Parents' Degree and Style of Restrictive Mediation of Young Children's Digital Gaming: Associations with Parental Attitudes and Perceived Child Adjustment

Objectives As young children increasingly grow up in a digital environment, parents are confronted with the question whether and how to regulate young children's digital gaming effectively. The goal of this study was to examine correlates of parents' degree of restrictive mediation and their (autonomy-supportive or controlling) style of doing so. Specifically, we tested associations of parents' degree and style of restrictive mediation with parents' attitudes about digital gaming, parental perceptions of children's defiance and problematic gaming, and their interest in social play. Methods A sample of 762 parents of children between 3 and 9 years filled out questionnaires on their degree and style of restrictive mediation, their attitudes about gaming, and their perceptions of children's oppositional defiance, problematic gaming, and interest in social play. Results We found that parents who hold more negative attitudes about digital gaming were more likely to use a controlling style when mediating their child's gaming. Further, a higher degree of restrictive mediation generally related to more adaptive child outcomes (i.e., lower levels of perceived defiance and problematic gaming, higher levels of perceived interest in social play), whereas the opposite pattern was found for parents' controlling style of mediation. Finally, these associations were not moderated by children's age or gender, nor by parents' gender or educational level. Conclusions Also in the context of children's digital gaming, it seems important for parents to set clear rules. Yet, when doing so, it is equally important to refrain from using controlling strategies, as they seem to be counterproductive

Knowledge, health beliefs and attitudes towards dementia and dementia risk reduction among descendants of people with dementia:a qualitative study using focus group discussions

Abstract Background Individuals with a parental family history of dementia have an increased risk of developing dementia because they share their genes as well as their psychosocial behaviour. Due to this increased risk and their experience with dementia, they may be particularly eager to receive information regarding dementia risk reduction (DRR). This study evaluated the knowledge, beliefs and attitudes towards dementia and DRR among descendants of people with dementia. Method Using a semi-structured topic guide, three focus group discussions were conducted consisting of 12 female (80%) and 3 male (20%) descendants of people with dementia with a mean (± SD) age of 48.8 (± 12) years. Focus group discussions were audio recorded and transcribed. Each transcript was analysed thoroughly, and where appropriate, a code was generated and assigned by two researchers independently. Then, similar codes were grouped together and categorized into themes. Results The items in the topic guide could only be addressed after participants had been given the opportunity to share their experiences of having a parent with dementia. Participants were unaware or uncertain about the possibility of reducing the risk of developing dementia and therefore hesitant to assess their dementia risk without treatment options in sight. Moreover, participants indicated that their general practitioner only gave some information on heritability, not on DRR. Although participants identified a large number of modifiable risk factors as a group during the group discussions, they were eager to receive more information on dementia and DRR. In the end, participants adopted a more positive attitude towards a DRR programme and provided suggestions for the development of future DRR programmes. Conclusions Although the research aim was to evaluate the knowledge, beliefs and attitudes towards dementia and DRR, sharing experiences of having a parent with dementia seemed a prerequisite for considering participants’ own risk of developing dementia and participating in a DRR programme. Knowledge of dementia and DRR was limited. Due to unawareness of the possibility of reducing dementia risk, participants were hesitant about assessing their dementia risk. Group discussions positively changed the perception of dementia risk assessment and participants’ willingness to participate in a DRR programme

27. New echocardiogram index alternatives to MAPSE and TAPSE z-scores in children

BackgroundMitral annular plane systolic excursion (MAPSE), and tricuspid annular plane systolic excursion (TAPSE) are relatively load independent longitudinal left ventricle (LV) and right ventricle (RV) measurement in both adults and children. Normal paediatric values of MAPSE and TAPSE unlike adults are based on inconvenient z-scores. We hypothesize novel indexes of (LSI) LV longitudinal systolic index and (RSI) RV longitudinal systolic index are BSA, age, gender independent and nullifies the need for MAPSE and TAPSE z-scores.MethodsNormal echocardiograms were retrospectively reviewed from 2009 to 2011. Ejection fraction, LV dimensions, MAPSE, and TAPSE were determined. LSI and RSI were calculated using MAPSE and TAPSE divided by LV length. Echocardiogram indices were correlated. Regression analysis was done for BSA, age, and gender.ResultsTwo hundred and one patients had normal ejection fractions (67.3;±5.1%). Mean MAPSE 10.4;±3.3mm, z-score −0.07;±1.2, and LSI 0.20;±0.03; Mean TAPSE 17.4;±5.4mm, z-score 0.74;±1.7, and RSI 0.34;±0.06. LSI and MAPSE z-scores correlated, r=0.73, p<0.001. Age, gender, and BSA did not correlate with LSI. RSI and TAPSE z-scores correlated with r=0.76, p<0.001. Age influences RSI, R2=0.58, p value <0.001, BSA and gender does not. RSI, with age stratification, is significantly decreased less than 2months.ConclusionLSI obviates need for-MAPSE z scores. RSI offers an additional non TAPSE z-score method to evaluate RV function, but does not nullify age effect. RSI, especially in the first two months is decreased

Adjustment disorder in cancer patients after treatment:Prevalence and acceptance of psychological treatment

PURPOSE: To investigate the prevalence of adjustment disorder (AD) among cancer patients and the acceptance of psychological treatment, in relation to sociodemographic, clinical, and psychological factors. METHODS: Breast, prostate, and head and neck cancer patients of all stages and treatment modalities (N = 200) participated in this observational study. Patients completed the Hospital Anxiety and Depression Scale, Checklist Individual Strength, Distress Thermometer and problem list. Patients with increased risk on AD based on these questionnaires were scheduled for a diagnostic interview. Patients diagnosed with AD were invited to participate in a randomized controlled trial on the cost-effectiveness of psychological treatment. Participation in this trial was used as a proxy of acceptance of psychological treatment. Logistic regression analyses were used to investigate associated factors. RESULTS: The overall prevalence of AD was estimated at 13.1%. Sensitivity analyses showed prevalence rates of AD of 11.5%, 15.0%, and 23.5%. Acceptance of psychological treatment was estimated at 65%. AD was associated both with being employed (OR = 3.3, CI = 1.3–8.4) and having a shorter time since diagnosis (OR = 0.3, CI = 0.1–0.8). CONCLUSION: Taking sensitivity analysis into account, the prevalence of AD among cancer patients is estimated at 13 to 15%, and is related to being employed and having a shorter time since diagnosis. The majority of cancer patients with AD accept psychological treatment

Interaction between geriatric syndromes in predicting three months mortality risk

Objectives: Capturing frailty using a quick tool has proven to be challenging. We hypothesise that this is due to the complex interactions between frailty domains. We aimed to identify these interactions and assess whether adding interactions between domains improves mortality predictability. Methods: In this retrospective cohort study, we selected all patients aged 70 or older who were admitted to one Dutch hospital between April 2015 and April 2016. Patient characteristics, frailty screening (using VMS (Safety Management System), a screening tool used in Dutch hospital care), length of stay, and mortality within three months were retrospectively collected from electronic medical records. To identify predictive interactions between the frailty domains, we constructed a classification tree with mortality as the outcome using five variables: the four VMS-domains (delirium risk, fall risk, malnutrition, physical impairment) and their sum. To determine if any domain interactions were predictive for three-month mortality, we performed a multivariable logistic regression analysis. Results: We included 4,478 patients. (median age: 79 years; maximum age: 101 years; 44.8% male) The highest risk for three-month mortality included patients that were physically impaired and malnourished (23% (95%-CI 19.0–27.4%)). Subgroups had comparable three-month mortality risks based on different domains: malnutrition without physical impairment (15.2% (96%-CI 12.4–18.6%)) and physical impairment and delirium risk without malnutrition (16.3% (95%-CI 13.7–19.2%)). Discussion: We showed that taking interactions between domains into account improves the predictability of three-month mortality risk. Therefore, when screening for frailty, simply adding up domains with a cut-off score results in loss of valuable information

Interaction between geriatric syndromes in predicting three months mortality risk

Objectives: Capturing frailty using a quick tool has proven to be challenging. We hypothesise that this is due to the complex interactions between frailty domains. We aimed to identify these interactions and assess whether adding interactions between domains improves mortality predictability. Methods: In this retrospective cohort study, we selected all patients aged 70 or older who were admitted to one Dutch hospital between April 2015 and April 2016. Patient characteristics, frailty screening (using VMS (Safety Management System), a screening tool used in Dutch hospital care), length of stay, and mortality within three months were retrospectively collected from electronic medical records. To identify predictive interactions between the frailty domains, we constructed a classification tree with mortality as the outcome using five variables: the four VMS-domains (delirium risk, fall risk, malnutrition, physical impairment) and their sum. To determine if any domain interactions were predictive for three-month mortality, we performed a multivariable logistic regression analysis. Results: We included 4,478 patients. (median age: 79 years; maximum age: 101 years; 44.8% male) The highest risk for three-month mortality included patients that were physically impaired and malnourished (23% (95%-CI 19.0–27.4%)). Subgroups had comparable three-month mortality risks based on different domains: malnutrition without physical impairment (15.2% (96%-CI 12.4–18.6%)) and physical impairment and delirium risk without malnutrition (16.3% (95%-CI 13.7–19.2%)). Discussion: We showed that taking interactions between domains into account improves the predictability of three-month mortality risk. Therefore, when screening for frailty, simply adding up domains with a cut-off score results in loss of valuable information.</p

Groups of diffeomorphisms and geometric loops of manifolds over ultra-normed fields

The article is devoted to the investigation of groups of diffeomorphisms and loops of manifolds over ultra-metric fields of zero and positive characteristics. Different types of topologies are considered on groups of loops and diffeomorphisms relative to which they are generalized Lie groups or topological groups. Among such topologies pairwise incomparable are found as well. Topological perfectness of the diffeomorphism group relative to certain topologies is studied. There are proved theorems about projective limit decompositions of these groups and their compactifications for compact manifolds. Moreover, an existence of one-parameter local subgroups of diffeomorphism groups is investigated.Comment: Some corrections excluding misprints in the article were mad

Dissociative recombination and electron-impact de-excitation in CH photon emission under ITER divertor-relevant plasma conditions

For understanding carbon erosion and redeposition in nuclear fusion devices, it is important to understand the transport and chemical break-up of hydrocarbon molecules in edge plasmas, often diagnosed by emission of the CH A^2\Delta - X^2\Pi Ger\"o band around 430 nm. The CH A-level can be excited either by electron-impact or by dissociative recombination (D.R.) of hydrocarbon ions. These processes were included in the 3D Monte Carlo impurity transport code ERO. A series of methane injection experiments was performed in the high-density, low-temperature linear plasma generator Pilot-PSI, and simulated emission intensity profiles were benchmarked against these experiments. It was confirmed that excitation by D.R. dominates at T_e < 1.5 eV. The results indicate that the fraction of D.R. events that lead to a CH radical in the A-level and consequent photon emission is at least 10%. Additionally, quenching of the excited CH radicals by electron impact de-excitation was included in the modeling. This quenching is shown to be significant: depending on the electron density, it reduces the effective CH emission by a factor of 1.4 at n_e=1.3*10^20 m^-3, to 2.8 at n_e=9.3*10^20 m^-3. Its inclusion significantly improved agreement between experiment and modeling