .008). Results suggested that the client-centered, skills-based communication intervention resulted in increased client visit satisfaction. Findings contribute to current evidence that client-centered communication and duration of the veterinarian-client relationship promote client satisfaction during veterinary visits.

Responding to the psychological needs of children following admission to paediatric Intensive Care for paediatric inflammatory multisystem syndrome: A Narrative Therapy based Photography Workshop.

This article briefly describes the development of a novel narrative therapy-based photography workshop group for children following acute hospital admission for Paediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS). The workshop was a collaboration between the psychology team, an artist and the medical multi-disciplinary team (MDT) to develop a group during the COVID-19 pandemic. The aims were to reduce isolation and promote resilience and psychological recovery post discharge from hospital. Nine children aged 8-11 years joined the photography group. Parents (n = 8) and children (n = 8) provided feedback on the group through semi-structured telephone interviews. Thematic analysis of the interviews identified three narrative themes for parents: reducing isolation through shared experience, creative activity as a different experience of hospital, and the positive sharing of experiences after the day. The resulting narrative themes for the children included that the workshop was a fun and interactive day and an opportunity to share in hospital experience with peers.

How to co-design a health literacy-informed intervention based on a needs assessment study in chronic obstructive pulmonary disease

ObjectiveTo develop a co-designed health literacy (HL)-informed intervention for people with chronic obstructive pulmonary disease (COPD) that enables them to find, understand, remember, use and communicate the health information needed...

Perceptions of sugar-sweetened beverages among adolescents in North Carolina.

IntroductionSugar-sweetened beverage (SSB) consumption among adolescents contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health.ObjectiveTo better understand adolescents' perceptions, attitudes, and consumption behaviors around SSBs by conducting virtual workshop discussions with adolescents in NC.Materials and methodsAdolescents ages 11–17 in communities with a high proportion of Supplemental Nutrition Assistance Program (SNAP) eligible households were selected to participate in a series of virtual group workshops during summer 2021. A semi-structured discussion guide was used by a workshop facilitator. Workshop discussions centered around general health perceptions, SSB perceptions, and consumption behaviors. A thematic analysis was used to summarize knowledge, beliefs, attitudes, and perceptions around SSBs.ResultsApproximately 36 adolescents participated across four group workshops. Parents and caregivers influenced adolescents most when it came to making beverage choices. Positive SSB perceptions included liking the taste and the association with special times and social events. Negative opinions focused on associated health risks (diet-related chronic disease and poor oral health). Some adolescents acknowledged SSBs were not healthy but suggested they could be consumed occasionally. Very few participants mentioned any benefits from SSBs; those that mentioned benefits stated they provided energy, replaced electrolytes, and tasted good.ConclusionFindings provide several key insights that can contribute to the development of messages aimed at curbing SSB consumption among adolescents. For example, messages that focus on catching adolescents' attention and sharing short- and long-term health consequences of high SSB consumption resonated with adolescents, but because occasional SSB intake was not seen as consequential, messages that suggest abstinence from SSBs may not be helpful in reducing consumption.

Maternal folate status and placental vascular malperfusion: Findings from a high-risk US minority birth cohort

IntroductionMaternal folate deficiency was associated with preeclampsia (PE) and PE was associated with placental maternal vascular malperfusion (MVM). However, no study has examined the association of maternal folate status with placental MVM. MethodsWe examined the association of maternal folate status and placental MVM in the Boston Birth Cohort. Primary exposure variables were maternal self-reported multivitamin supplement (<2, 3–5, >5 times/week) per trimester; and plasma folate levels (nmol/L) after birth. Primary outcome was presence/absence of placental MVM defined by the Amsterdam Placental Workshop Group standard classification. Covariates included demographics, chronic hypertension, clinically diagnosed PE, eclampsia and HELLP syndrome, gestational and pre-gestational diabetes, overweight/obesity, maternal cigarette smoking and alcohol use. Associations between folate and placental MVM were evaluated using multivariate logistic regressions. ResultsOf 3001 mothers in this study, 18.8% of mothers had PE, 37.5% had MVM. Mothers with the lowest self-reported frequency of folate intake had the highest risk of MVM (OR 1.45, 95% CI 1.03–2.05), after adjusting for the covariates. Consistently, among a subset of 939 mothers with plasma folate levels, folate insufficiency was associated with increased risk of MVM (OR 1.65, 95% CI 1.03–2.63), after adjusting for the covariables. As expected, mothers with low folate and placental MVM had highest rates of PE compared to those of high folate and no MVM (p < 0.001). DiscussionIn this high-risk birth cohort, low maternal folate status was associated with increased risk of placental MVM. Further investigation should explore the association between folate status, placental findings and the great obstetrical syndrome.

Cumulative effect of maternal vascular malperfusion types in the placenta on adverse pregnancy outcomes

IntroductionPlacental vascular disease, characterized by Maternal Vascular Malperfusion (MVM) lesions, is considered to be the underlying cause of pregnancy complications. Aim is to evaluate the relationship between the cumulative number of MVM lesion types, and adverse pregnancy- and neonatal outcomes. MethodsThis retrospective cohort study included 272 women with singleton gestations who gave birth at a Dutch tertiary hospital between 2017 and 2018 with available placental histopathology reports. Analyzed according to the Amsterdam Placental Workshop Group Consensus Statement, placentas were divided into groups based on the cumulative number of MVM lesions: no lesions (n = 124), 1–2 types (n = 124) and 3–5 types of lesions (n = 24). ResultsThe proportion of placenta syndrome (PS) was highest (95.8%) in the 3–5 MVM lesions group (p < 0.001). The presence of MVM lesions was highly associated with PS during pregnancy (aOR 6.81, 95% CI 3.76–12.33). Furthermore, every additional type of MVM lesion corresponded with a threefold increased odds for the occurrence of PS (aOR 3.00, 95% CI 2.10–4.29). The group with 3–5 types of MVM lesions showed the highest incidence of adverse neonatal outcomes, lower mean birth weight, prolonged hospitalization, NICU admissions and neonatal deaths (aOR 6.47, 95% CI 0.33–127.68), corresponding with a fourfold increased odds for the occurrence of neonatal death for every additional MVM lesion (aOR 4.19, 95% CI 1.39–12.68). DiscussionA higher number of MVM lesion types is strongly associated with an increased incidence of adverse pregnancy- and neonatal outcomes, indicating that guidelines should focus also on the amount of MVM lesion types for the monitoring/management of subsequent pregnancies.

An Integrated Assessment of the Horticulture Sector in Northern Australia to Inform Future Development

The horticulture sector in northern Australia, covering north of Western Australia (WA), Northern Territory (NT), and north Queensland (QLD), contributes $1.6 billion/year to the Australian economy by supplying diverse food commodities to meet domestic and international demand. To date, the Australian Government has funded several studies on developing the north’s agriculture sector, but these primarily focused on land and water resources and omitted an integrated, on-ground feasibility analysis for including farmers’/growers’ perspectives. This study is the first of its kind in the north for offering a detailed integrated assessment, highlighting farmers’ perspectives on the current state of the north’s horticulture sector, and related challenges and opportunities. For this, we applied a bottom-up approach to inform future agriculture development in the region, involving a detailed literature review and conducting several focus group workshops with growers and experts from government organisations, growers’ associations, and regional development agencies. We identified several key local issues pertaining to crop production, availability of, and secure access to, land and water resources, and workforce and marketing arrangements (i.e., transport or processing facilities, export opportunities, biosecurity protocols, and the role of the retailers/supermarkets) that affect the economic viability and future expansion of the sector across the region. For example, the availability of the workforce (skilled and general) has been a challenge across the north since the start of the COVID-19 pandemic in 2020. Similarly, long-distance travel for farm produce due to a lack of processing and export facilities in the north restricts future farm developments. Any major investment should be aligned with growers’ interests. This research highlights the importance of understanding and incorporating local growers’ and researchers’ perspectives, applying a bottom-up approach, when planning policies and programs for future development, especially for the horticulture sector in northern Australia and other similar regions across the globe where policy makers’ perspectives may differ from farmers.

Placental pathologic lesions associated with stroke in term neonates.

ObjectiveTo determine the birth prevalence of perinatal stroke in term born infants at our high-volume delivery center and assess the frequency of both gross and histologic placental pathologies associated with perinatal stroke using the Amsterdam Placental Workshop Group Consensus Statement guidelines and definitions.Study DesignA single-center retrospective cohort study spanning 2010-2020.ResultsThere were 129,759 live births at Parkland Hospital during the study period and a total of 18 term born infants leading to a birth prevalence of 1 in 6,829 infants. Perinatal risk factors were found in all but one patient, and 74% presented with seizures. Pathologic placental examination was available in 56% of the cohort and only one patient had normal placental examination. Acute histologic chorioamnionitis was described in five placentas (50%) and an additional two had isolated umbilical and/or chorionic plate vasculitis with or without funisitis compared to a rate of 28% with acute inflammation in a Control group. Chronic inflammation in the form of villitis of unknown etiology was described in three of the acutely inflamed placentas and was high-grade in each of those while none of the placentas from our Control group showed evidence of any chronic lesion.ConclusionBoth acute and chronic placental inflammation are common in perinatal stroke; placental examination should be considered an essential component to the diagnostic workup.

Aspirational hope, dairy farming practices, and milk production: Evidence from a randomized controlled trial in Bolivia

Development economics has increasingly studied the role of diminished aspirations and other internal constraints that may form poverty traps. We present results from a controlled experiment to develop aspirational hope among 531 dairy farmers in Bolivia. Subjects in the treatment group participated in three coaching sessions that involved watching an inspiring documentary and participating in group workshops designed to augment aspirations related to dairy production. Results three months after baseline show an increase of 0.20σ in both an aspirational hope index and a business goals index, a 1.07σ increase in an index of quality-enhancing practices, but an insignificant increase in milk production. Increases in aspirations and best practices were strongest among those displaying high levels of intrinsic motivation at baseline.

237.2: Transplant Procurement Management: 30 Years of International Training Program in Organ and Tissue Donation

Background: The educational project called Transplant Procurement Management (TPM) was launched in 1991 as a specialised program which main goal is to train health professionals in the field of organ donation for transplantation. Since then, 376 courses have been developed in 44 countries training 15575 health care professionals. The objective is to analyse the impact of the training in the donation rates on those countries where the TPM training has been developed nationally as part of a continuous professional development plan. Methods: TPM offer is organized by levels (introductory, intermediate, advanced) and training modalities (face-to-face, online, blended), with a result of tailored-made courses according to each country needs. Its core program goes through the clinical process of donation for transplantation and its methodology combines theoretical sessions with hands-on workshops in small groups, simulations, cases discussion and debate. Special attention is given to innovative tools: for donor detection workshop, a videogame has been developed to practice how to detect and evaluate donors in a virtual hospital; to practice communication of bad news and family interview for donation consent, an immersive experience with virtual reality has been designed. The impact of the training has been measured through a retrospective study that includes the organ donation rates published in IRODaT during the period 2009-2019 in 8 countries and the number of participants registered in our database. Results: The number of participants trained in these countries from 2009 to 2019 has been as follows: China, 1395; Croatia, 166; Iran, 318; Italy, 2268; Portugal, 301; Slovenia, 263; Thailand, 189; UAE, 283. The donation rates in all countries have increased during the period 2009-2019 in the following: China, 108%; Croatia, 99%, Iran, 394%, Italy, 16%, Portugal, 9%, Slovenia, 24%, Thailand, 217%, UAE, 110%. Conclusions: An increment of the donation rates has been demonstrated in all countries of the study being higher in those countries with lower initial rates. Therefore, TPM courses have been proven effective in those countries with a national strategy to increase the donation activity that includes education. Education is, among other factors, crucial in the development of donation and transplantation systems at regional or national level. Throughout these 30 years TPM has contributed to the professionalization of health professionals involved in this development and will keep on this endeavour.

Developing a pharmacist-led intervention to provide transitional pharmaceutical care for hospital discharged patients: A collaboration between hospital and community pharmacists

BackgroundPatients who transfer from the hospital back to the community are at risk of experiencing problems related to their medications. Hospital pharmacists (HPs) and community pharmacists (CPs) may play an important role and provide transitional pharmaceutical care in transition of care interventions. ObjectiveTo describe how a pharmacist-led intervention to provide transitional pharmaceutical care for hospital discharged patients was developed, utilizing already existing pharmacist interventions in the hospital and community pharmacy. MethodsA mixed-method approach to intervention development was applied. Existing evidence was identified through a literature review of effective transitional care interventions and existing services in the hospital and community pharmacy. Focus group interviews and a workshop were carried out with HPs and CPs to identify their perceived facilitators and uncertainties in relation to intervention development. The final intervention and the expected outcomes were developed in an expert group workshop. Finally, the hospital part of the intervention was tested in a small-scale feasibility study to assess what type of information the HP would transfer to the CP for follow up. ResultsFive components were identified through the 209 systematic reviews: pharmacist-led medication reconciliation, pharmacist-led medication review, collaboration with general practitioners (GPs), post discharge pharmacist follow up and patient counseling or education. HPs and CPs identified uncertainties related to the relevance of the information sent from the HP to the CP, identification of patients at the community pharmacy and communication. The expected outcomes for the patients receiving the intervention were an experience of increased safety and satisfaction and less use of healthcare resources. The feasibility study led to optimization of language and structure of the pharmacist referrals that were used to transfer information from the HP to the CP. ConclusionA patient centered intervention to provide transitional pharmaceutical care for hospital discharged patients was developed using existing evidence in transition of care, HPs and CPs, an expert group, and a small-scale feasibility study. A full-scale feasibility test of the intervention should be carried out for it to be further refined.

Placental dysfunction in congenital heart disease: Insights from anatomical pathology

Women with congenital heart disease are at increased risk of obstetric and fetal complications during pregnancy. Placental dysfunction seems to emerge among the different etiological hypotheses. However, studies supporting this pathway are scarce, especially histopathological studies. The objectives of this study were to describe the placental lesions observed in pregnant women with CHD and to compare these findings with placentas from a control group of healthy women. In this single-center prospective study, we reported the results of 69 histopathological analyses (43 placentas from CHD and 26 from healthy women). Pathological findings were classified according to the Amsterdam Placental Workshop Group Consensus. In the control group, patients with comorbidities or risk factors for pre-eclampsia or fetal growth restriction were excluded. Patients were matched for age and BMI. Median gestational age at delivery was 38 [36–38.5] weeks for CHD group vs. 39.4 [38.5–40] weeks for control group ( P < 0.001). Pathologies were identified in 84% of CHD placentas vs. 42% of healthy placentas ( P < 0.001). Among the CHD group, there was 49% of anatomic pathologies, the main one being low placental weight for gestational age (95%). There was also 46% of vascular, 16% of infectious and 9% of inflammatory pathologies. The rate of small placentas for gestational age was significantly higher in the CHD group (46% vs. 15%, P = 0.009). As vascular pathologies, maternal vascular malperfusion (MVM) was significantly more frequent in CHD placentas (28% vs. 8%, P = 0.043). There was no significant difference between groups for infectious, inflammatory and other lesions: choriomanionitis, chorangiosis and villitis ( Fig. 1 ). Pregnant women with CHD had significantly more placental histopathologic abnormalities than healthy women. The most common placental pathologies were anatomic and vascular abnormalities. Small placenta for gestational age and MVM were significantly more present in CHD placentas. These results support the hypothesis of placental dysfunction in CHD women.

Study protocol for a hybrid effectiveness-implementation trial of the Building Better Caregivers online workshop for rural family/friend caregivers of people living with dementia

IntroductionDementia caregiving is complex and disproportionally burdens caregivers living in rural areas due to fewer resources and formal support systems. There is an immediate need to identify effective, scalable, and accessible online programs to support rural caregivers' well-being. Building Better Caregivers (BBC), a possible solution, is an asynchronous online 6-week, interactive, and skills-building workshop developed for caregivers of persons with dementia. This research aims to assess the effectiveness and implementation of the BBC workshop when delivered among rural dementia caregivers in the United States. MethodsA hybrid effectiveness and implementation trial applying mixed methods will be conducted in collaboration with local, state, and national partnering organizations. Eligible participants live in a rural area of the United States, give care at least 10 h a week for a family member or friend with dementia, and have internet access. Evaluation is based on the RE-AIM framework. Effectiveness outcomes are assessed using a randomized control trial. Caregivers are randomly assigned to the BBC workshop (intervention) or attention control group. Implementation outcomes are assessed using surveys and debriefing interviews from partnering organizations and participants. The study protocol including the study design, methods of recruitment and assessment, and outcomes are described. ConclusionThis is the first known study to evaluate both the effectiveness and implementation of a caregiver support intervention under real-world conditions in rural areas. If successful, this online workshop will be a practical and acceptable approach for promoting the health and well-being of geographically isolated rural dementia caregivers.

Small group training as an effort to reduce stunting on toddlers in the working area of Puskesmas Kandang Sapi, Pasuruan

Background: The World Health Organization (WHO) said that South East Asia has a high stunting prevalence, where it is estimated that 22.2% of toddlers are stunted globally. The reality is that there are still many cases of inaccurate measurement methods, which question the validity of stunting prevalence. This study aims to know if small group training is effective in reducing stunting prevalence in toddlers. Methods: This descriptive study was done at all Posyandu in Bugul Lor from August to September 2019. Populations in this study were all helpers at Posyandu. Samples in this study were all helpers who met inclusive criteria but didn’t meet exclusive criteria. The inclusion criteria were helpers who attended when the study was conducted (5 helpers in each Posyandu), and the exclusive criteria were illiterate helpers. We used measurement guidelines from IDAI. The Group workshop started with a briefing about making sure that all tools were correctly set. Next, all helpers were asked to do height measurements, and if there was any error, we showed them how to do it correctly and let them do it again. We then compared the data before and after the intervention. Data from February 2019 were used as data before the intervention. Results: No helper in 10 Posyandu measured correctly. But after the group workshop, a helper from 8 Posyandu could measure correctly. Stunting prevalence in Bugul Lor decreased by about 4%. Conclusion: Group workshop seems to be effective in reducing stunting prevalence in toddlers.

Using Lego® Bricks to Build a Growth Mindset: A Case Study

This case study illustrates how building with Lego® bricks was used to help an athlete identify instances of growth mindset in his play such that this could help him overcome fix mindset thinking. The player, a member of a trophy winning hurling squad, was self-motivated and had developed a strategy of saying, “No” to avoid becoming injured due to ‘over playing’. He participated in a Lego® Serious Play® in Positive Psychology group workshop, the theme of which was the growth mindset. As a result, he was able to determine how he could work from fixed mindset triggers to more growth mindset beliefs. He was then able to transform his thinking from a stance where he felt he had to protect himself from the demands of others to realizing they can contribute to him as he developed as a player. He reported that building with Lego® bricks helped him “form new ideas in ways that you wouldn’t be able to do just through your mind”. This report demonstrates how a growth mindset workshop which incorporated Lego® Bricks can support player development after the experience adverse circumstances.

Addressing social and institutional vulnerabilities in the context of flood risk mitigation

AbstractThere are different perspectives of what constitutes disaster risk. Among the “hazards”‐tradition research, more focus is given to modelling hazards, and less effort is made to understand the vulnerabilities. Considering vulnerabilities as the inherent characteristics of the place that create the potential to harm, this paper highlights the importance of understanding the vulnerabilities of the place before defining actions for flood risk mitigation (FRM). In this sense, a participatory approach, the Project PLANEJEEE, was developed to understand the social and institutional vulnerabilities of FRM in Campina Grande, Brazil. Data was collected with the collaboration with 199 stakeholders through surveys, workshop and focus groups. The results reflect the analysis of risk perception and coping capacity of communities at risk (n = 172), and the institutional context with the involvement with policymakers and local specialists (n = 27). Although results confirm that individuals faced severe flood risk cases previously, they still need resources for increasing their coping capacity and their own risk protection. Institutional vulnerabilities are shown with the contrast between challenges and actions for FRM. Findings show that multiple challenges in social and institutional contexts should be systematically addressed to propose actions to reduce flood risk vulnerability, and increase resilience.

Participatory Action Research to Co-Design Internet-Based HIV Prevention with Young Men Who Have Sex with Men in HIV Prevention in Bali, Indonesia

There is increasing awareness of the need to develop innovative and relevant methodologies to best capture the voices of Young Men Who Have Sex with Men (YMSM), which will inform HIV prevention. This article discusses the process of researching with YMSM in Bali, the solution to methodological gaps in research for Internet-based HIV prevention. This research endorsed the Habermas Communicative Action Theory which was then translated to Participatory Action Research (PAR) methodology. Nine YMSM aged 18-24 years old participated in this research through multiple research activities for four months. Data collection included structured group meetings, group workshops, informal participant observations, and after-hour conversations over afternoon tea and shared meals. Participants used a range of visual and digital media to share their collective ideas and different trial strategies. We argue for the opportunity for participatory action research to strengthen the roles of YMSM in HIV prevention.

Association of Placental Pathologic Findings with the Severity of Necrotizing Enterocolitis in Preterm infants – A Matched Case-Control Study

Objective To determine the association of placental pathology with the severity of necrotizing enterocolitis (NEC) in preterm infants. Methods This single-center matched case-control study included infants with NEC (n = 107) and gestational age and birth weight-matched controls (n = 130), born between 2013 and 2020. Placentas were evaluated according to the Amsterdam Placental Workshop Group Consensus Statement. Results Acute histologic chorioamnionitis with the fetal response was significantly more common in infants with surgical NEC vs. medical NEC (35.4% vs. 15.3%; p = 0.02). On regression model, infants with multiple placental pathologies (OR 2.16; 95% CI 1.01 − 4.73; p = 0.04) and maternal vascular malperfusion (OR 2.2; 95% CI 1.12 − 4.51; p = 0.02) had higher odds of either medical or surgical NEC than controls. Conclusion Infants with multiple placental lesions, including placental inflammatory and vascular lesions, were at higher risk of medical or surgical NEC in the postnatal period.