699 research outputs found

    Fathers in Fragile Families

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    Nonmarital childbearing has increased dramatically in the U.S. since the early 1960s, rising from 6% of all births in 1960 to fully 40% in 2007 (Hamilton, Martin, & Ventura, 2009; Ventura & Bachrach, 2000). Whereas similar trends have occurred in many developed nations, the U.S. stands out in the extent to which such births are associated with socioeconomic disadvantage and relationship instability, giving rise to a new term ‘fragile families.’ The increase in fragile families reflects changes not only in the context of births but also in the fundamental nature and patterns of childrearing, particularly with respect to fathers’ roles and involvement with children.Fragile families, childbearing, nonmarital childbearing, fartherhood, fathers

    DOES MOTHER KNOW BEST?: A COMPARISON OF BIOLOGICAL AND SOCIAL FATHERS AFTER A NONMARITAL BIRTH

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    High rates of nonmarital childbearing combined with high rates of instability and repartnering in nonmarital relationships portend that a large proportion of children born to unmarried mothers can expect to spend time with a ‘social father.’ This paper uses data from the Fragile Families and Child Wellbeing Study to examine the prevalence and characteristics of social fathers during the first three years following a nonmarital birth. The results indicate that 22% of unmarried mothers have formed new partnerships by the time their child is age three, and 12% are living with their new partners. The results also indicate that re-partnering represents a gain for most mothers and children in terms of fathers’ human capital and pro-social behavior. Our findings are consistent with the idea that unmarried mothers continue to search for ‘good fathers’ after their children are born and that many of these women are successful in their search.

    Couples as Partners and Parents over Children’s Early Years

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    We use data from the Fragile Families and Child Wellbeing Study to examine couple how couple relationship quality and parental engagement are linked over children’s early years. Our sample includes 1,630 couples that are co-resident over years 1 to 3 and 1,376 over years 3 to 5 (1,196 over both periods). Overall, we find that better relationship quality predicts greater parental engagement for both mothers and fathers—especially from children’s infant to toddler years; we find little evidence that parenting predicts future relationship quality. Married and cohabiting couples are generally similar in how relationship quality and parenting are linked. When couples are having their first birth, relationship quality is more strongly tied to parental engagement for fathers (but not mothers).Couple relationship quality, parenting, fragile families

    Sex, pregnancy and aortic disease in Marfan syndrome

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    Background : Sex-related differences as well as the adverse effect of pregnancy on aortic disease outcome are well-established phenomena in humans with Marfan syndrome (MFS). The underlying mechanisms of these observations are largely unknown. Objectives : In an initial (pilot) step we aimed to confirm the differences between male and female MFS patients as well as between females with and without previous pregnancy. We then sought to evaluate whether these findings are recapitulated in a pre-clinical model and performed in-depth cardiovascular phenotyping of mutant male and both nulliparous and multiparous female Marfan mice. The effect of 17 beta-estradiol on fibrillin-1 protein synthesis was compared in vitro using human aortic smooth muscle cells and fibroblasts. Results : Our small retrospective study of aortic dimensions in a cohort of 10 men and 20 women with MFS (10 pregnant and 10 non-pregnant) confirmed that aortic root growth was significantly increased in the pregnant group compared to the non-pregnant group (0.64mm/year vs. 0.12mm/year, p = 0.018). Male MFS patients had significantly larger aortic root diameters compared to the non-pregnant and pregnant females at baseline and follow-up (p = 0.002 and p = 0.007, respectively), but no significant increase in aortic root growth was observed compared to the females after follow-up (p = 0.559 and p = 0.352). In the GT-8/+ MFS mouse model, multiparous female Marfan mice showed increased aortic diameters when compared to nulliparous females. Aortic dilatation in multiparous females was comparable to Marfan male mice. Moreover, increased aortic diameters were associated with more severe fragmentation of the elastic lamellae. In addition, 17 beta-estradiol was found to promote fibrillin-1 production by human aortic smooth muscle cells. Conclusions : Pregnancy-related changes influence aortic disease severity in otherwise protected female MFS mice and patients. There may be a role for estrogen in the female sex protective effect

    The opposites task: Using general rules to test cognitive flexibility in preschoolers

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    A brief narrative description of the journal article, document, or resource. Executive functions play an important role in cognitive development, and during the preschool years especially, children's performance is limited in tasks that demand flexibility in their behavior. We asked whether preschoolers would exhibit limitations when they are required to apply a general rule in the context of novel stimuli on every trial (the "opposites" task). Two types of inhibitory processing were measured: response interference (resistance to interference from a competing response) and proactive interference (resistance to interference from a previously relevant rule). Group data show 3-year-olds have difficulty inhibiting prepotent tendencies under these conditions, whereas 5-year-olds' accuracy is near ceiling in the task. (Contains 4 footnotes and 1 table.

    Real-world Multicenter Analysis of Clinical Outcomes and Safety of Meropenem-Vaborbactam in Patients Treated for Serious Gram-Negative Bacterial Infections

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    Fourty patients were treated with meropenem-vaborbactam (MEV) for serious Gram-negative bacterial (GNB) infections. Carbapenem-resistant Enterobacteriaceae (CRE) comprised 80.0% of all GNB infections. Clinical success occurred in 70.0% of patients. Mortality and recurrence at 30 days were 7.5% and 12.5%, respectively. One patient experienced a probable rash due to MEV

    Capacity Building for a New Multicenter Network Within the ECHO IDeA States Pediatric Clinical Trials Network

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    Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN. Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research capacity for pediatrician scientists and team members. The inventory findings were utilized by the ISPCTN Data Coordinating and Operations Center to construct training modules covering 3 broad domains: Faculty/coordinator development; Infrastructure; Trials/Research concept development. Results: Key lessons learned reveal substantial participation in the training modules, the importance of an inventory to guide the development of trainings, and recognizing local barriers to clinical trials research. Conclusions: Research networks that seek to implement successfully completed trials need to build capacity across and within the sites engaged. Our findings indicate that building research capacity is a multi-faceted endeavor, but likely necessary for sustainability of a unique network addressing high impact pediatric health problems. The ISPCTN emphasis on building and enhancing site capacity, including pediatrician scientists and team members, is critical to successful trial implementation/completion and the production of findings that enhance the lives of children and families

    Real-world, Multicenter Experience With Meropenem-Vaborbactam for Gram-Negative Bacterial Infections Including Carbapenem-Resistant Enterobacterales and Pseudomonas Aeruginosa

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    Background: We aimed to describe the clinical characteristics and outcomes of patients treated with meropenem-vaborbactam (MEV) for a variety of gram-negative infections (GNIs), primarily including carbapenem-resistant Enterobacterales (CRE). Methods: This is a real-world, multicenter, retrospective cohort within the United States between 2017 and 2020. Adult patients who received MEV for ≄72 hours were eligible for inclusion. The primary outcome was 30-day mortality. Classification and regression tree analysis (CART) was used to identify the time breakpoint (BP) that delineated the risk of negative clinical outcomes (NCOs) and was examined by multivariable logistic regression analysis (MLR). Results: Overall, 126 patients were evaluated from 13 medical centers in 10 states. The most common infection sources were respiratory tract (38.1%) and intra-abdominal (19.0%) origin, while the most common isolated pathogens were CRE (78.6%). Thirty-day mortality and recurrence occurred in 18.3% and 11.9%, respectively. Adverse events occurred in 4 patients: nephrotoxicity (n = 2), hepatoxicity (n = 1), and rash (n = 1). CART-BP between early and delayed treatment was 48 hours (P = .04). MEV initiation within 48 hours was independently associated with reduced NCO following analysis by MLR (adusted odds ratio, 0.277; 95% CI, 0.081-0.941). Conclusions: Our results support current evidence establishing positive clinical and safety outcomes of MEV in GNIs, including CRE. We suggest that delaying appropriate therapy for CRE significantly increases the risk of NCOs
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