The longitudinal relationship between child emotional disorder and parental mental health in the British Child and Adolescent Mental Health surveys 1999 and 2004.

BACKGROUND: Research suggests parental psychopathology has an adverse effect on child mental health. However, due to the interactional nature of parent-child relationships and with a high rate of emotional disorders reported in school-age children, it is important to know whether the effect is reciprocal. METHODS: We explored the longitudinal relationship between child and parent mental health in the British Child and Adolescent Mental Health Surveys (N=7,100 child-parent dyads) and their three-year follow-ups. The Development and Well-Being Assessment with DSM-IV diagnostic criteria was used to measure child psychiatric diagnoses, while parental mental health was assessed using the General Health Questionnaire. Multivariable logistic regression was used to explore the longitudinal association between child emotional disorder and parent mental health. RESULTS: Parents of children who had an emotional disorder at baseline were more likely to have poor mental health three years later compared with parents whose children had no psychiatric diagnosis (33.3% versus 16.7%; crude odds ratio=2.52; adjusted odds ratio=2.19, 95% CI=1.58 to 3.05, p<0.001). Children of parents with poor mental health at baseline were more likely to develop an emotional disorder three years later compared with children whose parents had good mental health (5.2% versus 2.5%; crude odds ratio=2.08; adjusted odds ratio=1.63, 95% CI=1.18 to 2.25, p=0.003). LIMITATIONS: The findings of this research are limited by the survey data collected, the measures used and survey dropout. CONCLUSIONS: We detected a bi-directional relationship between child and parent mental health, suggesting that effective intervention for one individual may benefit other family members.

A unique device for controlled electrospinning.

The purpose of this research was to develop a system for controlled electrospinning of fibro-porous scaffolds for tissue engineering applications and to use this system to assess mesh architecture sensitivity to manufacturing parameters. The intent was to achieve scaffolds with well-controlled fiber diameters and inter-fiber spacing. To accomplish these objectives, a custom, closed-loop controlled, electrospinning system was built. The system was unique in that it had a collection surface that was independent of the electrodes. The system allowed independent manipulation and analysis of a number of manufacturing parameters: distance between the electrodes, distance from the nozzle to the collection surface, applied voltage, temperature of the melt, collection surface dielectric strength, and collection surface area. Morphological analysis of fabricated meshes showed that all test parameters significantly affected fiber diameter and inter-fiber spacing. Further, contrary to what is generally accepted in the electrospinning literature, voltage and temperature (inversely related to viscosity) were not the most significant parameters. Features of the collection surface, including dielectric strength and surface area, were more significant. This dominance is, in part, a reflection of the unique electrospinning system used. The collection surface, which was not connected to either of the electrodes, substantially altered the electric field between the electrodes. Using the developed controlled electrospinning system, thermoplastic polyurethane meshes with fiber diameters ranging from 5 to 18 microm with variability less than 1.8% were made; inter-fiber spacing ranged from 4 to 90 microm with variability less than 20.2%. The system has potential use in biomedical applications where meshes with controlled fiber diameter and inter-fiber spacing are of interest.

Small fiber diameter fibro-porous meshes: tissue response sensitivity to fiber spacing.

The purpose of this research was to determine if fiber spacing for small fiber diameter fibro-porous meshes affected tissue response in vivo. Disk-shaped polyurethane meshes, with mean fiber diameters of 7.6 microm and fiber spacing between 6 and 68 microm, were implanted in rat subcutaneous dorsum for 5-week intervals and then prepared for light microscopy and morphological analysis. Results showed that implants with 12- to 68-microm spacing had no histologically apparent fibrous capsule around the perimeter, a result different from that for 6-microm spacing samples that had a capsule around a mean of 34.2% of the perimeter. For the 12- to 68-microm spacing range, a mean of 21.0% of individual fibers within the meshes were encapsulated. Qualitatively, it appeared that larger fibers were encapsulated more frequently than smaller ones. When nodeless or baggy meshes were implanted, cells tended to cluster three or more fibers into groups and then encapsulate each group. Over the 6- to 68-microm spacing range, cell nuclei volume fraction within the meshes increased from the 6- to the 29-microm spacing (p = 0.000) and then decreased from the 29- to the 68-microm spacing (p = 0.015). There was a trend of an increase in local vessel volume fraction with spacing over the 6- to 68-microm range, though the relationship was weak. The results indicate that the reason for the lack of encapsulation of small-fiber fibro-porous meshes is not exclusively a pore boundary explanation, as is proposed for small-pore porous meshes.

Polymer microfiber mechanical properties: a system for assessment and investigation of the link with fibrous capsule formation.

A novel microtensile testing instrument was developed to assess the mechanical properties of small-diameter polyethylene, polyurethane, and polyester microfibers. The instrument had a root-mean-square error of 2.96 microN for force measurement and 1.91 microm for displacement measurement. Microfibers ranging in diameter from 1.0 to 10.9 microm were strained at 2 mm/s in the device, and the slopes of their stress-strain curves (material moduli) were determined. Correlations between material modulus and previously published data on fibrous capsule presence and thickness for implanted polyethylene, polyurethane, and polyester microfibers were investigated. Results for the 1.0-5.9-microm microfiber diameter range showed that neither the percentage of unencapsulated fibers nor the capsule thickness correlated well with modulus. Correlation coefficients were 0.04 and 0.09, respectively. However, for the 6.0-10.9 microm diameter range the correlations were strong, 1.00 for both percentage of unencapsulated fibers and capsule thickness. It is suggested that the results reflect the greater attachment and mechanical interaction of cells with microfibers for the 6.0-10.9 microm-diameter range than for the 1.0-5.9 microm-diameter range.

Measuring sediment exchange rates on an intertidal bank at Blacktoft, Humber Estuary, UK.

Results from a suite of Photo Electronic Erosion Pins (PEEPs) and manual pins installed on an intertidal bank at Blacktoft, near the confluence of the Rivers Trent and (Yorkshire) Ouse, UK are presented for summer 1997 (1 May-28 September). These reveal a pattern of erosion and deposition, which can be related to variations in tidal range, freshwater flow and wind speed over the period. During spring tides, greater resuspension of bed sediment leads to a greater availability of sediment in the water column for deposition on the bank. High wind speeds cause greater erosion of material from the bank due to wind-induced wave action. These processes of sediment exchange are also modified by the effects of biological activity on the sediment and of consolidation. It was demonstrated that the mean daily change in elevation of the upper part of the bank at Blacktoft was approximately 11 mm, which is two-three-fold less than the equivalent figure measured by a similar method at Burringham on the River Trent. It is thought that this difference is due to the effects of a greater concentration of suspended sediment settling onto the banks at Burringham, which are also subject to greater erosion due to their steeper slope. Results from a longer and more widespread survey of eight other intertidal banks in the Trent-Ouse Estuary system suggest that deposition and erosion occur in phase on all intertidal banks within the study area. Intertidal banks towards the upstream end of the system show much less variation in bank level than those further downstream.

Use of vascular explants for ex vivo neovascularization of biomaterials.

Biomaterial polymers have been proposed as scaffolds for cell assembly in vascular bioengineering. We describe here a new method for the neovascularization of polyurethane meshes from explants of rat aorta. Aortic rings embedded in collagen-permeated polyurethane meshes and cultured in medium supplemented with fetal bovine serum and vascular endothelial growth factor generated florid microvascular outgrowths that efficiently vascularized the available spaces between polyurethane fibers. The neovessels could be identified in the live cultures by phase-contrast microscopy, and in formalin-fixed preparations by the ABC peroxidase procedure, using the endothelial-specific Griffonia isolectin B4. The aortic outgrowths were successfully labeled with the intravital fluorescent dyes Calcein AM or SPDiOC(18), which are nontoxic and can be used for tracking studies. This study shows that artificial biomaterial meshes can be colonized ex vivo with histotypic microvascular networks, and provides the proof of concept for the future development of stably vascularized devices for in vivo implantation.

A device to apply user-specified strains to biomaterials in culture.

An apparatus was developed to apply user-specified displacements to biomaterial samples in culture. The device allowed cyclic waveforms of bandwidth 0 Hz to 20 Hz to be applied under physiologic thermal (37.5 degrees C) and [CO2] (5%) conditions. For a 0 Hz to 20 Hz bandwidth signal similar in shape to a ventricular pressure waveform, the mean displacement error was 0.26% of the full-scale output. The maximum overshoot was 0.700%. Environmental system evaluation tests demonstrated a specimen cartridge temperature of 37.20 +/- 0.15 degrees C during cyclic loading and 37.23 +/- 0.21 degrees C during static conditions. [CO2] was 5.29 +/- 0.54% during cyclic loading and 5.25 +/- 0.61% during static conditions. Laminar flow applied at the loading rod entrances to the specimen cartridge ensured the sample remained sterile during testing. As a preliminary evaluation, polyurethane samples were seeded with fetal foreskin fibroblasts and subject to intermittent cyclic displacements. Results demonstrated enhanced cell proliferation and increased [PGE2] for samples subjected to 10% strain compared with unstrained controls. A next step will be to evaluate cell response sensitivity to strain magnitude, duration, direction, and frequency. The long-term intent is to establish mechanical loading configurations that induce acceptable or adaptation-inducing responses for use in implant design and tissue engineering applications.

Material properties of commonly-used interface materials and their static coefficients of friction with skin and socks.

Compressive stiffness (CS) of different supporting materials used in prosthetics and orthotics and their static coefficients of friction (COF) with skin and socks were characterized. Materials tested included Spenco, Poron, nylon-reinforced silicone, Soft Pelite, Medium Pelite, Firm Plastazote, Regular Plastazote, and Nickelplast. A displacement-controlled testing device was constructed to assess the CS of 11.1 mm diameter material specimens under cyclic loading (1 Hz) to 220 kPa over 10- and 60-min periods. Results demonstrated local CS ranging from 687 kPa (Poron) to 3,990 kPa (Soft Pelite). To fit the cyclic stress-strain (S-S) data within an error of 4.0 percent full-scale output, the minimum order of fit required for Spenco, Poron, and nylon-reinforced silicone was a third-order polynomial; for Soft Pelite, Medium Pelite, Firm Plastazote, and Regular Plastazote, a second-order polynomial; and for Nickelplast, a linear fit. For all materials, the nonrecovered strains were related to loading time using an exponential fit. A biaxial force-controlled load applicator device was used to assess COF at skin-material, sock-material, and skin-sock interfaces for shear forces of 1 to 4 N applied to a 10.2 x 7.8 mm loading pad. COFs ranged from 0.48 (+/- 0.05) to 0.89 (+/- 0.09). COFs at skin-material interfaces were significantly (p < 0.05) higher than those at skin-sock interfaces. There was a trend of a higher COF at sock-material interfaces than at skin-sock interfaces. These data are of potential utility in finite element modeling sensitivity analysis of residual limb-prosthetic socket systems or body-orthosis systems to characterize effects of material features on interface pressure and shear stress distributions.

Decreasing intracoronary stent complications.

With the release of intracoronary artery stents, the role of the critical care nurse is vital in decreasing complications in the stented patient as well as optimizing patient outcomes. The importance of understanding and adhering to anticoagulation and activity protocols is a must for successful patient management.

Viral hepatitis in the U.S. Air Force, 1980-89: an epidemiological and serological study.

This paper reports the epidemiology of hospital-diagnosed acute viral hepatitis in U.S. Air Force personnel from 1980-89. First hospitalizations for viral hepatitis generally declined, ranging from 24.6 to 47.2 per 100,000 personnel. Hepatitis rates were higher among men, (RR = 1.3; 95% C.I., 1.1-1.5) and higher among blacks, compared to whites (RR = 1.4; 95% C.I., 1.3-1.6). Analysis of risk associated with various occupations demonstrated an increased risk of viral hepatitis for procedurally oriented medical personnel (physicians, clinical nurses, dentists) when compared to all other occupations (RR = 1.5; 95% C.I., 1.1-1.9). Pilots and navigators demonstrated a decreased risk of acute viral hepatitis. Members hospitalized for hepatitis B had a prior or concurrent diagnosis for sexually transmitted disease in 37% of cases; for drug abuse, 32% of cases. Serum samples from 332 individuals demonstrated that hepatitis A had the highest rate of agreement (84%) between serology and hospital discharge diagnosis. Only 3% of individuals with the diagnosis of NANB hepatitis were positive for hepatitis C.