Relationships between family background problems and social problem solving skills of young normal children

Relationships between family background problems and social problem solving (SPS) skills were studied in normal third grade children. Twelve urban and suburban classroom teachers provided information about the presence of six family background problems for 243 children. Three problem solving skills were assessed: 1) alternative solution thinking, means-end thinking, and 3) social role taking. Overall, children with, one or more family problems, compared to those with no problems, generated fewer effective solutions and were less able to carry out a stepwise plan or to take the point of view of another. Differential reltionships were found between specific family background problems and specific problem solving skill deficiencies. Implications of the findings for school-based preventive programming were considered.This study was done with grant support from the N.Y.S. Education Department and the NIMH Experimental and Special Training Branch MH 14547-02. The authors acknowledge that support with gratitude. Reprint requests to the 3rd author, Department of Psychology, University of Rochester, Rochester, N.Y. 14627. Viviane Perez is now at the Jerusalem Psychoeducational Clinic, Jerusalem, Israel. Ellis L. Gesten is presently at the University of South Florida, Tampa, Florida. Bruce Rapkin is now at the Department of Psychology, University of Illinois, Champaign, Illinois.     

Standard term of pregnancy

What is it? This question arose early this year during a discussion with my doula partner, who lived in Great Britain for 20 years, and one of the midwives I work with, who attends only homebirths, which is very rare in France. The mom whose case we were discussing was late going into labor but not postdated according to the official pregnancy term here in France (37-42 WA--"weeks of amenorrhea"). The midwife expressed her discomfort with waiting. My doula partner and I felt differently, but we knew we were influenced by American and British midwives' practices. I had been shocked the previous December by the position of the chief of the maternity department in a private hospital (a small unit with no residents, in which nurse-midwives attend "normal" births and obstetricians are called in case of complications only). This OB explained to my client and me that if she didn't go into labor naturally, she would be called at 41 + 1 for a vaginal exam to check her cervix and would be induced at 41 + 2. Waiting until 42 weeks requires daily checks, for which he has neither the room nor personnel. He clearly stated that it was a matter of management of time and finances. A month later one of our clients reported the story of her brother and sister-in-law's planned homebirth in London. Their doctors had put a lot of pressure on the mother during her pregnancy with gestational diabetes regarding her length of term. They started to talk about induction. The parents didn't feel comfortable with this, and at that point our client had asked me to refer them to someone who could help them there. We referred them to the National Childbirth Trust and to the sweetest doula we know there. This doula (Liliana Lammers) and her famous doctor partner (Dr. Michel Odent) were a good match. The doctor advised waiting, on the condition that the health of the baby and the amount of fluid be checked daily at the local hospital. The mother had already been waiting several weeks past what was supposed to be her term. Finally, she went naturally into labor at home. The doctor and the doula came and, after some hours of observation, decided it would be wiser for the mother to deliver in the hospital. The doctor and doula were not comfortable with the prolonged prelabor, when, at nearly 44 weeks, the health of the baby and the amount of fluid had not been checked for five days. The mother finally had a vaginal birth without drugs at the hospital. After hearing this story, I suggested it would be interesting to collect the official lengths of term and the different routines in other countries as a learning tool and in order to give us something other than French protocol on which to base our practice. So I sent the question to every midwife for whom I had an e-mail address from the last Midwifery Today conference in Paris. Beyond this motivation was my own curiosity regarding the relationship between the official term in each country and its uses and routines. The most significant (because the most unique) answer, in my opinion, is from The Netherlands, where physiology is a priority.     

Safety of DTaP-based combined immunization in very-low-birth-weight premature infants: frequent but mostly benign cardiorespiratory events

OBJECTIVE: To evaluate the safety of diphtheria-tetanus-acellular pertussis-inactivated polio-Haemophilus influenzae type B (DTaP-IPV-HIB) immunization in premature infants. STUDY DESIGN: Observational study of 78 very low birth weight premature infants (mean gestational age, 28+/-2 weeks; mean birth weight, 1045+/-357 g) given DTaP-IPV-HIB vaccine before hospital discharge. Apnea, bradycardia, oxygen requirements and saturation, feeding practice, and medical interventions were assessed before and after immunization. The results were analyzed by the severity of the clinical condition and the persistence of prematurity-associated symptoms. RESULTS: Administration of DTaP-IPV-HIB elicited resurgence or increase in cardiorespiratory events in 47% of infants (15% had apnea, 21% had bradycardia, 42% of desaturations). Most vaccine-triggered events resolved spontaneously or after brief stimulation. The relative risk was 5- to 8-fold higher in infants with a severe clinical course or persistence of cardiorespiratory symptoms at the time of immunization. Bag-mask respiratory support was given to 5 of 78 infants, and O(2) requirements increased transiently in 4 of 21 infants with chronic lung disease, none requiring reventilation. Reintroduction of O(2) supplementation, interruption of active oral feeding, or postponing of hospital discharge was not required. CONCLUSIONS: Cardiorespiratory events were frequently increased after DTaP-IPV-HIB immunization, requiring monitoring and appropriate intervention. However, these episodes did not have detrimental impact on the infants' clinical course. Timely immunization is warranted even in the most vulnerable preterm infants.     

Effect of tomato product consumption on the plasma status of antioxidant microconstituents and on the plasma total antioxidant capacity in healthy subjects

OBJECTIVES: to identify the plasma antioxidant microconstituents mainly affected by tomato product consumption, to check whether tomato product consumption can affect antioxidant status, and to identify tomato-product antioxidant-microconstituents mainly involved in the effect of these products on oxidative stress. DESIGN: Medium-term dietary supplementation study. SETTING: Human Nutrition Laboratory, Clermont-Ferrand, France. SUBJECTS: Twenty healthy young (20 < years < 40), non obese (18 < BMI (kg/m2) < 25), females were recruited by advertisement. All of them completed the study. INTERVENTION: The usual diet of the subjects was supplemented for three weeks with 96 g/day tomato puree. The volunteers then avoided tomato-product-rich foods for a subsequent three-week period. Measures of Outcome: Fasting blood samples were collected the day before supplementation, the day after the supplementation period, and the day after the depletion period. The status of several antioxidant microconstituents (plasma microconstituent concentrations), and the antioxidant status (plasma total antioxidant capacity) were assessed. RESULTS: Supplementation with tomato puree significantly increased plasma lycopene, beta-carotene and lutein. Conversely it did not significantly affect plasma vitamin C and E, plasma antioxidant trace metals (Cu, Zn and Se), and plasma total antioxidant capacity. Avoidance of tomato-product-rich foods for three weeks significantly (p < 0.05) decreased plasma lycopene, beta-carotene, lutein and vitamin C, as well as plasma total antioxidant capacity. Plasma total antioxidant capacity, as measured by chemiluminescence, was positively related (p < 0.05) to the status of lycopene, vitamin C and beta-carotene. CONCLUSIONS: Tomato product consumption can affect not only the lycopene status, but also that of other antioxidant microconstituents (beta-carotene and lutein). Lycopene, but also beta-carotene, are apparently the main tomato microconstituents responsible for the effect of tomato products on antioxidant status.     

Decreased insulin secretion in islets from rats fed a low protein diet is associated with a reduced PKAalpha expression

A low protein diet has been shown to affect the amount and activity of several enzymes and to decrease insulin secretion by islets isolated from rats fed such a diet. To understand the mechanisms involved in this phenomenon, we investigated the effects of forskolin, a stimulator of adenylyl cyclase, on insulin secretion by pancreatic islets from rats fed a normal (17%; NP) or low (6%; LP) protein diet for 8 wk. Isolated islets were incubated for 1 h in Krebs-bicarbonate solution containing 8.3 mmol glucose/L, with or without 10 micromol forskolin/L. The forskolin-induced insulin secretion was higher in islets from NP rats than in those from LP rats (P<0.05). Western blotting revealed that the amount of the alpha catalytic subunit of protein kinase A (PKAalpha) was 35% lower in islets from LP rats than in islets from NP rats (P<0.05). Moreover, PKAalpha mRNA expression was reduced by 30% in islets from LP rats (P<0.05). Our results indicated a possible relationship between a low protein diet and a reduction in PKAalpha expression. These alterations in PKAalpha may be responsible in part for the decreased insulin secretion by islets from rats fed a low protein diet.     

Genotyping, Orientalis-like Yersinia pestis, and plague pandemics

Three pandemics have been attributed to plague in the last 1,500 years. Yersinia pestis caused the third, and its DNA was found in human remains from the second. The Antiqua biovar of Y. pestis may have caused the first pandemic; the other two biovars, Medievalis and Orientalis, may have caused the second and third pandemics, respectively. To test this hypothesis, we designed an original genotyping system based on intergenic spacer sequencing called multiple spacer typing (MST). We found that MST differentiated every biovar in a collection of 36 Y. pestis isolates representative of the three biovars. When MST was applied to dental pulp collected from remains of eight persons who likely died in the first and second pandemics, this system identified original sequences that matched those of Y. pestis Orientalis. These data indicate that Y. pestis caused cases of Justinian plague. The two historical plague pandemics were likely caused by Orientalis-like strains.     

Hypothalamic melanin-concentrating hormone is induced by cold exposure and participates in the control of energy expenditure in rats

Short-term cold exposure of homeothermic animals leads to higher thermogenesis and food consumption accompanied by weight loss. An analysis of cDNA-macroarray was employed to identify candidate mRNA species that encode proteins involved in thermogenic adaptation to cold. A cDNA-macroarray analysis, confirmed by RT-PCR, immunoblot, and RIA, revealed that the hypothalamic expression of melanin-concentrating hormone (MCH) is enhanced by exposure of rats to cold environment. The blockade of hypothalamic MCH expression by antisense MCH oligonucleotide in cold-exposed rats promoted no changes in feeding behavior and body temperature. However, MCH blockade led to a significant drop in body weight, which was accompanied by decreased liver glycogen, increased relative body fat, increased absolute and relative interscapular brown adipose tissue mass, increased uncoupling protein 1 expression in brown adipose tissue, and increased consumption of lean body mass. Thus, increased hypothalamic MCH expression in rats exposed to cold may participate in the process that allows for efficient use of energy for heat production during thermogenic adaptation to cold.     

Effect of new dentures on interocclusal distance during speech

PURPOSE: The aim of this study was to investigate the changes in interocclusal distance during the pronunciation of /m/ and /s/ sounds in the Portuguese language, in partially edentulous patients before and after insertion of new dentures. MATERIALS AND METHODS: Subjects were divided into a control group consisting of 18 completely dentate patients and an experimental group consisting of 18 patients who were edentulous in the maxilla and classified as Kennedy Class I in the mandible. The experimental group had new dentures placed and the occlusal vertical dimension corrected. A magnetic jaw-tracking device measured the interocclusal distance during pronunciation of the /m/ and /s/ phonemes. Interocclusal distance evaluations were carried out in a single session for the control group. In the experimental group, the measurements were carried out before insertion of new dentures; immediately after insertion; and after 6 and 24 hours; 2 days; 1 and 2 weeks; 1, 2, 3, and 6 months; and 1 year. RESULTS: Comparison between groups revealed significant difference in interocclusal distance for the /m/ sound both before and after insertion of dentures up to 2 months. For the /s/ phoneme, there was no difference between the groups before prosthesis insertion, or after 3, 6, and 12 months of prosthesis use. There were significant differences for the /m/ sound only at 6 and 12 months after new denture insertion, and for the /s/ sound at all periods evaluated. CONCLUSION: Insertion of new dentures, with the vertical dimension corrected, changes the interocclusal distance of speech during phonation of /m/ and /s/ sounds.     

In vivo performance and biocompatibility of the MagScrew ventricular assist device

Currently available ventricular assist devices (VADs) have limitations in long-term durability and blood compatibility. We evaluated a prototype of a pulsatile MagScrew VAD for in vivo hemodynamic performance and biocompatibility. The device is composed of an actuator, blood pump housing, diaphragm, pusher plate, and bioprosthetic valves. Its protein-coated ("biolized") blood-contacting surface inhibits clot formation. Forces between moving parts of the actuator are transmitted magnetically, eliminating a primary source of friction and wear. The pump fills passively and is highly preload sensitive. The device was implanted into three calves for 90, 10, and 57 days, respectively. No anticoagulants were given postoperatively. The device functioned without technical problems during the entire course of each experiment, with mean device flow ranging between 5.4 and 9.0 L/min. Autopsy of the first two calves revealed no sign of embolization and clean blood-contacting surfaces of the devices. The third experiment was complicated by a prosthetic valve endocarditis with infectious embolization, and a few small depositions were found in the pump. In conclusion, the MagScrew VAD has demonstrated a high level of performance and biocompatibility in three calves studied for 10-90 days. Vigorous development is in progress to bring this device to preclinical readiness and thus provide surgeons with the VAD of choice for permanent implantation.     

Nonmedical economic consequences attributable to visual impairment

The nonmedical costs of visual impairment are crucial when allocating resources for prevention or treatment programs. Were analyzed the data from two representative nationwide French surveys aimed at documenting impairments that included 14,603 subjects living in institutions and 16,945 in the community. Three groups were identified: blind (light perception), low vision (loss of shape perception, LV), and controls. Item consumption was standardized on confounding factors using logistic regression. Costs attributable to visual impairment were estimated from control subjects. National nonmedical costs due to visual impairment were euro 9,806 million, arising mostly from LV (euro 8,735 million). The annual average cost/subject was euro 7,242 for LV and euro 15,679 for blindness. Loss of family income was euro 4,552 million, the burden on the caregiver euro 2,525 million, paid assistance euro 2,025 million, social allowances euro 0,942 million, and unmet needs euro 5,553 million. Resource allocation strategies aimed at controlling visual impairment should cover all relevant economic dimensions, including nonmedical items.