A Model for Internalized Stigma in Children and Adolescents with Epilepsy

Objective Perceptions of stigma in children and adolescents with epilepsy are associated with higher rates of mental health problems. The purpose of this study was to test relationships in a model that identified variables most strongly associated with perceptions of stigma in children and adolescents with epilepsy. Our ultimate goal is to develop a theoretical foundation for future intervention research by identifying variables associated with perceptions of stigma that are potentially amenable to psychosocial interventions. Methods Participants were 173 children and adolescents with epilepsy who were between 9 and 14 years of age. Data were collected in telephone interviews. Stigma was measured using a self-report scale. Data were analyzed using structural equation modeling. Results Greater need for information and support, more fear and worry related to having epilepsy, greater seizure severity, and younger age were significantly associated with greater perceptions of stigma. Female gender, greater need for information and support, having at least one seizure in the past year, and lower self-efficacy for seizure management were significantly associated with more fear and worry related to having epilepsy. Conclusions Findings suggest that perceptions of stigma are associated with two variables that are amenable to psychosocial interventions: fear and worry about having epilepsy and need for information and support. Future research should test the efficacy of interventions that reduce fear and worry, provide information about epilepsy, and reduce need for support

Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial

Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics

Children with new onset seizures: A prospective study of parent variables, child behavior problems, and seizure occurrence

OBJECTIVE: Parent variables (stigma, mood, unmet needs for information and support, and worry) are associated with behavioral difficulties in children with seizures; however, it is not known how this relationship is influenced by additional seizures. This study followed children (ages 4-14 years) and their parents over a 24-month period (with data collected at baseline and 6, 12, and 24 months) and investigated the effect of an additional seizure on the relationship between parenting variables and child behavior difficulties. METHODS: The sample was parents of 196 children (104 girls and 92 boys) with a first seizure within the past 6 weeks. Child mean age at baseline was 8 years, 3 months (SD 3 years). Data were analyzed using t-tests, chi-square tests, and repeated measures analyses of covariance. RESULTS: Relationships between parent variables, additional seizures, and child behavior problems were consistent across time. Several associations between parent variables and child behavior problems were stronger in the additional seizure group than in the no additional seizure group. CONCLUSIONS: Findings suggest that interventions that assist families to respond constructively to the reactions of others regarding their child's seizure condition and to address their needs for information and support could help families of children with continuing seizures to have an improved quality of life

Sleep problems increase the risk of musculoskeletal pain in boys but not girls : a prospective cohort study

Adults with sleep problems are at higher risk for onset of musculoskeletal pain, but the evidence is less clear for children. This prospective cohort study investigated whether children with sleep problems are at higher risk for onset of musculoskeletal pain and explored whether sex is a modifier of this association. In a prospective cohort study of Australian schoolchildren (n = 1239, mean age 9 years), the associations between sleep problems at baseline and new onset of both musculoskeletal pain and persistent musculoskeletal pain (pain lasting > 3 months) 1 year later were investigated using logistic regression. The potential modifying effect of sex was also assessed. One-year incidence proportion for musculoskeletal pain onset is 43% and 7% for persistent musculoskeletal pain. Sleep problems were associated with musculoskeletal pain onset and persistent musculoskeletal pain onset in boys, odds ratio 2.80 (95% CI 1.39, 5.62) and OR 3.70 (1.30, 10.54), respectively, but not girls OR 0.58 (0.28, 1.19) and OR 1.43 (0.41, 4.95), respectively. Conclusions: Rates of musculoskeletal pain are high in children. Boys with sleep problems are at greater risk of onset of musculoskeletal pain, but girls do not appear to have higher risk. Consideration of sleep health may help prevent persistent musculoskeletal pain in children.What is Known:center dot Sleep problems are associated with the onset of musculoskeletal pain in adults.center dot It is not clear if the association between sleep problems and the onset of musculoskeletal pain is present also in children and if sex plays a role in this association.What is New:center dot This is the first large population-based study that has prospectively investigated the relationship between sleep problems and onset of musculoskeletal pain in school-aged children.center dot Children, especially boys with sleep problems, were at increased risk for the development of persistent musculoskeletal pain.Peer reviewe

Labeling of Biotechnology Products

labeling of biotech products in foodSpeakers t this symposium presented issues surround the issue of labeling of biotech products and the right of the consumer to know about the ingredients of the food they eat

Navegando no terreno disputado da política e prática da formação de professores: Os autores respondem a SCALE

Stanford Center for Assessment, Learning, and Equity (SCALE) provided a commentary on the manuscripts in the first part of this special issue, which highlighted the benefits of edTPA and the necessity for such assessment programs to improve teacher education and strengthen teaching practices. In turn, the authors responded to the SCALE commentary. The authors’ responses raise concerns about equity, fairness, and unintended consequences of teacher performance assessments. These responses highlight the need for continued dialogue on ways to improve teacher education and strengthen the teaching profession.Stanford Center for Assessment, Learning and Equity (SCALE) ofreció un comentario sobre los manuscritos en la primera parte de esta edicion especial, que destacó los beneficios de edTPA y la necesidad de dichos programas de evaluación para mejorar la formación docente y para fortalecer las prácticas docentes. A la vez, los autores respondieron al comentario SCALE. Las respuestas de los autores plantean inquietudes sobre la equidad, la rectitud y las consecuencias involuntarias de las evaluaciones del desempeño docente. Estas respuestas revelan la necesidad de un diálogo continuo sobre las formas de mejorar la formación docente y fortalecer la profesión docente.Stanford Center for Assessment, Learning and Equity Stanford (SCALE) ofereceu um comentário sobre os manuscritos na primeira parte desta edição especial, que destacou os benefícios do edTPA e a necessidade de tais programas de avaliação para melhorar a formação de professores e fortalecer práticas de ensino. Ao mesmo tempo, os autores responderam ao comentário SCALE. As respostas dos autores levantam preocupações sobre equidade, retidão e as conseqüências involuntárias das avaliações de desempenho dos professores. Essas respostas revelam a necessidade de um diálogo contínuo sobre formas de melhorar a formação de professores e fortalecer a profissão docente

Navigating the Contested Terrain of Teacher Education Policy and Practice: Authors Respond to SCALE

Stanford Center for Assessment, Learning, and Equity (SCALE) provided a commentary on the manuscripts in the first part of this special issue, which highlighted the benefits of edTPA and the necessity for such assessment programs to improve teacher education and strengthen teaching practices. In turn, the authors responded to the SCALE commentary. The authors’ responses raise concerns about equity, fairness, and unintended consequences of teacher performance assessments. These responses highlight the need for continued dialogue on ways to improve teacher education and strengthen the teaching profession

Automated Detection of Infectious Disease Outbreaks in Hospitals: A Retrospective Cohort Study

Susan Huang and colleagues describe an automated statistical software, WHONET-SaTScan, its application in a hospital, and the potential it has to identify hospital infection clusters that had escaped routine detection

Microbial nitrogen limitation in the mammalian large intestine

Resource limitation is a fundamental factor governing the composition and function of ecological communities. However, the role of resource supply in structuring the intestinal microbiome has not been established and represents a challenge for mammals that rely on microbial symbionts for digestion: too little supply might starve the microbiome while too much might starve the host. We present evidence that microbiota occupy a habitat that is limited in total nitrogen supply within the large intestines of 30 mammal species. Lowering dietary protein levels in mice reduced their faecal concentrations of bacteria. A gradient of stoichiometry along the length of the gut was consistent with the hypothesis that intestinal nitrogen limitation results from host absorption of dietary nutrients. Nitrogen availability is also likely to be shaped by host-microbe interactions: levels of host-secreted nitrogen were altered in germ-free mice and when bacterial loads were reduced via experimental antibiotic treatment. Single-cell spectrometry revealed that members of the phylum Bacteroidetes consumed nitrogen in the large intestine more readily than other commensal taxa did. Our findings support a model where nitrogen limitation arises from preferential host use of dietary nutrients. We speculate that this resource limitation could enable hosts to regulate microbial communities in the large intestine. Commensal microbiota may have adapted to nitrogen-limited settings, suggesting one reason why excess dietary protein has been associated with degraded gut-microbial ecosystems

Paternal obesity is associated with IGF2 hypomethylation in newborns: results from a Newborn Epigenetics Study (NEST) cohort

Data from epidemiological and animal model studies suggest that nutrition during pregnancy may affect the health status of subsequent generations. These transgenerational effects are now being explained by disruptions at the level of the epigenetic machinery. Besides in vitro environmental exposures, the possible impact on the reprogramming of methylation profiles at imprinted genes at a much earlier time point, such as during spermatogenesis or oogenesis, has not previously been considered. In this study, our aim was to determine associations between preconceptional obesity and DNA methylation profiles in the offspring, particularly at the differentially methylated regions (DMRs) of the imprinted Insulin-like Growth Factor 2 (IGF2) gene