Deactivation, hyperactivation, and anomalous content in the attachment script assessment: stability over time and significance for parenting behavior and physiology.

This study examined the stability of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous content and their significance for parenting outcomes in mothers (Mage = 31 years; 78% White/European American) and 6-month-old infants. Comparable to ASA secure base script knowledge (SBSK), mothers' ASA deactivation, hyperactivation, and anomalous content were significantly, moderately stable over two years (r's = .40 - .43). Mothers' ASA hyperactivation and anomalous content were associated with greater maternal intrusiveness, whereas ASA deactivation was associated with greater detachment and less intrusiveness. Only ASA anomalous content was associated with lower maternal sensitivity. Mothers' ASA deactivation was associated with less dynamic change in respiratory sinus arrhythmia during the Still-Face Procedure-reflective of limited mobilization of physiological resources to support responding to infants. Findings support the validity of ASA deactivation, hyperactivation, and anomalous content scripts, and demonstrate their utility in examining adult attachment stability and predictive significance for parent-child outcomes.

Comparing two durations of medically tailored meals posthospitalization: A randomized clinical trial.

BACKGROUND: Medically tailored meals (MTM) may be beneficial to patients after hospital discharge. OBJECTIVE: To determine if 2 versus 4 weeks of MTM posthospitalization will improve patient outcomes. DESIGN: Randomized unblinded trial. SETTINGS AND PARTICIPANTS: Six hundred and fifty patients pending hospital discharge with at least one chronic condition. INTERVENTION: One MTM a day for 2 versus 4 weeks. MAIN OUTCOME AND MEASURES: The primary outcome was a change from baseline to 60 days in the Hospital Anxiety Depression Scale (HADS). Secondary outcomes measured change in the Katz activities of daily living (ADLs), DETERMINE nutritional risk, and all-cause emergency department (ED) visits and rehospitalizations. RESULTS: From baseline to 60 days the HADS anxiety subscale changed 5.4-4.9 in the 2-week group (p = .03) and 5.4-5.3 in the 4-week group (p = .49); the difference in change between groups 0.4 (p = .25). HADS changed 5.4-4.8 in the 2-week group (p = .005) and 5.3-5.1 in the 4-week group (p = .34); the difference in change between groups 0.4 (p = .18). ADL score changed from 5.3 to 5.6 in the 2-week group (p ≤ .0001) and 5.2-5.5 in the 4-week group (p ≤ .0001); the difference in change between groups -0.01 (p = .90). The DETERMINE changed in the 2-week group from 7.2 to 6.4 (p = .0006) and from 7 to 6.7 in the 4-week group (p = .19); the difference in change between groups 0.5 (p = .13). There was no difference in ED visits and rehospitalizations between groups or time to rehospitalization. CONCLUSIONS: Different durations of short-term MTM did not affect patient-centered or utilization outcomes.

Participant perspectives on the impact of receiving medically tailored meals on post-hospitalization.

OBJECTIVE: The objective of this program evaluation was to measure the impact of a medically tailored meals (MTM) intervention on participants' self-reported recovery and satisfaction while recovering from a recent hospitalization. DESIGN: A qualitative design was employed using a brief survey among all participants at the end of the intervention and phone interviews with a subset of participants. SAMPLE: Participants in this study were recently discharged from the hospital and were members of (redacted for review) who had received 2-4 weeks of MTM. MEASUREMENTS: The survey assessed overall satisfaction with the meals and perceived impact on their recovery after hospitalization (81% response rate). Interview questions asked how they felt the meals may have helped while recovering (e.g., helped them financially or with their ability to remain independent). RESULTS: Among survey participants, 65% were extremely or very satisfied with their meals. Reasons that MTM were helpful while they were recovering included having sufficient food to eat, having healthy food to eat, the convenience of the meals, and ease of preparing the meals. CONCLUSIONS: Participants receiving MTM were generally very satisfied with the program. Including nutrition education and more flexibility in quantity and frequency of food may improve satisfaction and consumption of food.