Examining Associations between Mothers\u27 Early Adversity, Depression and Maternal Sensitivity

This study tested two models for the indirect influence of mothers’ early adversity on maternal sensitivity: Model A: Mothers’ appraisal of infant temperament was hypothesized to mediate the influence of mothers’ early adversity and depression on maternal sensitivity There would be no direct influence of maternal depression Model B: Mothers’ depression was hypothesized to have a direct influence on maternal sensitivity Mothers’ perception of infant temperament would not mediate the influence of maternal depression on maternal sensitivit

Maternal Sensitivity: From Child to the Neighborhood

The purpose of this study was to explore the possible association between maternal sensitivity and distal factors such as neighborhood quality. 480 mother-child dyads were videotaped during a naturalistic interaction. Maternal sensitivity was assessed from video-tapes using the Maternal Behavior Q-sort (MBQS; Pederson & Moran, 1995). Results of a hierarchical regression showed that maternal sensitivity was associated with: child characteristics (e.g. infant weight), maternal characteristics (e.g. age and depression) and family attributes (e.g. household income). Interviewers’ ratings of neighborhood challenge and mothers’ report of neighborhood quality were found to significantly relate to maternal sensitivity and explained additional variance. Results indicate that mothers’ ability to parent sensitively is hindered in contexts where the neighborhood challenges are great. These findings have important implications for policy interventions at the neighborhood level to promote maternal sensitivity

Psychometric Properties of a Short Version of the Maternal Behavior Q-sort: What You Need to Know Before Analyzing the Data

OVERVIEW • N =116 mother-infant dyads (2 months old) • Coders completed the MBQS-mini 2 ways—forced vs. unforced q-sort distributions—to determine whether psychometric properties differed. SENSITIVITY SCORES: • were virtually identical:r= .99. BEHAVIORAL DOMAINS: • Attachment related domains: esponsiveness, Non-Interference, Affective Communication. • For all 3 (but not the Teaching domain) forced and unforced were highly correlated, and high internal consistency. CONCLUSIONS: • Results support the use of forced q-sort data, but show no benefits associated with using forced over unforced distributions. Internal consistency was higher for the unforced teaching domain

Understanding Maternal Sensitivity: Early Adversity, Arginine Vasopressin 1a Receptor Gene and Gene-environment Interplay

The purpose of these studies was to examine mediation and moderation processes for the influence of early adversity and current stressful circumstances on maternal sensitivity. Evidence of mediation was found in Study 1 where maternal depression and mothers’ negative appraisal of their infant mediated the influence of early adversity and low family income on maternal sensitivity. Study 1 also examined the influence of the neighborhood. A moderate-mediation model was tested where the mediating influence afore-stated was hypothesized to vary across levels of neighborhood quality. Partial evidence of moderation was found. In the context of a high quality neighborhood, mothers’ early adversity was not associated with maternal depression. Across levels of neighborhood quality, complex relationships emerged between the variables low family income, maternal depression and mothers’ appraisal of infant temperament. In a context of low neighborhood quality, there was no evidence of a direct association between low family income and maternal sensitivity, rather, low family income operated indirectly through maternal depression. In a context of high neighborhood quality, there was evidence for a direct and indirect association between low family income and maternal sensitivity. Study 2 examined associations between variation in the Arginine Vasopressin 1a receptor gene (AVPR1a) and maternal sensitivity, and whether variation in this gene moderated the influence of mothers’ early adversity on sensitivity. Mothers homozygous for the long alleles of the RS3 microsatellite were significantly less sensitive than mothers heterozygous for the long alleles and those homozygous for the short alleles. Homozygosity for the RS3 long alleles moderated the influence of mothers’ early adversity on their sensitivity; the influence of early adversity on maternal sensitivity was most pronounced for mothers with the RS3 long/long genotype. These results suggest that variation in the AVPR1a gene may be important not only for human maternal behavior, but also for stress reactivity.Ph

Different impact of sex on baseline characteristics and major periprocedural outcomes of transcatheter and surgical aortic valve interventions: results of the multicenter Italian OBSERVANT Registry

Background: Despite the widespread use of transcatheter aortic valve implantation (TAVI), the role of sex on outcome after TAVI or surgical aortic valve replacement (AVR) has been poorly investigated. We investigated the impact of sex on outcome after TAVI or AVR. Methods: There were 2108 patients undergoing TAVI or AVR who were enrolled in the Italian Observational Multicenter Registry (OBSERVANT). Thirty-day mortality, major periprocedural morbidity, and transprosthetic gradients were stratified by sex according to interventions. Results: Female AVR patients showed a worse risk profile compared with male AVR patients, given the higher mean age, prevalence of frailty score of 2 or higher, New York Heart Association class of 3 or higher, lower body weight, and preoperative hemoglobin level (P ≤.02). Similarly, female TAVI patients had a different risk profile than male TAVI patients, given a higher age and a lower body weight and preoperative hemoglobin level (P ≤.005), but with a similar New York Heart Association class, frailty score, EuroSCORE (P = NS), a better left ventricular ejection fraction and a lower prevalence of left ventricular ejection fraction less than 30%, porcelain aorta, renal dysfunction, chronic obstructive pulmonary disease, arteriopathy, and previous cardiovascular surgery or percutaneous coronary intervention (P ≤.01). Women showed a smaller aortic annulus than men in both populations (P <.001). Female sex was an independent predictor in the AVR population for risk-Adjusted 30-day mortality (odds ratio [OR], 2.34; P =.043) and transfusions (OR, 1.47; P =.003), but not for risk-Adjusted acute myocardial infarction, stroke, vascular complications, permanent atrioventricular block (P = NS). Female sex was an independent predictor in the TAVI population for risk-Adjusted major vascular complications (OR, 2.92; P =.018) and transfusions (OR, 1.93; P =.003), but proved protective against moderate to severe postprocedural aortic insufficiency (P =.018). Conclusions: Female sex is a risk factor for mortality after aortic valve replacement, for major vascular complications after TAVI, and for transfusions after both approaches. Copyright © 2014 by The American Association for Thoracic Surgery