An individual’s birthweight, a marker of in utero exposures, was recently associated with certain psychiatric conditions. However, studies investigating the relationship between an individual’s preterm birth status and/or birthweight and risk for depression during adulthood are sparse; we used data from the Women’s Health Initiative (WHI) to investigate these potential associations. At study entry, 86,925 postmenopausal women reported their birthweight by category (<6 lbs., 6–7 lbs. 15 oz., 8–9 lbs. 15 oz., or ≥10 lbs.) and their preterm birth status (full-term or ≥4 weeks premature). Women also completed the Burnham screen for depression and were asked to self-report if: (a) they had ever been diagnosed with depression, or (b) if they were taking antidepressant medications. Linear and logistic regression models were used to estimate unadjusted and adjusted effect estimates. Compared to those born weighing between 6 and 7 lbs. 15 oz., individuals born weighing <6 lbs. (βadj = 0.007, P < 0.0001) and ≥10 lbs. (βadj = 0.006, P = 0.02) had significantly higher Burnam scores. Individuals born weighing <6 lbs. were also more likely to have depression (adjOR 1.21, 95% CI 1.11–1.31). Individuals born preterm were also more likely to have depression (adjOR 1.18, 95% CI 1.02–1.35); while attenuated, this association remained in analyses limited to only those reportedly born weighing <6 lbs. Our research supports the role of early life exposures on health risks across the life course. Individuals born at low or high birthweights and those born preterm may benefit from early evaluation and long-term follow-up for the prevention and treatment of mental health outcomes.

Emerging evidence suggests that preterm-born individuals (<37 weeks gestation) are at increased risk of developing chronic health conditions in adulthood. This study compared the prevalence, co-occurrence, and cumulative prevalence of three female predominant chronic health conditions – hypertension, rheumatoid arthritis [RA], and hypothyroidism – alone and concurrently. Of 82,514 U.S. women aged 50–79 years enrolled in the Women’s Health Initiative, 2,303 self-reported being born preterm. Logistic regression was used to analyze the prevalence of each condition at enrollment with birth status (preterm, full term). Multinomial logistic regression models analyzed the association between birth status and each condition alone and concurrently. Outcome variables using the 3 conditions were created to give 8 categories ranging from no disease, each condition alone, two-way combinations, to having all three conditions. The models adjusted for age, race/ethnicity, and sociodemographic, lifestyle, and other health-related risk factors. Women born preterm were significantly more likely to have any one or a combination of the selected conditions. In fully adjusted models for individual conditions, the adjusted odds ratios (aORs) were 1.14 (95% CI, 1.04, 1.26) for hypertension, 1.28 (1.12, 1.47) for RA, and 1.12 (1.01, 1.24) for hypothyroidism. Hypothyroidism and RA were the strongest coexisting conditions [aOR 1.69, 95% CI (1.14, 2.51)], followed by hypertension and RA [aOR 1.48, 95% CI (1.20, 1.82)]. The aOR for all three conditions was 1.69 (1.22, 2.35). Perinatal history is pertinent across the life course. Preventive measures and early identification of risk factors and disease in preterm-born individuals are essential to mitigating adverse health outcomes in adulthood.

We provide an overview of diagnostic stewardship with key concepts that include the diagnostic pathway and the multiple points where interventions can be implemented, strategies for interventions, the importance of multidisciplinary collaboration, and key microbiologic diagnostic tests that should be considered for diagnostic stewardship. The document focuses on microbiologic laboratory testing for adult and pediatric patients and is intended for a target audience of healthcare workers involved in diagnostic stewardship interventions and all workers affected by any step of the diagnostic pathway (ie, ordering, collecting, processing, reporting, and interpreting results of a diagnostic test). This document was developed by the Society for Healthcare Epidemiology of America Diagnostic Stewardship Taskforce.

We assessed whether implementation of matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry without antimicrobial stewardship support would impact antimicrobial utilization and clinical outcomes in inpatient pneumonia. Implementation significantly reduced time to organism identification and time to optimal therapy but did not have a detectable impact on clinical outcomes.

Four dimensions of motor competence were evaluated in 4-year-old term and preterm children and were related to academic achievement and use of school services at age 8 years. The objective of the study was to evaluate a graduated ‘stair-step’ effect between perinatal morbidity, mild motor delay, and later school outcomes in 168 children (88 females, 80 males) stratified into four study groups: 134 healthy term infants [ges ] 37 weeks' gestation, birthweight [ges ] 2500g); 134 preterm infants [les ]37 weeks' gestation divided into healthy preterm (n=41), clinically ill preterms (n=59), and preterm infants with neurological illness (n=34). Significant differences were found in total, fine and gross motor performance, and visual–motor integration at age 4 years. Scores for the preterm groups decreased with increasing morbidity. At age 4 years, mild motor delay was found in all preterm groups. Children with mild motor delay had lower academic achievement scores (Wide Range Achievement Test-3) and higher rates of school service use at age 8 years. Perinatal morbidity and compromised motor performance are important precursors of educational underachievement.

In the early development of their spiritual and theological roots, the Sisters of Mercy are indebted to many Irish diocesan priests and to many religious orders active in Dublin and the surrounding area during the early nineteenth century, especially to those most supportive of Catherine McAuley and the first Sisters of Mercy prior to and following the founding of the Institute of Mercy in Baggot Street in 1831. Among the religious orders, the Carmelite Fathers on Clarendon Street, the Presentation Sisters on George’s Hill, the Dominican Fathers at Carlow College, the Irish Sisters of Charity (in the person of their founder, Mary Aikenhead), the Poor Clares, and the Irish Christian Brothers come immediately to mind. The theological debt of Catherine McAuley (1778–1841) and the Sisters of Mercy to the Society of Jesus, however, is fundamental and quite specific. The subsequent historical affiliations of the Sisters of Mercy with members of the Society of Jesus and the frequent consultations which many congregations of Sisters of Mercy have had, and continue to have, with various Jesuit advisers and spiritual directors have their earliest exemplar in the remarkably close association of Catherine McAuley with the classical religious writings of the well-known sixteenth-century Spanish Jesuit theologian, Alonso Rodriguez (1526–1616). This intellectual relationship is suggested by much in Catherine’s thought and writing, but, for the purpose of this article, most notably in the remarkable parallels that exist between Catherine’s only long essay and Rodriguez’s early seventeenth-century essay on the same general theme.