Family Quality of Life for Parents of Children with Autism: The Role of Social Support and Unsupportive Social Interactions

Family quality of life refers to the extent to which families are satisfied with different domains in their lives. The concept of family quality of life was originally developed by a group of international researchers as a way to evaluate how having a family member with a disability, such as autism, affects the entire family unit. Parents of children with autism report higher levels of stress than other parents. McCubbin and Patterson developed the double ABCX model, which describes how families adapt to stress. In the double ABCX model, the stressor (aA factor), social support (bB factor), parental appraisals (cC factor), and coping skills (BC factor) interact to determine family adaptation (xX factor). The purpose of the present study was to evaluate the utility of the double ABCX model in predicting family quality of life for parents of children with autism. The variables were operationalized as child challenging behaviour (aA factor), child disability severity (aA factor), unsupportive social interactions (aA factor), social support (bB factor), parental sense of competence (cC factor), acceptance (cC factor), coping (BC factor), and family quality of life (xX factor). Another purpose of this study was to determine the extent to which unsupportive social interactions and online social support may also affect parents of children with autism. Unsupportive social interactions refer to responses from others that are perceived as being unhelpful, and may be detrimental to the well-being of parents of children with autism. Seeking social support online or using technology may also influence family quality of life, but little is known from past research. A sample of 194 parents (103 mothers and 91 fathers) of children with autism aged 4 to 11 years completed an online survey, and 24 participants (12 mothers and 12 fathers) completed follow-up phone interviews. The double ABCX model was found to be a good fit for understanding what contributes to family quality of life for both mothers and fathers of children with autism. Higher adequacy of social support and greater use of the reframing coping style were the most closely related to higher family quality of life for fathers. For mothers, greater adequacy of social support, higher psychological acceptance, and greater use of the reframing and acquiring social support coping styles and less use of passive coping styles were the most closely related to higher family quality of life. Unsupportive social interactions were not significantly related to family quality of life within the double ABCX model, but they were associated with lower ratings of family quality of life on their own, particularly for parents with poorer coping. Online social support was not significantly related to family quality of life. However, parents who reported using technology daily to access social support also reported more unsupportive social interactions, and more child challenging behaviour than parents who used technology less frequently. Thematic analysis was conducted with the parents’ interview responses and several themes were identified related to both within-family and external influences on family quality of life. Some themes were identified that were not captured in the survey component, including the importance of connecting with other parents of children with autism, and access to appropriate childcare. These results suggest that the double ABCX model is useful for understanding how the stresses associated with raising children with autism affect parents’ family quality of life. Consistent with this model, the resources employed and parent responses to the stressors are key for family quality of life. The findings of this study are hopeful, in that most parents of children with autism in this study reported good family quality of life, especially the parents who had relatively more supports and resources. Applied implications of the results are presented in the context of the double ABCX model

Dual separable feedback systems govern firing rate homeostasis.

Firing rate homeostasis (FRH) stabilizes neural activity. A pervasive and intuitive theory argues that a single variable, calcium, is detected and stabilized through regulatory feedback. A prediction is that ion channel gene mutations with equivalent effects on neuronal excitability should invoke the same homeostatic response. In agreement, we demonstrate robust FRH following either elimination of Kv4/Shal protein or elimination of the Kv4/Shal conductance. However, the underlying homeostatic signaling mechanisms are distinct. Eliminating Shal protein invokes Krüppel-dependent rebalancing of ion channel gene expression including enhanced slo, Shab, and Shaker. By contrast, expression of these genes remains unchanged in animals harboring a CRISPR-engineered, Shal pore-blocking mutation where compensation is achieved by enhanced IKDR. These different homeostatic processes have distinct effects on homeostatic synaptic plasticity and animal behavior. We propose that FRH includes mechanisms of proteostatic feedback that act in parallel with activity-driven feedback, with implications for the pathophysiology of human channelopathies

Primary Care Service Utilization Among People at High Risk of Fatal Opioid Overdose: A Short Communication on an Autopsy Study

Objectives: We sought to explore the sociodemographics and primary care service utilization among people who died from opioid overdose and to assess the possibility of using this information to identify those at high risk of opioid overdose using routine linked data. Methods: Data related to decedents of opioid overdose between January 1, 2012 and December 31, 2015 were linked with general practitioner (GP) records over a period of 36 months prior to death. Results: Of n = 312 decedents of opioid overdose, 73% were male (n = 228). Average age at death was 40.72 (SD 11.92) years. A total of 63.8% of the decedents were living in the 2 most deprived quintiles according to the Welsh Index of Multiple Deprivation. Over 80% (n = 258) of the decedents were recorded as having at least 1 GP episode during the 36-month observation period prior to death. The median number of episodes per decedent was 75 [38-118]. Overall, 31.8% (n = 82) of decedents with at least 1 GP episode received a prescription for a proton pump inhibitor and 31% (n = 80) were prescribed a broad-spectrum antibiotic. According to their GP records, less than 10% were referred to or receiving specialist drug treatment (n = 24, 9.3%); or were known to be drug dependent (n = 21, 8.14%), or a drug user (n = 5, 1.94%). In all, 81% were recorded as smokers (n = 209) and 10.5% as ex-smokers (n = 27). Conclusions: The majority of decedents of opioid overdose were in contact with GP services prior to death. GPs are either often unaware of high-risk opioid use, or rarely record details of opioid use in patient notes. It is possible that GP awareness of high-risk opioid use could be increased. For example, awareness of the risks associated with opioid use, and the relationship between the sociodemographic and clinical characteristics of opioid overdose decedents could be raised using educational materials prominently displayed in waiting areas. Clinicians in primary care may be in an excellent position to intervene in problematic opioid use

USDA Instructional Risk Messages for High Pathogen Avian Influenza

High Pathogen Avian Influenza (HPAI) is a highly contagious disease threatening United States poultry farms. The aim of this study is to examine the extent to which current instructional risk communication by the United States Department of Agriculture (USDA) meets the expectations of existing literature, particularly the IDEA model. This study examined two documents produced by the USDA for the ongoing threat of HPAI, the Red Book and the Defend the Flock campaign. The aim of the documents is to provide U.S. poultry farmers and the publics with knowledge and information about prevention and response to HPAI. The IDEA model was applied to serve as a framework to analyze how much of each component was present in the messaging. Specifically, the internalization, explanation, and action components were applied to the USDA documents. The documents were coded by two researchers. The researchers, using a codebook, examined the documents and assessed each section (Red Book) or slogan (Defend the Flock) for the presence or absence of three components of the IDEA model: internalization, explanation, and action. When discrepancies arose between the coders, they were resolved through discussion. The results indicated the majority of the Red Book was dedicated to the explanation component of the IDEA model. Conversely, the majority of the Defend the Flock campaign was identified as either internalization or action. The findings in this study can serve as lessons learned to help to improve the effectiveness of instructional risk messaging in similar crises. Specifically, this study recommends that messages be adapted to the intended audience to help them recognize their personal risks, that explanatory messages be intertwined with recommended actions, and that organizations and agencies consider following the USDA\u27s lead and provide complementary materials. For example, some materials may be highly detailed while an accompanying document could provide a simple, brief overview of the risk and recommended actions

Group Triple P- Positive Parenting Program: Pre-Post Examination of Parent and Child Outcomes, Externalizing Behaviour as a Moderator, and Characteristics of Program Drop Outs

Triple P (Positive Parenting Program) is an evidence-based parent management training program based on social learning theory principles (Sanders, 2012). Parents are taught parenting skills in eight weekly sessions with a trained facilitator. This study evaluated parent and child outcomes for level 4 Group and level 4 Group-Teen Triple P in community (n = 152) and clinic (n = 89) samples. Comparison of standard pre- and post-intervention measures revealed significant improvements in both child emotional and behavioural symptoms, and parenting skills and confidence. There was no differential treatment effect for children presenting with clinical levels of externalizing symptoms only (n = 19) compared to those presenting with comorbid internalizing and externalizing symptoms (n = 25). No significant differences were found in demographic variables or initial child behaviour ratings among parents who dropped out of the program prematurely compared to those who completed the program. Results are discussed in terms of implications for practice and theory

Tolerance of the lamprey olfactory system to copper concentrations found in roadway runoff waters to the Great Lakes

In fishes, olfaction mediates a variety of behaviours necessary for survival and reproduction. Environmental contaminants, specifically copper, are able to disrupt a broad range of olfaction-mediated behaviour, and can cause long-lasting damage due to physiological and genetic changes at low concentrations. To investigate effects of copper on olfaction, the sea lamprey (Petromyzon marinus), an invasive fish species in the Laurentian Great Lakes, was exposed to environmentally relevant copper concentrations of 0, 5, 10 and 30 µg Cu-L. Three techniques were used to measure the effects of exposure of contamination: (i) immunohistochemical analysis of olfactory epithelium, (ii) local field potential recordings in odor-evoked responses, and (iii) gene transcription response to copper toxicity. Impairment in olfactory epithelium was demonstrated through loss of dendritic extension of olfactory sensory neurons, as well as a dose-dependent reduction in olfactory response to male sex pheromone odors. Differentially expressed genes were identified following exposure in each concentration. Low levels of copper measured in urban waterways were found to impair olfactory senses of the sea lamprey

Are GIS-modelled routes a useful proxy for the actual routes followed by commuters?

Active commuting offers the potential to increase physical activity among adults by being built into daily routines. Characteristics of the route to work may influence propensity to walk or cycle. Geographic information system (GIS) software is often used to explore this by modelling routes between home and work. However, if the validity of modelled routes depends on the mode of travel used, studies of environmental determinants of travel may be biased. We aimed to understand how well modelled routes reflect those actually taken, and what characteristics explain these differences. We compared modelled GIS shortest path routes with actual routes measured using QStarz BT-Q1000X Global Positioning System (GPS) devices in a free-living sample of adults working in Cambridge and using varying travel modes. Predictors of differences, according to length and percentage overlap, between the two route sets were assessed using multilevel regression models and concordance coefficients. The 276 trips, made by 51 participants, were on average 27% further than modelled routes, with an average geographical overlap of 39%. However, predictability of the route depended on travel mode. For route length, there was moderate-to-substantial agreement for journeys made on foot and by bicycle. Route overlap was lowest for trips made by car plus walk (22%). The magnitude of difference depended on other journey characteristics, including travelling via intermediate destinations, distance, and use of busy roads. In conclusion, GIS routes may be acceptable for distance estimation and to explore potential routes, particularly active commuting. However, GPS should be used to obtain accurate estimates of environmental contexts in which commuting behaviour actually occurs. Public health researchers should bear these considerations in mind when studying the geographical determinants and health implications of commuting behaviour, and when recommending policy changes to encourage active travel.The Commuting and Health in Cambridge study was developed by David Ogilvie, Simon Griffin, Andy Jones and Roger Mackett and initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence (087636/Z/08/Z and ES/G007462/1). Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study is now funded by the National Institute for Health Research Public Health Research programme (project number 09/3001/06: see http://www.phr.nihr.ac.uk/funded_projects). David Ogilvie is supported by the Medical Research Council (Unit Programme number MC_UU_12015/6). Jenna Panter is supported by an NIHR post-doctoral fellowship (NIHR-PDF-2012-05-157). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR PHR programme or the Department of Health. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript. We thank all staff from the MRC Epidemiology Unit Functional Group Team, in particular for study coordination and data collection (led by Cheryl Chapman), physical activity data processing and data management.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.jth.2014.10.00

Environmental determinants of active travel in youth: a review and framework for future research.

BACKGROUND: Many youth fail to meet the recommended guidelines for physical activity. Walking and cycling, forms of active travel, have the potential to contribute significantly towards overall physical activity levels. Recent research examining the associations between physical activity and the environment has shown that environmental factors play a role in determining behaviour in children and adolescents. However, links between the environment and active travel have received less attention. METHODS: Twenty four studies were identified which examined the associations between the environment (perceived or objectively measured) and active travel among youth aged 5-18 years. Findings were categorised according to the location of the environmental measure examined; attributes of the neighbourhood, destination and the route between home and destination. RESULTS: Results from the reviewed studies indicated that youth active travel is positively associated with social interactions, facilities to assist active travel and urban form in the neighbourhood as well as shorter route length and road safety en-route. A conceptual framework is presented which highlights the associations between active travel behaviours and environmental factors, drawing upon both existing and hypothesised relationships. CONCLUSION: We provide a review of the available literature and present a novel theoretical framework that integrates the environment into the wider decision making process around travel choices for children and adolescents. Further work should explore associations where gaps in understanding have been identified, and account for the main moderators of behaviour so hypothesised associations can be confirmed.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Correlates of time spent walking and cycling to and from work: baseline results from the commuting and health in Cambridge study.

PURPOSE: Environmental perceptions and psychological measures appear to be associated with walking and cycling behaviour; however, their influence is still unclear. We assessed these associations using baseline data from a quasi-experimental cohort study of the effects of major transport infrastructural developments in Cambridge, UK. METHODS: Postal surveys were sent to adults who travel to work in Cambridge (n = 1582). Questions asked about travel modes and time spent travelling to and from work in the last week, perceptions of the route, psychological measures regarding car use and socio-demographic characteristics. Participants were classified into one of two categories according to time spent walking for commuting ('no walking' or 'some walking') and one of three categories for cycling ('no cycling', '1-149 min/wk' and ' ≥ 150 min/wk'). RESULTS: Of the 1164 respondents (68% female, mean (SD) age: 42.3 (11.4) years) 30% reported any walking and 53% reported any cycling to or from work. In multiple regression models, short distance to work and not having access to a car showed strong positive associations with both walking and cycling. Furthermore, those who reported that it was pleasant to walk were more likely to walk to or from work (OR = 4.18, 95% CI 3.02 to 5.78) and those who reported that it was convenient to cycle on the route between home and work were more likely to do so (1-149 min/wk: OR = 4.60, 95% CI 2.88 to 7.34; ≥ 150 min/wk: OR = 3.14, 95% CI 2.11 to 4.66). Positive attitudes in favour of car use were positively associated with time spent walking to or from work but negatively associated with cycling to or from work. Strong perceived behavioural control for car use was negatively associated with walking. CONCLUSIONS: In this relatively affluent sample of commuters, a range of individual and household characteristics, perceptions of the route environment and psychological measures relating to car use were associated with walking or cycling to and from work. Taken together, these findings suggest that social and physical contexts of travel decision-making should be considered and that a range of influences may require to be addressed to bring about behaviour change.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are