Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

Seagrass ecosystems as a globally significant carbon stock

The protection of organic carbon stored in forests is considered as an important method for mitigating climate change. Like terrestrial ecosystems, coastal ecosystems store large amounts of carbon, and there are initiatives to protect these ‘blue carbon’ stores. Organic carbon stocks in tidal salt marshes and mangroves have been estimated, but uncertainties in the stores of seagrass meadows—some of the most productive ecosystems on Earth—hinder the application of marine carbon conservation schemes. Here, we compile published and unpublished measurements of the organic carbon content of living seagrass biomass and underlying soils in 946 distinct seagrass meadows across the globe. Using only data from sites for which full inventories exist, we estimate that, globally, seagrass ecosystems could store as much as 19.9 Pg organic carbon; according to a more conservative approach, in which we incorporate more data from surface soils and depth-dependent declines in soil carbon stocks, we estimate that the seagrass carbon pool lies between 4.2 and 8.4 Pg carbon. We estimate that present rates of seagrass loss could result in the release of up to 299 Tg carbon per year, assuming that all of the organic carbon in seagrass biomass and the top metre of soils is remineralized.

Group presence in virtual worlds: Supporting collaborative e-learning

Even though e-learning endeavors have significantly proliferated in recent years, current e-learning technologies provide poor support for group-oriented learning. The now popular virtual world's technologies offer a possible solution. Virtual worlds provide the users with a 3D - computer generated shared space in which they can meet and interact through their virtual representations. Virtual worlds are very successful in developing high levels of engagement, presence and group presence in the users. These elements are also desired in educational settings since they are expected to enhance performance. The goal of this research is to test the hypothesis that a virtual world learning environment provides better support for group-oriented collaborative e-learning than other learning environments, because it facilitates the emergence of group presence. To achieve this, a quasi-experimental study was conducted and data was gathered through the use of various survey instruments and a set of collaborative tasks assigned to the participants. Data was gathered on the dependent variables: Engagement, Group Presence, Individual Presence, Perceived Individual Presence, Perceived Group Presence and Performance. The data was analyzed using the statistical procedures of Factor Analysis, Path Analysis, Analysis of Variance (ANOVA) and Multivariate Analysis of Variance (MANOVA). The study provides support for the hypothesis. The results also show that virtual world learning environments are better than other learning environments in supporting the development of all the dependent variables. It also shows that while only Individual Presence has a significant direct effect on Performance; it is highly correlated with both Engagement and Group Presence. This suggests that these are also important in regards to performance. Developers of e-learning endeavors and educators should incorporate virtual world technologies in their efforts in order to take advantage of the benefit they provide for e-learning group collaboration.