Low-income minority mothers’ reports of infant health care utilisation compared with medical records

This study aimed to investigate mothers’ reporting of the nature, location, frequency and content of health care visits for their infants, as compared with data abstracted from the infants’ medical records. It was part of a community-based parenting intervention designed to improve preventive health care utilisation among minority mothers in Washington, DC. Mothers 18 years old with newborn infants and with poor or no prenatal care were enrolled in the study. A total of 160 mother–infant dyads completed the 12-month study. Mothers were interviewed when the infants were 4, 8 and 12 months old, and were asked to recall infant visits to all health care providers. Medical records from identified providers were used for verification. The number and type of immunisations given, types of providers visited, and reason for the visits were compared. Only about a quarter of mothers agreed with their infants’ medical records on the number of specific immunisations received. The mothers reported fewer polio (1.8 vs. 2.1, P = 0.006), diphtheria and tetanus toxoids and pertussis (DTP) (1.8 vs. 2.2, P = 0.002), and Haemophilus influenzae type b (HiB) (1.3 vs. 2.1, P \u3c 0.0001) immunisations than were recorded. Similarly, about a quarter of the mothers were unaware of any polio, DTP or hepatitis B immunisations given, as documented in the medical records, and 38% did not know that their infant was immunised for HiB. Nearly half of the mothers recalled more infant doctors’ visits than were recorded in the medical records (4.1 vs. 3.6 visits, P = 0.017). The mothers generally disagreed with the providers about the reason for a particular visit and reported fewer sick-baby visits (1.5 vs. 3.3, P \u3c 0.0001) than the providers recorded. Mothers’ reports and medical records matched in only 19% of the cases. In 47%, mothers under-reported and in 34% overreported the total number of visits. The strongest agreement between mothers’ reports and medical records was in the case of emergency room visits (63%). In conclusion, in this population, mothers’ reporting did not match that of providers with respect to specific information: the number of immunisations, the location where services were provided, and the classification of sick- vs. well-baby visits. Future studies that evaluate health care utilization data should take these discrepancies into consideration in their selection of information source, and in their interpretation of the data

A two-component regulatory system modulates twitching motility in Dichelobacter nodosus

© 2015 Elsevier B.V. All rights reserved. Dichelobacter nodosus is the essential causative agent of footrot in sheep and type IV fimbriae-mediated twitching motility has been shownto be essential for virulence.Wehave identified a two-component signal transduction system (TwmSR) that shows similarity to chemosensory systems from other bacteria. Insertional inactivation of the gene encoding the response regulator, TwmR, led to a twitching motility defect, with the mutant having a reduced rate of twitching motility when compared to the wild-type and a mutant complemented with the wild-type twmR gene. The reduced rate of twitching motility was not a consequence of a reduced growth rate or decreased production of surface located fimbriae, but video microscopy indicated that it appeared to result from an overall loss of twitching directionality. These results suggest that a chemotactic response to environmental factors may play an important role in the D. nodosus-mediated disease process

High thermal tolerance in high-elevation species and laboratory-reared colonies of tropical bumble bees

Bumble bees are key pollinators with some species reared in captivity at a commercial scale, but with significant evidence of population declines and with alarming predictions of substantial impacts under climate change scenarios. While studies on the thermal biology of temperate bumble bees are still limited, they are entirely absent from the tropics where the effects of climate change are expected to be greater. Herein, we test whether bees' thermal tolerance decreases with elevation and whether the stable optimal conditions used in laboratory-reared colonies reduces their thermal tolerance. We assessed changes in the lower (CTMin) and upper (CTMax) critical thermal limits of four species at two elevations (2600 and 3600 m) in the Colombian Andes, examined the effect of body size, and evaluated the thermal tolerance of wild-caught and laboratory-reared individuals of Bombus pauloensis. We also compiled information on bumble bees' thermal limits and assessed potential predictors for broadscale patterns of variation. We found that CTMin decreased with increasing elevation, while CTMax was similar between elevations. CTMax was slightly higher (0.84°C) in laboratory-reared than in wild-caught bees while CTMin was similar, and CTMin decreased with increasing body size while CTMax did not. Latitude is a good predictor for CTMin while annual mean temperature, maximum and minimum temperatures of the warmest and coldest months are good predictors for both CTMin and CTMax. The stronger response in CTMin with increasing elevation, and similar CTMax, supports Brett's heat-invariant hypothesis, which has been documented in other taxa. Andean bumble bees appear to be about as heat tolerant as those from temperate areas, suggesting that other aspects besides temperature (e.g., water balance) might be more determinant environmental factors for these species. Laboratory-reared colonies are adequate surrogates for addressing questions on thermal tolerance and global warming impacts

Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers

Background—Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods—From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001–October 2003), cotinine-confirmed nonsmokers with partners, household/ family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS avoidance. Data were initially analyzed in 2004. Final models were reviewed and revised in 2007 and 2008. Results—Twenty-seven percent of pregnant nonsmokers were confirmed as ETS avoiders. In multivariate logistic regression analysis, the odds of ETS avoidance were increased among women who reported household smoking bans (OR=2.96; 95% CI=1.83, 4.77; p Conclusions—Social contextual factors were the strongest determinants of ETS avoidance during pregnancy. Results highlight the importance of prenatal screening to identify pregnant nonsmokers at risk, encouraging household smoking bans, gaining support from significant others, and fully understanding the interpersonal context of a woman’s pregnancy before providing behavioral counseling and advice to prevent ETS exposure

Parametrically excited surface waves: Two-frequency forcing, normal form symmetries, and pattern selection

Motivated by experimental observations of exotic standing wave patterns in the two-frequency Faraday experiment, we investigate the role of normal form symmetries in the pattern selection problem. With forcing frequency components in ratio m/n, where m and n are co-prime integers, there is the possibility that both harmonic and subharmonic waves may lose stability simultaneously, each with a different wavenumber. We focus on this situation and compare the case where the harmonic waves have a longer wavelength than the subharmonic waves with the case where the harmonic waves have a shorter wavelength. We show that in the former case a normal form transformation can be used to remove all quadratic terms from the amplitude equations governing the relevant resonant triad interactions. Thus the role of resonant triads in the pattern selection problem is greatly diminished in this situation. We verify our general results within the example of one-dimensional surface wave solutions of the Zhang-Vinals model of the two-frequency Faraday problem. In one-dimension, a 1:2 spatial resonance takes the place of a resonant triad in our investigation. We find that when the bifurcating modes are in this spatial resonance, it dramatically effects the bifurcation to subharmonic waves in the case of forcing frequencies are in ratio 1/2; this is consistent with the results of Zhang and Vinals. In sharp contrast, we find that when the forcing frequencies are in ratio 2/3, the bifurcation to (sub)harmonic waves is insensitive to the presence of another spatially-resonant bifurcating mode

Young carers in England: findings from the 2018 BBC survey on the prevalence and nature of caring among young people

Background Many young people are involved in caring for parents, siblings, or other relatives who have an illness or disability. The aim of this study was to estimate the prevalence of caring by young people in England. Method A national survey of 925 English young people was conducted using the 18‐item survey version of the Multidimensional Assessment of Caring Activities Checklist for Young Carers. Results Around 7% of young people were identified as doing at least a high amount of caring activity and 3% a very high amount. Most frequently, caring by a young person is for a mother or a sibling, with a physical disability. Caring activity consisted mostly of domestic activities, household management, and emotional care. Conclusion This study provides the most up to date and methodologically sophisticated survey data on the prevalence of young caring in England, with implications for policy and practice

Bargaining with Optimism

Excessive optimism is a prominent explanation for bargaining delays. Recent results demonstrate that optimism plays a subtle role in bargaining, and its careful analysis may shed valuable insights into negotiation behavior. This article reviews some of these results, focusing on the following findings. First, when there is a nearby deadline, optimistic players delay the agreement to the last period before the deadline, replicating a broad empirical regularity known as the deadline effect. Second, there cannot be a substantial delay under persistent optimism; i.e., excessive optimism alone cannot explain delays. Third, when optimistic players are expected to learn during the negotiation, they delay the agreement in order to persuade their opponents. The delays in these results can be quite costly, Pareto inefficient, and common knowledge at the beginning of the game

Application of reflectance parameters in the estimation of the structural order of coals and carbonaceous materials. Precision and bias of measurements derived from the ICCP structural working group

Optical reflectance of vitrinite is one of the fundamental physical properties that have been used for the study of coal and carbonaceous materials. Organic matter in coals and carbonaceous matter consists mainly of aromatic lamellae, whose dimensions and spatial orientation define its internal structure. Various reflectance parameters describe well the average degree of order of the molecular structure of organic matter. Moreover, reflectance parameters are numerical values which characterize the samples unambiguously, facilitating the comparison of the optical properties of different carbonaceous materials as well as comparison between optical parameters and other physical or chemical factors. The focus of this study is the evaluation of the precision and bias of reflectance measurements (R and R) performed by various analysts in different laboratories in order to check the applicability of reflectance parameters to the estimation of the structural order of coals and carbonaceous materials. Additionally, it was desirable to compare reflectance parameters with other parameters obtained by different analytical methods able to provide structural information. The consistency and repeatability of the reflectance measurements obtained by different participants turned out to enable the drawing of similar conclusions regarding the structural transformation of anthracite during heating. Good correlations were found between the reflectance parameters studied and structural factors obtained by comparative methods. The reflectance parameters examined proved to be very sensitive to any changes of the structural order of coals and carbonaceous materials and seem to be a perfect complement to structural studies made by X-ray diffraction or Raman spectroscopy