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Remission Of Maternal Depression And Child Symptoms Among Single Mothers: A Star*d-child Report
Objective: Offspring of depressed parents are at increased risk for depressive and other disorders. We recently found that when depressed mothers reached full remission over 3 months of treatment, a significant improvement in the children’s disorders occurred. Since only a third of the mothers remitted, factors related to maternal remission rates, and thereby child outcomes, were important. This report examined the relationship of the presence of a father in the household to maternal depression remission and child outcomes.
Method: Maternal depression was measured using the 17-item Hamilton Rating Scale for Depression (HRSD17); social functioning was assessed using the Social Adjustment Scale-Self Report (SAS-SR). Children (age 7–17) were assessed independently, blind to maternal outcome, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and the Child Global Assessment Scale (C-GAS).
Results: Single mothers (n = 50), as compared to those in two-parent households (n = 61), were more likely to discontinue treatment (31% vs. 16%, P = 0.04), and less likely to remit if they remained in treatment (20% vs. 43%, P = 0.013). These differences remained significant after adjusting for socioeconomic status and potential confounders, but were partially explained by the mother’s pre-treatment social functioning. The reduction in child diagnoses following maternal remission was greater in two-parent than in single-parent households, although a formal test of interaction between the odds ratios was not significant.
Conclusion: Single depressed mothers are more likely to drop out of treatment, and less likely to reach remission if they stay in treatment. This high-risk group requires vigorous treatment approaches
Combining genomic and epidemiological data to compare the transmissibility of SARS-CoV-2 variants Alpha and Iota.
SARS-CoV-2 variants shaped the second year of the COVID-19 pandemic and the discourse around effective control measures. Evaluating the threat posed by a new variant is essential for adapting response efforts when community transmission is detected. In this study, we compare the dynamics of two variants, Alpha and Iota, by integrating genomic surveillance data to estimate the effective reproduction number (Rt) of the variants. We use Connecticut, United States, in which Alpha and Iota co-circulated in 2021. We find that the Rt of these variants were up to 50% larger than that of other variants. We then use phylogeography to show that while both variants were introduced into Connecticut at comparable frequencies, clades that resulted from introductions of Alpha were larger than those resulting from Iota introductions. By monitoring the dynamics of individual variants throughout our study period, we demonstrate the importance of routine surveillance in the response to COVID-19
Course and Severity of Maternal Depression: Associations with Family Functioning and Child Adjustment
Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother–child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major Depressive Disorder; children (80 males and 71 females) ranged in age from 7 to 17 years. Measures of child adjustment included psychiatric diagnoses, internalizing and externalizing symptoms, and functional impairment. Measures of family functioning included family cohesion, expressiveness, conflict, organization, and household control; parenting measures assessed maternal acceptance and psychological control. Children of mothers with longer current depressive episodes were more likely to have internalizing and externalizing symptoms, with this association being moderated by child gender. Mothers with more lifetime depressive episodes were less likely to use appropriate control in their homes
Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms
Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major depressive disorder and were treated initially with citalopram; 33% of mothers experienced remission of depressive symptoms. Youth ranged in age from 7 to 17. Remission of maternal depression was associated with changes in children's reports of their mothers' warmth/acceptance, which in turn partially mediated the relation between maternal depression remission and youth internalizing symptoms, accounting for 22.9% of the variance
ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to update the 1998 pacemaker guidelines)
The current update of the ACC/AHA/NASPE Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices includes several significant changes in the recommendations and in the supporting narrative portion. In this summary, we list the updated recommendations along with the respective 1998 recommendations, each one accompanied by a brief comment outlining the rationale for the changes, additions, or deletions. All new or revised recommendations are listed in the second column and appear in boldface type. References that support either the 1998 recommendations that have not changed or the new or revised recommendations are noted in parentheses at the end of each recommendation. The reader is referred to the full-text version of the guidelines posted on the American College of Cardiology (ACC), American Heart Association (AHA), and North American Society for Pacing and Electrophysiology (NASPE) World Wide Web sites for a more detailed exposition of the rationale for these changes. In addition to the recommendation changes listed here, this update includes an expanded section on the selection of pacemakers and implantable cardioverter-defibrillators (ICDs) that reflects the technical advances that have taken place since 1998. A brief expanded summary of pacemaker follow-up procedures is also new to these guidelines. For both of these expanded sections, the reader is referred to the online full-text version
Fine-scale Explosive Energy Release at Sites of Prospective Magnetic Flux Cancellation in the Core of the Solar Active Region Observed by Hi-C 2.1, IRIS, and SDO
The second Hi-C flight (Hi-C 2.1) provided unprecedentedly high spatial and temporal resolution (~250 km, 4.4 s) coronal EUV images of Fe ix/x emission at 172 Å of AR 12712 on 2018 May 29, during 18:56:21–19:01:56 UT. Three morphologically different types (I: dot-like; II: loop-like; III: surge/jet-like) of fine-scale sudden-brightening events (tiny microflares) are seen within and at the ends of an arch filament system in the core of the AR. Although type Is (not reported before) resemble IRIS bombs (in size, and brightness with respect to surroundings), our dot-like events are apparently much hotter and shorter in span (70 s). We complement the 5 minute duration Hi-C 2.1 data with SDO/HMI magnetograms, SDO/AIA EUV images, and IRIS UV spectra and slit-jaw images to examine, at the sites of these events, brightenings and flows in the transition region and corona and evolution of magnetic flux in the photosphere. Most, if not all, of the events are seated at sites of opposite-polarity magnetic flux convergence (sometimes driven by adjacent flux emergence), implying likely flux cancellation at the microflare's polarity inversion line. In the IRIS spectra and images, we find confirming evidence of field-aligned outflow from brightenings at the ends of loops of the arch filament system. In types I and II the explosion is confined, while in type III the explosion is ejective and drives jet-like outflow. The light curves from Hi-C, AIA, and IRIS peak nearly simultaneously for many of these events, and none of the events display a systematic cooling sequence as seen in typical coronal flares, suggesting that these tiny brightening events have chromospheric/transition region origin
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