Mothers’ and fathers’ perceptions of marital relationships and coparenting twins during school transition

Coparenting and the marital relationship are closely related yet distinct family subsystems hypothesized to influence one another. Little is known about these processes with consideration of more than one child in the family, which may have important implications. Here, we specifically focus on families with young twins, enabling us to account for sibling age-difference confounds, as well as due to the greater parenting demands and higher divorce rates in twin families. Using cross-lagged models for both mothers and fathers, we examined bidirectional associations between coparenting and the marital relationship during children’s transition to formal schooling. Parents of twins from 107 ‘intact’ families reported perceptions of coparenting and the marital relationship via telephone interview at Time 1 (Mchild age = 4years 8 months, SDchild age = 4.44 months) and questionnaire at Time 2 (Mchild age = 6 years, SDchild age = 6.12 months). Accounting for within-time associations and temporal stability for both mothers and fathers, coparenting was positively associated with subsequent reports of the marital relationship; there was no evidence of reciprocal associations between the marital relationship and subsequent coparenting. As children transition to primary school, the quality of coparenting may be a driver of the quality of the marital relationship for parents of twins. Those seeking to improve the marital relationship should pay due attention to perceptions of coparenting

A harsh parenting team? Maternal reports of coparenting and coercive parenting interact in association with children’s disruptive behaviour

Background: Parenting and coparenting are both important for children’s adjustment, but their interaction has been little explored. Using a longitudinal design and considering two children per family, we investigated mothers’ and fathers’ perceptions of coparenting as moderators of associations between their coercive parenting and children’s disruptive behaviour. Methods: Mothers and fathers from 106 ‘intact’ families were included from the Twins, Family and Behaviour study (TFaB). At Time 1 (Mchild age=3 years 11 months, SDchild age=4.44 months) parents reported on their coercive parenting and children’s disruptive behaviour via questionnaire; at Time 2 (Mchild age=4 years 8 months, SDchild age=4.44 months) perceptions of coparenting and the marital relationship were collected by telephone interview. Questionnaire-based reports of children’s disruptive behaviour were collected at follow-up (Mchild age=5 years 11 months, SDchild age=5.52 months). Multilevel modelling was used to examine child-specific and family-wide effects. Results: Conservative multilevel models including both maternal and paternal perceptions demonstrated that maternal perceptions of coparenting and overall coercive parenting interacted in their prediction of parent-reported child disruptive behaviour. Specifically, accounting for perceived marital quality, behavioural stability, and fathers’ perceptions, only in the context of perceived higher quality coparenting was there a positive association between mother-reported overall coercive parenting and children’s disruptive behaviour at follow-up. Conclusions: When combined with highly coercive parenting, maternal perceptions of high quality coparenting may be detrimental for children’s adjustment

Ischemic Heart Disease Incidence in Relation to Fine versus Total Particulate Matter Exposure in a U.S. Aluminum Industry Cohort.

Ischemic heart disease (IHD) has been linked to exposures to airborne particles with an aerodynamic diameter <2.5 μm (PM2.5) in the ambient environment and in occupational settings. Routine industrial exposure monitoring, however, has traditionally focused on total particulate matter (TPM). To assess potential benefits of PM2.5 monitoring, we compared the exposure-response relationships between both PM2.5 and TPM and incidence of IHD in a cohort of active aluminum industry workers. To account for the presence of time varying confounding by health status we applied marginal structural Cox models in a cohort followed with medical claims data for IHD incidence from 1998 to 2012. Analyses were stratified by work process into smelters (n = 6,579) and fabrication (n = 7,432). Binary exposure was defined by the 10th-percentile cut-off from the respective TPM and PM2.5 exposure distributions for each work process. Hazard Ratios (HR) comparing always exposed above the exposure cut-off to always exposed below the cut-off were higher for PM2.5, with HRs of 1.70 (95% confidence interval (CI): 1.11-2.60) and 1.48 (95% CI: 1.02-2.13) in smelters and fabrication, respectively. For TPM, the HRs were 1.25 (95% CI: 0.89-1.77) and 1.25 (95% CI: 0.88-1.77) for smelters and fabrication respectively. Although TPM and PM2.5 were highly correlated in this work environment, results indicate that, consistent with biologic plausibility, PM2.5 is a stronger predictor of IHD risk than TPM. Cardiovascular risk management in the aluminum industry, and other similar work environments, could be better guided by exposure surveillance programs monitoring PM2.5

Particle Size Distribution in Aluminum Manufacturing Facilities.

As part of exposure assessment for an ongoing epidemiologic study of heart disease and fine particle exposures in aluminum industry, area particle samples were collected in production facilities to assess instrument reliability and particle size distribution at different process areas. Personal modular impactors (PMI) and Minimicro-orifice uniform deposition impactors (MiniMOUDI) were used. The coefficient of variation (CV) of co-located samples was used to evaluate the reproducibility of the samplers. PM2.5 measured by PMI was compared to PM2.5 calculated from MiniMOUDI data. Mass median aerodynamic diameter (MMAD) and concentrations of sub-micrometer (PM1.0) and quasi-ultrafine (PM0.56) particles were evaluated to characterize particle size distribution. Most of CVs were less than 30%. The slope of the linear regression of PMI_PM2.5 versus MiniMOUDI_PM2.5 was 1.03 mg/m3 per mg/m3 (± 0.05), with correlation coefficient of 0.97 (± 0.01). Particle size distribution varied substantively in smelters, whereas it was less variable in fabrication units with significantly smaller MMADs (arithmetic mean of MMADs: 2.59 μm in smelters vs. 1.31 μm in fabrication units, p = 0.001). Although the total particle concentration was more than two times higher in the smelters than in the fabrication units, the fraction of PM10 which was PM1.0 or PM0.56 was significantly lower in the smelters than in the fabrication units (p < 0.001). Consequently, the concentrations of sub-micrometer and quasi-ultrafine particles were similar in these two types of facilities. It would appear, studies evaluating ultrafine particle exposure in aluminum industry should focus on not only the smelters, but also the fabrication facilities

Incident Ischemic Heart Disease After Long-Term Occupational Exposure to Fine Particulate Matter: Accounting for 2 Forms of Survivor Bias.

Little is known about the heart disease risks associated with occupational, rather than traffic-related, exposure to particulate matter with aerodynamic diameter of 2.5 µm or less (PM2.5). We examined long-term exposure to PM2.5 in cohorts of aluminum smelters and fabrication workers in the United States who were followed for incident ischemic heart disease from 1998 to 2012, and we addressed 2 forms of survivor bias. Left truncation bias was addressed by restricting analyses to the subcohort hired after the start of follow up. Healthy worker survivor bias, which is characterized by time-varying confounding that is affected by prior exposure, was documented only in the smelters and required the use of marginal structural Cox models. When comparing always-exposed participants above the 10th percentile of annual exposure with those below, the hazard ratios were 1.67 (95% confidence interval (CI): 1.11, 2.52) and 3.95 (95% CI: 0.87, 18.00) in the full and restricted subcohorts of smelter workers, respectively. In the fabrication stratum, hazard ratios based on conditional Cox models were 0.98 (95% CI: 0.94, 1.02) and 1.17 (95% CI: 1.00, 1.37) per 1 mg/m(3)-year in the full and restricted subcohorts, respectively. Long-term exposure to occupational PM2.5 was associated with a higher risk of ischemic heart disease among aluminum manufacturing workers, particularly in smelters, after adjustment for survivor bias

The cadmium-phosphate relationship in brine: biological versus physical control over micronutrients in sea ice environments

Despite supporting productive ecosystems in the high latitudes, the relationship between macro- and micronutrients in sea ice environments and their impact on surface productivity is poorly documented. In seawater, the macronutrient phosphate and the micronutrient cadmium follow similar distributions, which are controlled by biological processes in surface waters. We investigated cadmium and phosphate in sea ice brine, and the biological and physical processes controlling their distribution. Cadmium concentrations in sea ice brine ranged from 0.092.4 nmol kg-1, and correlated well with salinity. Our results show that micronutrients in sea ice are most probably sourced from the seawater from which it froze rather than external sources such as atmospheric deposition. The weak correlation between sea ice cadmium and phosphate, and the positive relationship between cadmium and biomass, suggests against biological uptake being a principal control over micronutrient distribution even in a highly productive setting. Instead, brine expulsion and dilution play a dominant role in cadmium distribution in sea ice. Nutrient dilution within brine channels during melting, and contrasting sea ice and open water phytoplankton populations, suggests that late spring sea ice is not a significant source of nutrients or biomass to seawater. We suggest that future changes in sea ice seasonality may impact nutrient distribution and Antarctic marine ecosystems. © 2009 Antarctic Science Ltd

Social prescribing practices and learning across the North West Coast region: essential elements and key challenges to implementing effective and sustainable social prescribing services

IntroductionSocial prescribing has become an important feature of the UK primary care offer. However, there remains limited evidence on how best to implement and deliver social prescribing programmes to maximise effectiveness and long-term sustainability.AimTo explore social prescribing practices and experience of implementing social prescribing programmes across National Institute for Health and Social Care Research (NIHR) Collaborative Leadership for Applied Health and Care Research (CLAHRC) North West Coast (NWC) and NIHR Applied Research Collaboration (ARC) NWC region to identify key learning points that can be applied to other settings.MethodWe held a learning exchange workshop attended by practitioners and Public Advisors who had been involved in implementing and evaluating eight different social prescribing programmes with the support of NIHR CLAHRC NWC. We followed this with an online survey of social prescribing practice and priorities within the NIHR ARC NWC area. We used the findings from the workshop and survey to develop an initial model of the elements needed to successfully implement and sustain a working social prescribing programme.FindingsWe identified three core essential elements for a successful social prescribing programme: a personalised approach; meaningful service-user and community involvement; and whole systems working. These core elements need to be supported with adequate resources in the form of continuity of funding and adequate community resources to refer people to, capacity building and appropriate evaluation.ConclusionWe were able to use a learning exchange workshop to both facilitate learning between practitioners and begin the process of identifying the ingredients needed for a successful social prescribing programme, which may be built on with further research

Peripheral blood monocyte gene expression profile clinically stratifies patients with recent-onset type 1 diabetes

Novel biomarkers of disease progression after type 1 diabetes onset are needed. We profiled peripheral blood (PB) monocyte gene expression in six healthy subjects and 16 children with type 1 diabetes diagnosed ∼3 months previously and analyzed clinical features from diagnosis to 1 year. Monocyte expression profiles clustered into two distinct subgroups, representing mild and severe deviation from healthy control subjects, along the same continuum. Patients with strongly divergent monocyte gene expression had significantly higher insulin dose-adjusted HbA 1clevels during the first year, compared with patients with mild deviation. The diabetes-associated expression signature identified multiple perturbations in pathways controlling cellular metabolism and survival, including endoplasmic reticulum and oxidative stress (e.g., induction of HIF1A, DDIT3, DDIT4, and GRP78). Quantitative PCR (qPCR) of a 9-gene panel correlated with glycemic control in 12 additional recent-onset patients. The qPCR signature was also detected in PB from healthy first-degree relatives. A PB gene expression signature correlates with glycemic control in the first year after diabetes diagnosis and is present in at-risk subjects. These findings implicate monocyte phenotype as a candidate biomarker for disease progression pre- and post-onset and systemic stresses as contributors to innate immune function in type 1 diabetes. © 2012 by the American Diabetes Association

Low Frequency Variants in the Exons Only Encoding Isoform A of HNF1A Do Not Contribute to Susceptibility to Type 2 Diabetes

Background: There is considerable interest in the hypothesis that low frequency, intermediate penetrance variants contribute to the proportion of Type 2 Diabetes (T2D) susceptibility not attributable to the common variants uncovered through genome-wide association approaches. Genes previously implicated in monogenic and multifactorial forms of diabetes are obvious candidates in this respect. In this study, we focussed on exons 8-10 of the HNF1A gene since rare, penetrant mutations in these exons (which are only transcribed in selected HNF1A isoforms) are associated with a later age of diagnosis of Maturity onset diabetes of the young (MODY) than mutations in exons 1-7. The age of diagnosis in the subgroup of HNF1A-MODY individuals with exon 8-10 mutations overlaps with that of early multifactorial T2D, and we set out to test the hypothesis that these exons might also harbour low-frequency coding variants of intermediate penetrance that contribute to risk of multifactorial T2D. Methodology and principal findings: We performed targeted capillary resequencing of HNF1A exons 8-10 in 591 European T2D subjects enriched for genetic aetiology on the basis of an early age of diagnosis (≤ 45 years) and/or family history of T2D (≥ 1 affected sibling). PCR products were sequenced and compared to the published HNF1A sequence. We identified several variants (rs735396 [IVS9-24T>C], rs1169304 [IVS8+29T>C], c.1768+44C>T [IVS9+44C>T] and rd61953349 [c.1545G>A, p.T515T] but no novel non-synonymous coding variants were detected. Conclusions and significance: We conclude that low frequency, nonsynonymous coding variants in the terminal exons of HNF1A are unlikely to contribute to T2D-susceptibility in European samples. Nevertheless, the rationale for seeking low-frequency causal variants in genes known to contain rare, penetrant mutations remains strong and should motivate efforts to screen other genes in a similar fashion