The Dialectics of Parenting: Changes in the Interplay of Maternal Behaviors during Early and Middle Childhood

Parent and child relationships continuously evolve, part of an ongoing dialectic that derives from developmental changes in both parent and child. The focus of this study is on changes in the strength of association among four types of parenting behaviors considered important for children’s development: supportive presence, respect for autonomy, stimulation, and hostility. Mother–child interaction was observed for 1229 parent–child dyads at 36 months, 54 months, 1st grade, 3rd grade, and 5th grade using similar observational paradigms. The association between respect for autonomy and supportive presence was strong at age three and continued to be strong over time. The association between respect for autonomy and stimulation was modest but also showed little change from age three to 5th grade. Respect for autonomy was negatively associated with maternal hostility, but the relation was complex. It was stronger at 54 months than 36 months but then became weaker through time. Supportive presence showed a moderate relation with stimulation at age 3 but the association became weaker over time. Supportive presence showed an expected negative association with hostility, a relation that changed little over time. The relation between hostility and stimulation also became weaker over time. In effect, there appears to be a shifting pattern of relations between maternal behaviors during early and middle childhood, one that reflects an evolving dialectic in the mother–child relationship

Determining the clog state of constructed wetlands using an embeddable Earth's Field Nuclear Magnetic Resonance probe

The recent rise in interest of green technologies has led to significant adoption of the constructed wetland as a waste water treatment technique. This increased popularity has only been mired by the decline in operational lifetime of wetland units, leading to the need for more regular, time consuming, and expensive rejuvenation techniques to be performed than initially anticipated. To extend operational lifetimes and increase efficiency of wetland units, it is crucial to have an accurate method to determine the internal state of the wetland system. The most important parameter to measure within the reed bed is the clog state of the system, which is representative of the overall system health. In previous work, magnetic resonance (MR) measurements, parameters of T1 and T2eff, have been demonstrated as extremely powerful tools to determine the internal clog state of a wetland [1, 2]. Measurements have been performed in a laboratory setting, using low field permanent magnet arrangements. This work presents an Earth's Field Nuclear Magnetic Resonance (EFNMR) probe suitable for in situ measurements within constructed wetlands. We show T2eff and T1 measurements using the EFNMR probe. T1 values are shown to be sensitive to the change in the clog state with 1498 ms for the thickly clogged sample and 2728 ms for the thinly clogged sample. T2eff values are shown to be marginally more sensitive to clog state with 630 ms for a thickly clogged sample and 1212 ms for the thinly clogged sample. This gives distinguishable variation within both parameters suggesting that this probe is suitable for embedding into an operational constructed wetland. This work was conducted as part of an EU FP7 project to construct an Automated Reed Bed Installation, "ARBI"

Parenting and the decline of physical activity from age 9 to 15

<p>Abstract</p> <p>Background</p> <p>There is a rapid decline in moderate-to-vigorous physical activity (MVPA) during middle childhood and adolescence. Information on the environmental factors implicated in this decline is limited. This study focuses on family factors associated with the rate of decline in objectively measured physical activity during middle childhood and adolescence.</p> <p>Methods</p> <p>Longitudinal analysis of 801 participants from 10 US sites in the NICHD Study of Early Child Care and Youth Development whose data included accelerometer-determined levels of moderate-to-vigorous physical activity (MVPA) between ages 9 and 15 years, as well as family process, BMI and demographic information. The sample included an even split of boys (49%) and girls (51%), was predominantly white (77%), and contained about 26% low income and 19% single parent families. The outcome measure was mean MVPA. It was based on 4 to 7 days of monitored physical activity.</p> <p>Results</p> <p>Boys with lower parental monitoring scores and more days of parental encouragement had significantly more minutes of MVPA at age 9 years. The effect of parental monitoring, however, was moderated by early puberty. High parental monitoring was associated with decreased activity levels for boys experiencing later puberty and increased activity for boy experiencing early puberty. Minutes of MVPA for boys living in the Midwest decreased at significantly faster rates than boys living in any other region; and boys in the South declined faster than boys in the West. Girls in the Midwest and South declined faster than girls in the West and Northeast. Among girls, more days of parental exercise and transportation to activities were associated with more MVPA per day at age 9. However, more parental transportation to activities and less monitoring was associated with faster linear declines in daughters' MVPA between the ages of 9 and 15 years. For girls who experienced puberty early, parental encouragement was associated with more MVPA.</p> <p>Conclusions</p> <p>Parenting processes, such as monitoring and encouragement, as well as the parents' own level of physical activity, showed significant, but small, gender-specific associations with MVPA levels at age nine and the linear rate of decline in MVPA between ages 9 and 15.</p

Woven natural fibre reinforced composite materials for medical imaging

Repeatable patient positioning is key to minimising the burden on planning radiotherapy treatment. There are very few materials commercially available which are suitable for use in all common imaging and treatment modalities such as magnetic resonance imaging (MRI), X-Ray computed tomography (CT) and radiotherapy. In this article, we present several such materials based on woven natural fibres embedded in a range of different resin materials which are suitable for such applications. By investigating a range of resins and natural fibre materials in combination and evaluating their performance in terms of MRI and X-Ray imaging, we show that a woven cotton material impregnated with a two-part epoxy resin provides a 15% improvement in passage of X-Rays and has no impact on the MRI signal (unlike the 40% MRI signal attenuation from carbon fibre), whilst also retaining a flexural modulus up to 71% of that of carbon fibre. These results demonstrate that natural fibre composites produced using such materials provide desirable properties for use in patient support and positioning devices for multi-modal imaging, without the need to significantly compromise on the strength of the material

Determinants of cognitive function in childhood: A cohort study in a middle income context

BACKGROUND: There is evidence that poverty, health and nutrition affect children's cognitive development. This study aimed to examine the relative contributions of both proximal and distal risk factors on child cognitive development, by breaking down the possible causal pathways through which poverty affects cognition. METHODS: This cohort study collected data on family socioeconomic status, household and neighbourhood environmental conditions, child health and nutritional status, psychosocial stimulation and nursery school attendance. The effect of these on Wechsler Pre-School and Primary Scale of Intelligence scores at five years of age was investigated using a multivariable hierarchical analysis, guided by the proposed conceptual framework. RESULTS: Unfavourable socioeconomic conditions, poorly educated mother, absent father, poor sanitary conditions at home and in the neighbourhood and low birth weight were negatively associated with cognitive performance at five years of age, while strong positive associations were found with high levels of domestic stimulation and nursery school attendance. CONCLUSION: Children's cognitive development in urban contexts in developing countries could be substantially increased by interventions promoting early psychosocial stimulation and preschool experience, together with efforts to prevent low birth weight and promote adequate nutritional status

Mitochondrial myopathy presenting as fibromyalgia: a case report

<p>Abstract</p> <p>Introduction</p> <p>To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy. Treatment of the mitochondrial myopathy resulted in resolution of symptoms. This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia.</p> <p>Case presentation</p> <p>Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points. Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms. A six-minute walk study demonstrated an elevated lactic acid level (5 mmol/L; normal < 2 mmol/L). Biochemical and genetic studies from a muscle biopsy revealed a mitochondrial myopathy. Our patient was started on a compound of coenzyme Q10 (ubiquinone) 200 mg, creatine 1000 mg, carnitine 200 mg and folic acid 1 mg to be taken four times a day. She gradually showed significant improvement in her symptoms over a course of several months.</p> <p>Conclusions</p> <p>This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy. This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms.</p

Psychometrics of HRQoL questionnaires in bronchiectasis: A systematic review and meta-analysis

INTRODUCTION: Understanding the psychometric properties of health related quality of life (HRQoL) questionnaires can help inform selection in clinical trials. OBJECTIVE: To assess the psychometric properties of HRQoL questionnaires in bronchiectasis. METHODS: A literature search was conducted. HRQoL questionnaires were assessed for psychometric properties (reliability, validity, minimal clinically important difference (MCID), floor/ceiling effects). Meta-analyses assessed the associations of HRQoL with clinical measures and responsiveness of HRQoL in clinical trials. RESULTS: 166 studies and 12 HRQoL questionnaires were included. The BHQ, LCQ, CAT and SF-36 had good internal consistency in all domains reported (Cronbach's α≥0.7) across all studies and the QoL-B, SGRQ, CRDQ and SOLQ had good internal consistency in all domains in the majority of (but not all) studies. The BHQ, SGRQ, LCQ and CAT had good test-retest reliability in all domains reported ((intraclass correlation coefficient) ICC ≥0.7) across all studies and the QoL-B, CRDQ and SOLQ had good test-retest reliability in all domains in the majority of (but not all) studies. HRQoL questionnaires were able to discriminate between demographics, important markers of clinical status, disease severity, exacerbations and bacteriology. For HRQoL responsiveness, there was a difference between the treatment and placebo effect. CONCLUSION: SGRQ was the most widely used HRQoL questionnaire in bronchiectasis studies and it had good psychometric properties, however good psychometric data are growing on bronchiectasis specific HRQoL questionnaires, QoL-B and BHQ. Future studies should focus on the medium-long term test-retest reliability, responsiveness and MCID in these HRQoL questionnaires which show potential in bronchiectasis

Design and Effectiveness of a Required Pre-Clinical Simulation-based Curriculum for Fundamental Clinical Skills and Procedures

For more than 20 years, medical literature has increasingly documented the need for students to learn, practice and demonstrate competence in basic clinical knowledge and skills. In 2001, the Louisiana State University Health Science Centers (LSUHSC) School of Medicine &#x2013; New Orleans replaced its traditional Introduction in to Clinical Medicine (ICM) course with the Science and Practice of Medicine (SPM) course. The main component within the SPM course is the Clinical Skills Lab (CSL). The CSL teaches 30 plus skills to all pre-clinical medical students (Years 1 and 2). Since 2002, an annual longitudinal evaluation questionnaire was distributed to all medical students targeting the skills taught in the CSL. Students were asked to rate their self- confidence (Dreyfus and Likert-type) and estimate the number of times each clinical skill was performed (clinically/non-clinically). Of the 30 plus skills taught, 8 were selected for further evaluation. An analysis was performed on the eight skills selected to determine the effectiveness of the CSL. All students that participated in the CSL reported a significant improvement in self-confidence and in number performed in the clinically/non-clinically setting when compared to students that did not experience the CSL. For example, without CSL training, the percentage of students reported at the end of their second year self-perceived expertise as &#x201C;novice&#x201D; ranged from 21.4% (CPR) to 84.7% (GU catheterization). Students who completed the two-years CSL, only 7.8% rated their self-perceived expertise at the end of the second year as &#x201C;novice&#x201D; and 18.8% for GU catheterization. The CSL design is not to replace real clinical patient experiences. It&#x0027;s to provide early exposure, medial knowledge, professionalism and opportunity to practice skills in a patient free environment