Elevated protein concentrations in newborn blood and the risks of autism spectrum disorder, and of social impairment, at age 10 years among infants born before the 28th week of gestation

Among the 1 of 10 children who are born preterm annually in the United States, 6% are born before the third trimester. Among children who survive birth before the 28th week of gestation, the risks of autism spectrum disorder (ASD) and non-autistic social impairment are severalfold higher than in the general population. We examined the relationship between top quartile inflammation-related protein concentrations among children born extremely preterm and ASD or, separately, a high score on the Social Responsiveness Scale (SRS total score ≥65) among those who did not meet ASD criteria, using information only from the subset of children whose DAS-II verbal or non-verbal IQ was ≥70, who were assessed for ASD, and who had proteins measured in blood collected on ≥2 days (N = 763). ASD (N = 36) assessed at age 10 years is associated with recurrent top quartile concentrations of inflammation-related proteins during the first post-natal month (e.g., SAA odds ratio (OR); 95% confidence interval (CI): 2.5; 1.2–5.3) and IL-6 (OR; 95% CI: 2.6; 1.03–6.4)). Top quartile concentrations of neurotrophic proteins appear to moderate the increased risk of ASD associated with repeated top quartile concentrations of inflammation-related proteins. High (top quartile) concentrations of SAA are associated with elevated risk of ASD (2.8; 1.2–6.7) when Ang-1 concentrations are below the top quartile, but not when Ang-1 concentrations are high (1.3; 0.3–5.8). Similarly, high concentrations of TNF-α are associated with heightened risk of SRS-defined social impairment (N = 130) (2.0; 1.1–3.8) when ANG-1 concentrations are not high, but not when ANG-1 concentrations are elevated (0.5; 0.1–4.2)

Sense of coherence in mothers of children with developmental delay

In light of the absence of studies on sense of coherence (SOC) in parents in general, and in parents of children with disabilities in particular, the present study was designed to examine the development of SOC and its relationship with reported levels of parental stress, ambiguity of diagnosis, parental adherence to treatment, and parental participation in treatment planning. Two samples of mothers were included in this study. The target sample included 88 mothers of children with developmental delay, aged 0-36 months who were receiving Early Intervention services. The comparison sample included 100 mothers of children aged 0-36 months who were using Day Care services in the same region. Research methodology involved a mailed survey including three measures: The Orientation to Life Questionnaire (Antonovsky, 1987) was administered to measure SOC; The Parenting Stress Index (Abidin, 1993) was administered to measure stress emanating from the role of parenting; and a 12 question survey designed to measure ambiguity of diagnosis, parental adherence to treatment, and parental perception of participation in treatment planning. No significant differences were found between the two samples on the SOC, and both samples responded within normal limits on the PSI. PSI subtests of Parental Distress and Parent-Child Dysfunctional Interaction did differentiate between the two samples. Significant negative relationships were found between the SOC and parental stress. SOC and mother\u27s age were also significantly related. Further analysis of this relationship supported Antonovsky\u27s theory that SOC stabilizes around age 30. For mothers using Early Intervention Services significant relationships were found between SOC and three aspects of their experiences with Early Intervention services: Ambiguity of diagnosis, level of treatment adherence, and perceived level of participation in treatment goal planning. Results were reanalyzed excluding respondents with low scores on the Defensive Responding scale an the PSI and similar findings were obtained. Stepwise multiple regression analyses were performed on each of the samples and indicated that the best predictors of SOC for mothers receiving Day Care services were Total Stress and mother\u27s age. For mothers receiving Early Intervention strives, the best predictors of SOC included Total Stress, child\u27s age, mother\u27s level of education, and sex of child

Occurrence and Policy Consequences of Referendums: A Theoretical Model and Empirical Evidence

Referendums provide citizen control over policy outcomes under various institutional provisions. This paper offers a theoretical model covering four types of referendums, which differ with respect to their likelihood of occurring and their policy consequences. Implications derived from this model suggest that provisions that allow an opposition group to propose policies to be adopted by referendum should lead to more popular votes. Under these provisions policies adopted should also more closely reflect the policy preferences of the median voter. Support for these implications appears in data on American states and countries around the world