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Background Policy-makers are increasingly seeking rigorous evidence on the impact of programs that go beyond typical health care settings to improve outcomes for low-income families during the critical period around the transition to parenthood and through early childhood. Methods This study is a randomized controlled trial evaluating the impact of the Nurse-Family Partnership’s expansion in South Carolina. The scientific trial was made possible by a “Pay for Success” program embedded within a 1915(b) Waiver from Medicaid secured by the South Carolina Department of Health and Human Services. This protocol describes study procedures and defines primary and secondary health-related outcomes that can be observed during the intervention period (including pregnancy through the child’s first 2 years of life). Primary study outcomes include (1) a composite indicator for adverse birth outcomes including being born small for gestational age, low birth weight (less than 2500 g), preterm birth (less than 37 weeks’ gestation), or perinatal mortality (fetal death at or after 20 weeks of gestation or mortality in the first 7 days of life), (2) a composite outcome indicating health care utilization or mortality associated with major injury or concern for abuse or neglect occurring during the child’s first 24 months of life, and (3) an indicator for an inter-birth interval of < 21 months. Secondary outcomes are defined similarly in three domains: (1) improving pregnancy and birth outcomes, (2) improving child health and development, and (3) altering the maternal life course through changes in family planning. Discussion Evidence from this trial on the impact of home visiting services delivered at scale as part of a Medicaid benefit can provide policy-makers and stakeholders with crucial information about the effectiveness of home visiting programs in improving health and well-being for low-income mothers and children and about novel financing mechanisms for cross-silo interventions. Trial registration The trial was registered prospectively on the American Economic Association Trial Registry (the primary registry for academic economists doing policy trials) on 16 February 2016 ( AEARCTR-0001039 ). ClinicalTrials.gov NCT03360539 . Registered on 28 November 2017.

There is an urgent need to improve maternal and neonatal health outcomes and decrease their racial disparities in the US. Prenatal nurse home visiting programs could help achieve this by increasing the use and quality of prenatal care and facilitating healthy behaviors during pregnancy. We conducted a randomized controlled trial of 5,670 Medicaid-eligible pregnant people in South Carolina to evaluate how a nurse home visiting program affected prenatal health care and health outcomes. We compared outcomes between the treatment and control groups and found little evidence of statistically significant differences in the intensity of prenatal care use, receipt of guideline-based prenatal care services, other health care use, or gestational weight gain. Nor did we find treatment effects in subgroup analyses of socially vulnerable participants (46.9 percent of the sample) or non-Hispanic Black participants (52.0 percent of the sample). Compared with the broader Medicaid population, our trial participants had more health and social risk factors, more engagement with prenatal care, and similar pregnancy outcomes. Delivering intensive nurse home visiting programs to the general Medicaid population might not be an efficient method to improve prenatal care for those who need the most support during pregnancy.

ObjectivesTo assess the impact of financial support on maternal caregiving activities for preterm infants.MethodsWe conducted a small randomized controlled trial (RCT) in two Massachusetts Neonatal Intensive Care Units (NICUs). We enrolled 46 Medicaid-eligible mothers of preterm infants between January 2017 and June 2018 and randomly assigned them to a treatment group (up to 3 weekly financial transfers of $200 each while their infant was in the hospital) or a control group. We collected hospital-record data while the infant was admitted. The primary outcome was a binary variable indicating skin-to-skin care (STSC) was provided during a hospital day. Secondary outcomes included daily maternal visitation, daily provision of breastmilk, neonatal growth and length of stay (LOS). Multilevel generalized linear models with random effects were used to estimate treatment effects on daily maternal behaviors and ordinary least squares models were used to estimate impacts on neonatal growth and LOS.ResultsWe assigned 25 women to the intervention and 21 to the control and observed them over 703 days of their infants’ hospitalization. Mothers who received financial support were more likely to provide STSC (adjusted risk ratio: 1.85; 95% confidence interval [CI] 1.31–2.62) and breastmilk (adjusted risk ratio: 1.36; 95% CI 1.06–1.75) while their infant was in the NICU. We see no statistically significant impact on neonatal growth outcomes or LOS, though estimated confidence intervals are imprecise.ConclusionsOur evidence demonstrates the potential for financial support to increase mothers' engagement with caregiving behaviors for preterm infants during the NICU stay.

Several temperate toads undergo oogenesis soon after breeding which could be exploited by captive breeding programs to increase tadpole production. In this study, non-hibernated Fowler’s toads produced fertilizable oocytes after a four month refractory period without significantly impacting the number of ovulating females, total egg production, or egg quality. Abstract Many amphibian species reinitiate the processes of preparing for reproduction (e.g. oogenesis) soon after breeding indicating hormone-induced ovulation could potentially be achieved out-of-season, which would lead to higher annual fecundity compared to mono-seasonal breeding. Such strategies would be beneficial to captive breeding programs for threatened species that are short-lived, have aging populations or need large numbers of offspring to meet reintroduction goals for species recovery. Unfortunately, little is known regarding how female anurans respond to multiple ovulation events within a year, which could lead to higher annual fecundity compared to mono-seasonal breeding. Thus, we evaluated the effect of temporal period between exogenous hormone stimulation events on egg production using the Fowler’s toad Anaxyrus fowleri as a model species. Female toads (n = 21) were administered hormone therapy twice in 1 year with toads randomly assigned to a treatment of either a 4-, 8- or 12-month recovery period between hormone stimulations. Ovulation was induced using two priming doses of human chorionic gonadotropin (100 IU; hCG) 72 h apart, followed by a resolving dose of hCG (500 IU) plus gonadotropin releasing hormone analogue (GnRHa; 15 μg) given 24 h after the second priming injection. Measured response variables include the number of females ovulating after treatment, total number of eggs produced and percent fertilization, neurula and tadpole development. No significant treatment effects were observed for any response variable (P > 0.05). Findings from this study suggest that hormone therapy can be administered in a bufonid species every 4 or 8 months without significantly affecting the number of ovulating females, egg production, fertilization, neurulation or tadpole development. By collecting gametes out-of-season or multiple times throughout the year, captive breeding programs could potentially increase tadpole production for reintroductions as well as extend the breeding window in captivity.

Many amphibian species reinitiate the processes of preparing for reproduction (e.g. oogenesis) soon after breeding indicating hormone-induced ovulation could potentially be achieved out-of-season, which would lead to higher annual fecundity compared to mono-seasonal breeding. Such strategies would be beneficial to captive breeding programs for threatened species that are short-lived, have aging populations or need large numbers of offspring to meet reintroduction goals for species recovery. Unfortunately, little is known regarding how female anurans respond to multiple ovulation events within a year, which could lead to higher annual fecundity compared to mono-seasonal breeding. Thus, we evaluated the effect of temporal period between exogenous hormone stimulation events on egg production using the Fowler's toad Anaxyrus fowleri as a model species. Female toads (n = 21) were administered hormone therapy twice in 1 year with toads randomly assigned to a treatment of either a 4-, 8- or 12-month recovery period between hormone stimulations. Ovulation was induced using two priming doses of human chorionic gonadotropin (100 IU; hCG) 72 h apart, followed by a resolving dose of hCG (500 IU) plus gonadotropin releasing hormone analogue (GnRHa; 15 ug) given 24 h after the second priming injection. Measured response variables include the number of females ovulating after treatment, total number of eggs produced and percent fertilization, neurula and tadpole development. No significant treatment effects were observed for any response variable (P> 0.05). Findings from this study suggest that hormone therapy can be administered in a bufonid species every 4 or 8 months without significantly affecting the number of ovulating females, egg production, fertilization, neurulation or tadpole development. By collecting gametes out-of-season or multiple times throughout the year, captive breeding programs could potentially increase tadpole production for reintroductions as well as extend the breeding window in captivity.

This study explores the relation between the \"cognitive\" domain and the \"social.\" It seeks to differentiate the ideas of Piaget and Vygotsky concerning the child's developing understanding of physical relationships (embodied in balance scale problems) and social relationships (embodied in the interactions between children who are working simultaneously). It examines cognitive theorists (R. Siegler, N. Anderson) who analyze domains of knowledge as task analyses, Piagetian research (A. N. Perret-Clermont) specifying the relation between operations and co-operations, and recent work (V. V. Rubtsov) in the Vygotskian tradition, in which the problem-solving activity dictated by the task arrangement is varied. In the present study a comparison was made of children's performance at balance scale problems while working individually with the experimenter and while working in small groups. Three group conditions were organized to model theoretical accounts of how social interactions are related to cognitive problems. Data from the interactions and from individualized tests were evaluated by five theoretical models. Results of multiple partial correlation analyses showed that changes in individual children's performance on balance scale problems, following group interactions, were best predicted by a model that included the contribution of group members' skill levels and the extent to which individuals engaged in particular types of verbal exchange. Engaging in fruitful verbal exchange was shown to be dependent on task arrangement. Individual cognitive measures failed to account for changes as well as is predicted by traditional models of development. It was concluded that, in a general way, the kinds of interactions a child engaged in are complementary to the child's cognitive level. In the case of a specific task domain, however, it is the inter-individual transactions which allow a child to engage in on-task activity and to acquire the goal of problem-solving. In the concluding chapter the implications of assuming social origins to problem-solving activity for the study of cognitive development are discussed.

Large galaxies grow through the accumulation of dwarf galaxies 1 , 2 . In principle it is possible to trace this growth history via the properties of a galaxy’s stellar halo 3 – 5 . Previous investigations of the galaxy Messier 31 (M31, Andromeda) have shown that outside a galactocentric radius of 25 kiloparsecs the population of halo globular clusters is rotating in alignment with the stellar disk 6 , 7 , as are more centrally located clusters 8 , 9 . The M31 halo also contains coherent stellar substructures, along with a smoothly distributed stellar component 10 – 12 . Many of the globular clusters outside a radius of 25 kiloparsecs are associated with the most prominent substructures, but some are part of the smooth halo 13 . Here we report an analysis of the kinematics of these globular clusters. We find two distinct populations rotating perpendicular to each other. The rotation axis for the population associated with the smooth halo is aligned with the rotation axis for the plane of dwarf galaxies 14 that encircles M31. We interpret these separate cluster populations as arising from two major accretion epochs, probably separated by billions of years. Stellar substructures from the first epoch are gone, but those from the more recent second epoch still remain. There are two distinct kinematic populations of globular clusters in Messier 31 (M31, the Andromeda galaxy) with rotation axes perpendicular to each other, suggesting that they arose from merger events separated by billions of years.

Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus capable of causing a severe hemorrhagic fever disease in humans. There are currently no licensed vaccines to prevent CCHFV-associated disease. We developed a DNA vaccine expressing the M-segment glycoprotein precursor gene of CCHFV and assessed its immunogenicity and protective efficacy in two lethal mouse models of disease: type I interferon receptor knockout (IFNAR-/-) mice; and a novel transiently immune suppressed (IS) mouse model. Vaccination of mice by muscle electroporation of the M-segment DNA vaccine elicited strong antigen-specific humoral immune responses with neutralizing titers after three vaccinations in both IFNAR-/- and IS mouse models. To compare the protective efficacy of the vaccine in the two models, groups of vaccinated mice (7-10 per group) were intraperitoneally (IP) challenged with a lethal dose of CCHFV strain IbAr 10200. Weight loss was markedly reduced in CCHFV DNA-vaccinated mice as compared to controls. Furthermore, whereas all vector-control vaccinated mice succumbed to disease by day 5, the DNA vaccine protected >60% of the animals from lethal disease. Mice from both models developed comparable levels of antibodies, but the IS mice had a more balanced Th1/Th2 response to vaccination. There were no statistical differences in the protective efficacies of the vaccine in the two models. Our results provide the first comparison of these two mouse models for assessing a vaccine against CCHFV and offer supportive data indicating that a DNA vaccine expressing the glycoprotein genes of CCHFV elicits protective immunity against CCHFV.

Purpose Service robots can offer benefits to consumers (e.g. convenience, flexibility, availability, efficiency) and service providers (e.g. cost savings), but a lack of trust hinders consumer adoption. To enhance trust, firms add human-like features to robots; yet, anthropomorphism theory is ambiguous about their appropriate implementation. This study therefore aims to investigate what is more effective for fostering trust: appearance features that are more human-like or social functioning features that are more human-like. Design/methodology/approach In an experimental field study, a humanoid service robot displayed gaze cues in the form of changing eye colour in one condition and static eye colour in the other. Thus, the robot was more human-like in its social functioning in one condition (displaying gaze cues, but not in the way that humans do) and more human-like in its appearance in the other (static eye colour, but no gaze cues). Self-reported data from 114 participants revealing their perceptions of trust, anthropomorphism, interaction comfort, enjoyment and intention to use were analysed using partial least squares path modelling. Findings Interaction comfort moderates the effect of gaze cues on anthropomorphism, insofar as gaze cues increase anthropomorphism when comfort is low and decrease it when comfort is high. Anthropomorphism drives trust, intention to use and enjoyment. Research limitations/implications To extend human–robot interaction literature, the findings provide novel theoretical understanding of anthropomorphism directed towards humanoid robots. Practical implications By investigating which features influence trust, this study gives managers insights into reasons for selecting or optimizing humanoid robots for service interactions. Originality/value This study examines the difference between appearance and social functioning features as drivers of anthropomorphism and trust, which can benefit research on self-service technology adoption.