Exploring the use of workplaces to recruit "hard-to-reach" male drinkers to a survey on alcohol use and awareness of health messages.

BACKGROUND: Lower socioeconomic status (SES) groups, particularly lower SES males, are at greater risk of alcohol-related harm than higher SES groups, despite drinking at the same level or less. However, they are rarely recruited for research through typical recruitment strategies. Consequently, limited evidence exists on patterns of alcohol use and effectiveness of public health messages for these groups. Using workplaces to recruit male drinkers from lower SES backgrounds may provide a feasible and accessible approach to research participation and enable improved understanding of alcohol use, drinking motives and acceptance of alcohol-related public health messages in this underrepresented and high-risk group. We investigated workplace-based strategies to recruit male drinkers from lower SES backgrounds. We also investigated their experiences and motivations for alcohol use, and acceptance of alcohol-related public health messages. METHODS: A feasibility element investigated the effectiveness of workplace-based strategies to recruit male drinkers from lower SES backgrounds in the south west of England. A pilot element investigated this population's experiences and motivations for alcohol use, and acceptance of alcohol-related public health messages, through a mixed-methods survey. RESULTS: Feasibility results indicated that workplace-based recruitment strategies, including recruiting participants in person at their workplace and providing a financial incentive, effectively led to the recruitment of 84 male drinkers (70% recruitment rate), predominately from lower SES backgrounds, to a survey. Pilot results indicated that more than half of participants were at increasing risk of alcohol-related harm, and approximately one fifth engaged in weekly heavy episodic drinking. Participation in campaigns aimed at reducing alcohol use, and knowledge of government alcohol consumption guidelines, were low. Participants reported negative beliefs about alcohol including health effects, dependency and excess use, and financial and occupational effects. Positive beliefs about alcohol included relaxation, socialising, and enjoyment. CONCLUSIONS: Workplace-based recruitment, using in-person recruitment and a financial incentive, may be a feasible strategy to recruit male drinkers from lower SES backgrounds. Pilot results may direct larger scale research aiming to understand alcohol use in this population and inform targeted public health messages. Workplace-based recruitment may represent a promising avenue for future research aiming to tackle inequalities in participation in alcohol research.

A randomized controlled trial comparing parent child interaction therapy - toddler, circle of security- parenting™ and waitlist controls in the treatment of disruptive behaviors for children aged 14-24 months: study protocol.

BACKGROUND: It is common for toddlers to display disruptive behaviors (e.g., tantrums, aggression, irritability) but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence. Parent Child Interaction Therapy - Toddler is an intervention model designed to meet the specific developmental needs of toddlers aged 12-24 months presenting with disruptive behaviors. METHODS: This study will use a randomized controlled design to evaluate the efficacy of the Parent Child Interaction Therapy - Toddler intervention for children aged 14-24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior will be randomly allocated to either Parent Child Interaction Therapy - Toddler, Circle of Security- Parenting™ or a waitlist control group. Key parenting capacity outcome variables will include positive and negative parenting, parenting sensitivity, parental sense of competence in managing negative toddler emotions, parent sense of caregiving helplessness, parent mentalizing about the child, parent emotion regulation, child abuse potential and parental stress. Key outcome variables for children will include child social-emotional functioning (initiative, relationship functioning, self-regulation), child emotion regulation, child attachment security, and child behavior. DISCUSSION: Delivered in the early intervention period of toddlerhood, Parent Child Interaction Therapy - Toddler has the potential to bring about significant and lasting changes for children presenting with early onset behavioral issues. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR), 12618001554257 . Registered 24 September 2018 - retrospectively registered.

Successful Treatment of Refractory Cardiac Arrest With ß-Blockade and Extracorporeal Life Support in a Pediatric Patient With Catecholaminergic Polymorphic Ventricular Tachycardia: A Case Report.

We describe a case of refractory pulseless polymorphic ventricular tachycardia successfully treated with a bolus of propranolol intravenously, followed by an esmolol infusion and extracorporeal life support for 4 days in a 12-year-old boy later diagnosed with catecholaminergic polymorphic ventricular tachycardia. He had an excellent neurological outcome. Genetic testing for mutations associated with cardiac arrhythmias yielded a mutation of the syntrophin α-1 gene. The pathogenicity of this specific variant is uncertain. A mutation of this gene at a different locus is implicated in rare cases of long-QT syndrome. The patient subsequently underwent left cardiac sympathetic denervation followed by implantable cardiac defibrillator insertion. He remains symptom and arrhythmia free on atenolol.

Moderating effects of maternal emotional availability on language and cognitive development in toddlers of mothers exposed to a natural disaster in pregnancy: The QF2011 Queensland Flood Study.

BACKGROUND: Prenatal maternal stress exposure has been linked to sub-optimal developmental outcomes in toddlers, while maternal emotional availability is associated with better cognitive and language abilities. It is less clear whether early care-giving relationships can moderate the impact of prenatal stress on child development. The current study investigates the impact of stress during pregnancy resulting from the Queensland Floods in 2011 on toddlers' cognitive and language development, and examines how maternal emotional availability is associated with these outcomes. METHODS: Data were available from 131 families. Measures of prenatal stress (objective hardship, cognitive appraisal, and three measures of maternal subjective stress) were collected within one year of the 2011 Queensland floods. Maternal emotional availability was rated from video-taped mother-child play sessions at 16 months: sensitivity (e.g., affective connection, responsiveness to signals) and structuring (e.g., scaffolding, guidance, limit-setting). The toddlers' cognitive and language development was assessed at 30 months. Interactions were tested to determine whether maternal emotional availability moderated the relationship between prenatal maternal stress and toddler cognitive and language functioning. RESULTS: Prenatal stress was not correlated with toddlers' cognitive and language development at 30 months. Overall, the higher the maternal structuring and sensitivity, the better the toddlers' cognitive outcomes. However, significant interactions showed that the effects of maternal structuring on toddler language abilities depended on the degree of prenatal maternal subjective stress: when maternal subjective stress was above fairly low levels, the greater the maternal structuring, the higher the child vocabulary level. CONCLUSION: The current study highlights the importance of maternal emotional availability, especially structuring, for cognitive and language development in young children. Findings suggest that toddlers exposed to higher levels of prenatal maternal stress in utero may benefit from high maternal structuring for their language development.

The Relations Between Maternal Prenatal Anxiety or Stress and Child's Early Negative Reactivity or Self-Regulation: A Systematic Review.

In the present review, we examine the association between maternal prenatal stress or anxiety and children's early negative reactivity or self-regulation. The review includes 32 studies that focus on pregnancy-related anxiety, state or trait anxiety, perceived stress, and stressful life events in relation to child's crying, temperament, or behavior during the first 2 years of life. We searched four electronic databases and 32 studies were selected based on the inclusion criteria. Twenty-three studies found an association between maternal prenatal anxiety or stress and a child's negative reactivity or self-regulation, and typically the effect sizes varied from low to moderate. The association was found regardless of the form of prenatal stress or anxiety and the trimester in which the prenatal stress or anxiety was measured. In conclusion, several forms of prenatal anxiety and stress may increase the risk of emotional and self-regulatory difficulties during the first 2 years of life.

Human IFNAR2 deficiency: Lessons for antiviral immunity.

Type I interferon (IFN-α/ß) is a fundamental antiviral defense mechanism. Mouse models have been pivotal to understanding the role of IFN-α/ß in immunity, although validation of these findings in humans has been limited. We investigated a previously healthy child with fatal encephalitis after inoculation of the live attenuated measles, mumps, and rubella (MMR) vaccine. By targeted resequencing, we identified a homozygous mutation in the high-affinity IFN-α/ß receptor (IFNAR2) in the proband, as well as a newborn sibling, that rendered cells unresponsive to IFN-α/ß. Reconstitution of the proband's cells with wild-type IFNAR2 restored IFN-α/ß responsiveness and control of IFN-attenuated viruses. Despite the severe outcome of systemic live vaccine challenge, the proband had previously shown no evidence of heightened susceptibility to respiratory viral pathogens. The phenotype of IFNAR2 deficiency, together with similar findings in STAT2-deficient patients, supports an essential but narrow role for IFN-α/ß in human antiviral immunity.

Supporting depressed mothers at home: their views on an innovative relationship-based intervention.

This study explored the responses of a group of 111 mothers who experienced distress and/or depression in the early months after childbirth and who received an innovative home visiting service until their child's first birthday. The current study reports a thematic content analysis of the qualitative questionnaire responses returned by the mothers after completing the intervention. The mothers valued the home visiting program for its capacity to increase their parenting confidence and to enhance their bond to their infants. They attributed this to the reassurance provided by the program and the skills and qualities of the home visitors. Their responses complement the benefits identified in quantitative analysis of the program and demonstrate its impact from participants' viewpoint.

Maternal state of mind regarding attachment, maternal depression and children's family drawings in the early school years.

The current study explored how children's family drawings in the early school years might be related to their exposure to recurrent episodes of maternal depression. We also examined prospectively relations among maternal state of mind regarding attachment derived from the Adult Attachment Interview and earlier mother-child attachment from the Strange Situation Procedure (both measured when the child was 12-15 months old) and later family drawings. Seventy-five mothers were assessed for symptoms of depression periodically between birth and child age 6-8 years. At this age, children completed a family drawing rated using an attachment-based scoring system. Both mothers' state of mind regarding attachment and their overall depression were modestly, but significantly, correlated with a global rating of the child's drawings. When both predictors were considered together, however, neither was significant, reflecting collinearity between the two variables. In this study, women with a non-autonomous state of mind regarding attachment were significantly more likely to experience recurrent depression. The earlier classification of the child's attachment to the mother from the Strange Situation Procedure was not related to the family drawing.