Investigators will prospectively assign all 200 women to this screening, education and referral intervention, without concurrent comparison or control groups, to study the cause-and-effect relationship between a health-related intervention and a health outcome. The health-related intervention, in this case, is an educational program and related process-of-care changes.

Pre-Eclampsia

Depression

Inflammation

Vitamin D Deficiency

I. Psychosocial assessments:
Mental health screening for: (1) depressive symptoms with the EPDS, (2) post-traumatic stress symptoms with the IES, (3) for perceived stress with the PSS (4) for anxiety with the OASIS.
Exercise, smoking & substance use, sleep and nutrition.
II. If women are above cutoff values the SCID will be conducted.
III. Education and referral information via Maternal Mental Health NOW:
All receive a brochure entitled, Speak Up When You Are Down
If above cutoffs, participants will also receive referral information; and will be scheduled for a SCID
Trained study staff will review the brochure and show the woman how to use the MMHN online referral system to input their zip code and find preferred maternal mental health practitioners.
IV. Follow up with a survey at 3 months postpartum: acceptability of screening, benefit of referral service, and outcome of this referral.

mental health screening, education and referral program

Maternal Mental Health NOW Referral Directory

Maternal Mental Health NOW Educational Brochure

Cedars-Sinai Medical Center

Preeclampsia Research on Vitamin D, Inflammation, & Depression

The PROVIDE Study; Preeclampsia Research on Vitamin D, Inflammation, & Depression

as measured by reliable and validated screening tool (EPDS)

as measured by diagnostic interview (SCID)

Results will be based on data from structured (Likert-scale) surveys completed at 4 time points, from the patient perspective

Results will be based on data from the follow-up structured (Likert-scale) survey

The program's feasibility and MMH-Now training will be rated by clinic staff according to structured surveys completed at multiple time points, e.g. pre/post training.

Eynav Accortt

Assistant Professor

Maternal Mental Health NOW

These patients will receive standard of care when undergoing anterior cruciate ligament reconstruction and will NOT be receiving a posterior capsular knee injection of Marcaine 0.5%.
They will be monitored for pain control and pill intake while in the PACU and the first four days post-operatively the same as the patients in the INJECTION Arm of the study.

These patients will receive standard of care when undergoing anterior cruciate ligament reconstruction but will additionally be receiving a one-time posterior capsular knee injection of Marcaine 0.5% (20cc) during the surgery.
They will be monitored for pain control and pill intake while in the PACU and the first four days post-operatively the same as the patients in the NO injection Arm of the study.

These patients will receive standard of care when undergoing anterior cruciate ligament reconstruction and will NOT be receiving a posterior capsular knee injection of Marcaine 0.5%.
They will be monitored for pain control and pill intake while in the PACU and the first four days post-operatively the same as the patients in the INJECTION Arm of the study.
Ice
Percocet
Knee Brace and Crutches

No Injection

These patients will receive standard of care when undergoing anterior cruciate ligament reconstruction but will additionally be receiving a one-time posterior capsular knee injection of Marcaine 0.5% (20cc) during the surgery.
They will be monitored for pain control and pill intake while in the PACU and the first four days post-operatively the same as the patients in the NO injection Arm of the study.
Marcaine: Pain control medication to theoretically reduce the amount of posterior knee pain that is common after ACL surgery by placing the injection into the posterior capsule of the knee during surgery. This is very easy and safe to accomplish as the surgeon will have direct visualization of the posterior capsule during the surgery.
Ice
Percocet
Knee Brace and Crutches

Injection

Total

Sex: Female, Male

Race (NIH/OMB)

Subjects Injected or Not Injected

VAS Scores

Patients will log the number of pills they take the first four days after surgery.

Pain Pill Count

Overall Study

Josh Page

Anesthesia

Pain control medication to theoretically reduce the amount of posterior knee pain that is common after ACL surgery by placing the injection into the posterior capsule of the knee during surgery. This is very easy and safe to accomplish as the surgeon will have direct visualization of the posterior capsule during the surgery.

cedrela odorata/anti inflammatoire

Preeclampsia Research on Vitamin D, Inflammation, & Depression

Pain Outcomes After Anterior Cruciate Ligament Reconstruction With Posterior Capsular Marcaine Injection

The Anti-allergic Effects of Specific Probiotics

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