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AIMS: Assess bacterial community changes over time in soybean (Glycine max) crop fields following cover crop (CC) and no-till (NT) implementation under natural abiotic stressors. METHOD AND RESULTS: Soil bacterial community composition was obtained by amplifying, sequencing, and analysing the V4 region of the 16S rRNA gene. Generalized linear mixed models were used to assess the effects of tillage, CC, and time on bacterial community response. The most abundant phyla present were Acidobacteria, Actinobacteria, Bacteroidetes, and Verrucomicrobia. Bacterial diversity increased in periods with abundant water. Reduced tillage (RT) increased overall bacterial diversity, but NT with a CC was not significantly different than RT treatments under drought conditions. CCs shifted abundances of Firmicutes and Bacteroidetes depending on abiotic conditions. CONCLUSIONS: In the Lower Mississippi Alluvial Valley (LMAV), USA, NT practices lower diversity and influence long-term community changes while cover crops enact a seasonal response to environmental conditions. NT and RT management affect soil bacterial communities differently than found in other regions of the country.
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Microbiología del Suelo , Suelo , ARN Ribosómico 16S/genética , Mississippi , Agricultura , Bacterias/genética , Bacteroidetes/genética , Productos Agrícolas/microbiologíaRESUMEN
Background: Patients often ask about the time taken to return to activities of daily living (ADLs) after breast surgery, but there is a lack of data to give accurate guidance. We aimed to assess the feasibility of a study to determine the time taken to return to ADLs after mastectomy with or without breast reconstruction. Materials and Methods: A prospective multicentre, self-reported questionnaire-based feasibility study of women who had undergone mastectomy ± reconstruction was performed, between Jan 2017 and Dec 2019. Women were asked to self-report when they returned to 15 ADLs with a 5-option time scale for "return to activity." Results: The questionnaire was returned by 42 patients (median [range] age: 64 [31-84]). Of these, 22 had simple mastectomy, seven mastectomy and implant reconstruction, seven mastectomy and autologous reconstruction (DIEP), and six did not specify. Overall, over 90% could manage stairs and brush hair by two weeks and 84% could get in and out of the bath by four weeks. By 1-2 months, 92% could do their own shopping and 86% could drive. 68% of women employed returned to work within four months. Compared to simple mastectomy, patients undergoing reconstruction took a longer time to return to getting in/out of bath (<2 vs. 2-4 weeks), vacuuming (2-4 weeks vs. 1-2 months), and fitness (1-2 vs. 3-4 months). There was a slower return to shopping (1-2 months vs. 2-4 weeks), driving and work (both 3-4 vs. 1-2 months), and sports (3-4 vs. 1-2 months) in autologous reconstruction compared to implant reconstruction. Conclusion: This study is feasible. It highlights slower return to specific activities (particularly strength-based) in reconstruction patients, slower in autologous compared with implant reconstruction. The impact on return to ADLs should be discussed as part of the preoperative counselling as it will inform patients and help guide their decision making. A larger study is required to confirm these results.
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Neoplasias de la Mama , Mamoplastia , Humanos , Femenino , Persona de Mediana Edad , Mastectomía , Neoplasias de la Mama/cirugía , Actividades Cotidianas , Estudios Prospectivos , Mamoplastia/métodos , Encuestas y Cuestionarios , Estudios RetrospectivosRESUMEN
Relative expression of miR-21-5p in serum was upregulated in response to 30 days of bed rest, and miRNA fold changes were positively associated with serum calcium changes. INTRODUCTION: Circulating miRNAs (c-miRNAs) have potential as biomarkers of cellular activity, and they may play a role in cell-to-cell communication. The purpose of this study was to examine c-miRNA and bone marker responses to a 30-day six-degree head-down bed rest protocol at an ambient 0.5% CO2. METHODS: Eleven participants (6 males/5 females, 25-50 years) had fasting blood draws taken 3 days before and immediately after completing the 30-day bed rest protocol at the Institute for Aerospace Medicine in Germany. Serum relative expression of miRNAs associated with bone function (miR-21-5p, -100-5p, -125b-5p, -126-3p) were analyzed using qPCR, and serum bone markers were quantitated using ELISA. RESULTS: Serum bone markers, sclerostin, and calcium significantly increased (p ≤ 0.036), and total hip aBMD significantly decreased (p = 0.003) post bed rest. Serum miR-21-5p relative expression was significantly upregulated (p = 0.018) post bed rest. Fold changes in miR-126-3p (r = 0.82, p = 0.002) and miR-21-5p (r = 0.62, p = 0.042) were positively correlated with absolute change in serum calcium. There were no sex differences in miRNA responses; women had greater percent increases in TRAP5b (37.3% vs. 16.9% p = 0.021) and greater percent decreases in total hip aBMD (- 2.15% vs. - 0.69%, p = 0.034) than men. CONCLUSION: c-miR-21-5p has potential as a biomarker of bone resorption and bone loss in an unloading condition. The upregulation of miR-21-5p may reflect an increase in osteoclast activity after bed rest, which is corroborated by the increase in TRAP5b.
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Reposo en Cama , MicroARNs , Reposo en Cama/efectos adversos , Biomarcadores , Femenino , Alemania , Inclinación de Cabeza , Humanos , Masculino , MicroARNs/genéticaRESUMEN
Cyclists may be at greater risk of developing asymmetrical force and motion patterns than other ground-based athletes. However, functional asymmetries during cycling tend to be highly variable, making them difficult to assess. Dual-energy x-ray absorptiometry (DXA) measurements of areal bone mineral density (aBMD) and lean mass (LM) in the lower limbs may be a more sensitive and consistent method to identify asymmetries in cyclists. The goal of this study was to determine if competitive cyclists have greater levels of asymmetries in the lower body compared to non-cyclists using DXA. A secondary aim was to determine if aBMD and LM asymmetries change over the road cycling season. 17 competitive cyclists and 21 non-cyclist, healthy controls underwent DXA scans. Lower-body asymmetries were greater in cyclists compared to non-cyclists in aBMD and LM for all lower limb segments. However, these asymmetries did not tend to consistently favour a particular side, except for the pelvis having more LM on the dominant side. The were no longitudinal changes in aBMD or LM in the cyclists. Asymmetry analysis via DXA provides evidence that although functional asymmetries during cycling are variable, cyclists have increased lower body LM and aBMD asymmetries compared to non-cyclists.
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Ciclismo/fisiología , Índice de Masa Corporal , Densidad Ósea/fisiología , Extremidad Inferior/fisiología , Absorciometría de Fotón , Ciclismo/lesiones , Composición Corporal/fisiología , Conducta Competitiva/fisiología , Estudios Transversales , Trastornos de Traumas Acumulados/fisiopatología , Femenino , Humanos , Extremidad Inferior/diagnóstico por imagen , Masculino , Adulto JovenRESUMEN
The high acquisition rate of drug resistance by Mycobacterium tuberculosis necessitates the ongoing search for new drugs to be incorporated in the tuberculosis (TB) regimen. Compounds used for the treatment of other diseases have the potential to be repurposed for the treatment of TB. In this study, a high-throughput screening of compounds against thiol-deficient Mycobacterium smegmatis strains and subsequent validation with thiol-deficient M. tuberculosis strains revealed that ΔegtA and ΔmshA mutants had increased susceptibility to azaguanine (Aza) and sulfaguanidine (Su); ΔegtB and ΔegtE mutants had increased susceptibility to bacitracin (Ba); and ΔegtA, ΔmshA, and ΔegtB mutants had increased susceptibility to fusaric acid (Fu). Further analyses revealed that some of these compounds were able to modulate the levels of thiols and oxidative stress in M. tuberculosis This study reports the activities of Aza, Su, Fu, and Ba against M. tuberculosis and provides a rationale for further investigations.
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Antituberculosos/farmacología , Mycobacterium tuberculosis/efectos de los fármacos , Azaguanina/farmacología , Mutación/genética , Mycobacterium tuberculosis/genética , Estrés Oxidativo/efectos de los fármacos , Estrés Oxidativo/genética , Sulfaguanidina/farmacología , Compuestos de Sulfhidrilo/metabolismoRESUMEN
Mycobacterium tuberculosis (M.tb.), the causative agent of tuberculosis (TB), cannot synthesize GSH, but synthesizes two major low molecular weight thiols namely mycothiol (MSH) and ergothioneine (ERG). Gamma-glutamylcysteine (GGC), an intermediate in GSH synthesis, has been implicated in the protection of lactic acid bacteria from oxidative stress in the absence of GSH. In mycobacteria, GGC is an intermediate in ERG biosynthesis, and its formation is catalysed by EgtA (GshA). GGC is subsequently used by EgtB in the formation of hercynine-sulphoxide-GGC. In this study, M.tb. mutants harbouring unmarked, in-frame deletions in each of the fives genes involved in ERG biosynthesis (egtA, egtB, egtC, egtD and egtE) or a marked deletion of the mshA gene (required for MSH biosynthesis) were generated. Liquid chromatography tandem mass spectrometry analyses (LC-MS) revealed that the production of GGC was elevated in the MSH-deficient and the ERG-deficient mutants. The ERG-deficient ΔegtB mutant which accumulated GGC was more resistant to oxidative and nitrosative stress than the ERG-deficient, GGC-deficient ΔegtA mutant. This implicates GGC in the detoxification of reactive oxygen and nitrogen species in M.tb.
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Dipéptidos/metabolismo , Ergotioneína/genética , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/metabolismo , Estrés Nitrosativo , Estrés Oxidativo , Vías Biosintéticas , Cisteína/genética , Cisteína/metabolismo , Dipéptidos/genética , Ergotioneína/metabolismo , Eliminación de Gen , Glicopéptidos/genética , Glicopéptidos/metabolismo , Humanos , Inositol/genética , Inositol/metabolismo , Tuberculosis/microbiologíaRESUMEN
We realize a Λ system in a superconducting circuit, with metastable states exhibiting lifetimes up to 8 ms. We exponentially suppress the tunneling matrix elements involved in spontaneous energy relaxation by creating a "heavy" fluxonium, realized by adding a capacitive shunt to the original circuit design. The device allows for both cavity-assisted and direct fluorescent readouts, as well as state preparation schemes akin to optical pumping. Since direct transitions between the metastable states are strongly suppressed, we utilize Raman transitions for coherent manipulation of the states.
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BACKGROUND: Three low molecular weight thiols are synthesized by Mycobacterium tuberculosis (M.tb), namely ergothioneine (ERG), mycothiol (MSH) and gamma-glutamylcysteine (GGC). They are able to counteract reactive oxygen species (ROS) and/or reactive nitrogen species (RNS). In addition, the production of ERG is elevated in the MSH-deficient M.tb mutant, while the production of MSH is elevated in the ERG-deficient mutants. Furthermore, the production of GGC is elevated in the MSH-deficient mutant and the ERG-deficient mutants. The propensity of one thiol to be elevated in the absence of the other prompted further investigations into their interplay in M.tb. METHODS: To achieve that, we generated two M.tb mutants that are unable to produce ERG nor MSH but are able to produce a moderate (ΔegtD-mshA) or significantly high (ΔegtB-mshA) amount of GGC relative to the wild-type strain. In addition, we generated an M.tb mutant that is unable to produce GGC nor MSH but is able to produce a significantly low level of ERG (ΔegtA-mshA) relative to the wild-type strain. The susceptibilities of these mutants to various in vitro and ex vivo stress conditions were investigated and compared. RESULTS: The ΔegtA-mshA mutant was the most susceptible to cellular stress relative to its parent single mutant strains (ΔegtA and ∆mshA) and the other double mutants. In addition, it displayed a growth-defect in vitro, in mouse and human macrophages suggesting; that the complete inhibition of ERG, MSH and GGC biosynthesis is deleterious for the growth of M.tb. CONCLUSIONS: This study indicates that ERG, MSH and GGC are able to compensate for each other to maximize the protection and ensure the fitness of M.tb. This study therefore suggests that the most effective strategy to target thiol biosynthesis for anti-tuberculosis drug development would be the simultaneous inhibition of the biosynthesis of ERG, MSH and GGC.
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Cisteína/biosíntesis , Dipéptidos/biosíntesis , Ergotioneína/biosíntesis , Glicopéptidos/biosíntesis , Inositol/biosíntesis , Tuberculosis/microbiología , Animales , Cisteína/antagonistas & inhibidores , Cisteína/genética , Dipéptidos/antagonistas & inhibidores , Dipéptidos/genética , Ergotioneína/antagonistas & inhibidores , Ergotioneína/genética , Glicopéptidos/antagonistas & inhibidores , Glicopéptidos/genética , Humanos , Inositol/antagonistas & inhibidores , Inositol/genética , Ratones , Peso Molecular , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/patogenicidad , Estrés Oxidativo , Especies de Nitrógeno Reactivo/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Compuestos de Sulfhidrilo/química , Compuestos de Sulfhidrilo/metabolismo , Tuberculosis/tratamiento farmacológico , Tuberculosis/genética , Tuberculosis/patologíaRESUMEN
BACKGROUND: Despite studies of how parent-child interactions relate to early child language development, few have examined the continued contribution of parenting to more complex language skills through the preschool years. The current study explored how positive and negative parenting behaviours relate to growth in complex syntax learning from child age 3 to age 4 years, for children with typical development or developmental delays (DDs). METHODS: Participants were children with or without DD (N = 60) participating in a longitudinal study of development. Parent-child interactions were transcribed and coded for parenting domains and child language. Multiple regression analyses were used to identify the contribution of parenting to complex syntax growth in children with typical development or DD. RESULTS: Analyses supported a final model, F(9,50) = 11.90, P < .001, including a significant three-way interaction between positive parenting behaviours, negative parenting behaviours and child delay status. This model explained 68.16% of the variance in children's complex syntax at age 4. Simple two-way interactions indicated differing effects of parenting variables for children with or without DD. CONCLUSIONS: Results have implications for understanding of complex syntax acquisition in young children, as well as implications for interventions.
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Discapacidades del Desarrollo/complicaciones , Trastornos del Desarrollo del Lenguaje/complicaciones , Trastornos del Desarrollo del Lenguaje/fisiopatología , Desarrollo del Lenguaje , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Desarrollo Infantil , Preescolar , Discapacidades del Desarrollo/fisiopatología , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
BACKGROUND: Morbidly adherent placenta (MAP) is a serious obstetric complication causing mortality and morbidity. OBJECTIVE: To evaluate whether outcomes of patients with MAP improve with increasing experience within a well-established multidisciplinary team at a single referral center. STUDY DESIGN: All singleton pregnancies with pathology-confirmed MAP (including placenta accreta, increta, or percreta) managed by a multidisciplinary team between January 2011 and August 2016 were included in this retrospective study. Turnover of team members was minimal, and cases were divided into 2 time periods so as to compare 2 similarly sized groups: T1 = January 2011 to April 2014 and T2 = May 2014 to August 2016. Outcome variables were estimated blood loss, units of red blood cell transfused, volume of crystalloid transfused, massive transfusion protocol activation, ureter and bowel injury, and neonatal birth weight. Comparisons and adjustments were made by use of the Student t test, Mann-Whitney U test, χ2 test, analysis of covariance, and multinomial logistic regression. RESULTS: A total of 118 singleton pregnancies, 59 in T1 and 59 in T2, were managed during the study period. Baseline patient characteristics were not statistically significant. Forty-eight of 59 (81.4%) patients in T1 and 42 of 59 (71.2%) patients in T2 were diagnosed with placenta increta/percreta. The median [interquartile range] estimated blood loss (T1: 2000 [1475-3000] vs T2: 1500 [1000-2700], P = .04), median red blood cell transfusion units (T1: 2.5 [0-7] vs T2: 1 [0-4], P = .02), and median crystalloid transfusion volume (T1: 4200 [3600-5000] vs T2: 3400 [3000-4000], P < .01) were significantly less in T2. Also, a massive transfusion protocol was instituted more frequently in T1: 15/59 (25.4%) vs 3/59 (5.1%); P < .01. Neonatal outcomes and surgical complications were similar between the 2 groups. CONCLUSION: Our study shows that patient outcomes are improved over time with increasing experience within a well-established multidisciplinary team performing 2-3 cases per month. This suggests that small, collective changes in team dynamics lead to continuous improvement of clinical outcomes. These findings support the development of centers of excellence for MAP staffed by stable, core multidisciplinary teams, which should perform a significant number of these procedures on an ongoing basis.
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Comunicación Interdisciplinaria , Placenta Accreta/terapia , Resultado del Tratamiento , Adulto , Peso al Nacer , Pérdida de Sangre Quirúrgica , Cesárea , Soluciones Cristaloides , Transfusión de Eritrocitos , Femenino , Edad Gestacional , Humanos , Histerectomía , Recién Nacido , Soluciones Isotónicas/administración & dosificación , Grupo de Atención al Paciente , Hemorragia Posparto/terapia , Embarazo , Calidad de la Atención de Salud , Estudios RetrospectivosRESUMEN
TEMPO was selected in 2012 by NASA as the first Earth Venture Instrument, for launch between 2018 and 2021. It will measure atmospheric pollution for greater North America from space using ultraviolet and visible spectroscopy. TEMPO observes from Mexico City, Cuba, and the Bahamas to the Canadian oil sands, and from the Atlantic to the Pacific, hourly and at high spatial resolution (~2.1 km N/S×4.4 km E/W at 36.5°N, 100°W). TEMPO provides a tropospheric measurement suite that includes the key elements of tropospheric air pollution chemistry, as well as contributing to carbon cycle knowledge. Measurements are made hourly from geostationary (GEO) orbit, to capture the high variability present in the diurnal cycle of emissions and chemistry that are unobservable from current low-Earth orbit (LEO) satellites that measure once per day. The small product spatial footprint resolves pollution sources at sub-urban scale. Together, this temporal and spatial resolution improves emission inventories, monitors population exposure, and enables effective emission-control strategies. TEMPO takes advantage of a commercial GEO host spacecraft to provide a modest cost mission that measures the spectra required to retrieve ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), formaldehyde (H2CO), glyoxal (C2H2O2), bromine monoxide (BrO), IO (iodine monoxide),water vapor, aerosols, cloud parameters, ultraviolet radiation, and foliage properties. TEMPO thus measures the major elements, directly or by proxy, in the tropospheric O3 chemistry cycle. Multi-spectral observations provide sensitivity to O3 in the lowermost troposphere, substantially reducing uncertainty in air quality predictions. TEMPO quantifies and tracks the evolution of aerosol loading. It provides these near-real-time air quality products that will be made publicly available. TEMPO will launch at a prime time to be the North American component of the global geostationary constellation of pollution monitoring together with the European Sentinel-4 (S4) and Korean Geostationary Environment Monitoring Spectrometer (GEMS) instruments.
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BACKGROUND: Emotion regulation has been identified as a robust predictor of adaptive functioning across a variety of domains (Aldao et al. ). Furthermore, research examining early predictors of competence and deficits in ER suggests that factors internal to the individual (e.g. neuroregulatory reactivity, behavioural traits and cognitive ability) and external to the individual (e.g. caregiving styles and explicit ER training) contribute to the development of ER (Calkins ). Many studies have focused on internal sources or external sources; however, few have studied them simultaneously within one model, especially in studies examining children with developmental delays (DD). Here, we addressed this specific research gap and examined the contributions of one internal factor and one external factor on emotion dysregulation outcomes in middle childhood. Specifically, our current study used structural equation modelling (SEM) to examine prospective, predictive relationships between DD status, positive parenting at age 4 years and child emotion dysregulation at age 7 years. METHOD: Participants were 151 families in the Collaborative Family Study, a longitudinal study of young children with and without DD. A positive parenting factor was composed of sensitivity and scaffolding scores from mother-child interactions at home and in the research centre at child age 4 years. A child dysregulation factor was composed of a dysregulation code from mother-child interactions and a parent-report measure of ER and lability/negativity at age 7 years. Finally, we tested the hypothesis that positive parenting would mediate the relationship between DD and child dysregulation. RESULTS: Mothers of children with DD exhibited fewer sensitive and scaffolding behaviours compared with mothers of typically developing children, and children with DD were more dysregulated on all measures of ER. SEM revealed that both DD status and early positive parenting predicted emotion dysregulation in middle childhood. Furthermore, findings provided support for our hypothesis that early positive parenting mediated the relationship between DD and dysregulation. CONCLUSIONS: This work enhances our understanding of the development of ER across childhood and how endogenous child factors (DD status) and exogenous family factors (positive parenting) affect this process. Our findings provide clear implications for early intervention programmes for children with DD. Because of the predictive relationships between (a) developmental status and ER and (b) parenting and ER, the results imply that sensitive parenting behaviours should be specifically targeted in parent interventions for children with DD.
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Desarrollo Infantil/fisiología , Discapacidades del Desarrollo/fisiopatología , Emociones/fisiología , Conducta Materna/psicología , Responsabilidad Parental/psicología , Autocontrol/psicología , Niño , Preescolar , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
BACKGROUND: Maternal controlling behaviour has been found to influence child development, particularly in behavioural and emotional regulation. Given the higher rates of interfering parent control found in mothers of children with developmental delays (DD) and Latina mothers, their children could be at increased risk for behavioural and emotional dysregulation. While studies generally support this increased risk for children with DD, findings for Latino children are mixed and often attributed to cultural models of child rearing. The present study sought to determine the moderating roles of child DD and mother ethnicity in determining the relationships between two types of parent control (supportive directiveness and interference) and child dysregulation over time. METHODS: The present study, involving 178 3-year old children with DD (n = 80) or typical development (n = 98), examined observed parent control (directive versus interfering) of Latina and Anglo mothers as it relates to change in preschool child dysregulation over 2 years. RESULTS: Interfering parent control was greater for children with DD and also for Latino mothers. Supportive directive parenting generally related to relatively greater decline in child behaviour and emotion dysregulation over time, while interfering parenting generally related to less decline in child behaviour dysregulation over time. In Anglo but not Latino families, these relationships tended to vary as a function of child disability. CONCLUSIONS: Parent directives that support, rather than deter, ongoing child activity may promote positive regulatory development. These results particularly hold for children with DD and Latino families, and have implications for parenting practices and intervention.
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Discapacidades del Desarrollo/etnología , Hispánicos o Latinos/psicología , Conducta Materna/etnología , Responsabilidad Parental/etnología , Autocontrol/psicología , Preescolar , Femenino , Humanos , Masculino , Población Blanca/etnologíaRESUMEN
INTRODUCTION: Simulation-based training (SBT) has become an increasingly important method by which doctors learn. Stress has an impact upon learning, performance, technical, and non-technical skills. However, there are currently no studies that compare stress in the clinical and simulated environment. We aimed to compare objective (heart rate variability, HRV) and subjective (state trait anxiety inventory, STAI) measures of stress theatre with a simulated environment. METHODS: HRV recordings were obtained from eight anesthetic trainees performing an uncomplicated rapid sequence induction at pre-determined procedural steps using a wireless Polar RS800CX monitor © in an emergency theatre setting. This was repeated in the simulated environment. Participants completed an STAI before and after the procedure. RESULTS: Eight trainees completed the study. The theatre environment caused an increase in objective stress vs baseline (p = .004). There was no significant difference between average objective stress levels across all time points (p = .20) between environments. However, there was a significant interaction between the variables of objective stress and environment (p = .045). There was no significant difference in subjective stress (p = .27) between environments. DISCUSSION: Simulation was unable to accurately replicate the stress of the technical procedure. This is the first study that compares the stress during SBT with the theatre environment and has implications for the assessment of simulated environments for use in examinations, rating of technical and non-technical skills, and stress management training.
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Simulación por Computador , Educación de Postgrado en Medicina/métodos , Estrés Psicológico/epidemiología , Estudiantes de Medicina/psicología , Anestesia/métodos , Competencia Clínica , Femenino , Frecuencia Cardíaca , Humanos , Masculino , Estrés Psicológico/fisiopatologíaRESUMEN
BACKGROUND: Children with intellectual disability (ID) are at heightened risk for developing other psychological disorders, including internalising disorders. Anxiety and depression have been shown to be familial, and parenting is a contributing factor to the development of these disorders. To extend this research, we examined the extent to which mother and father depression and negative, unsupportive parenting related to child internalising behaviour problems, in children with ID or with typical development (TD). METHOD: Participants were 156 mother and father dyads and their children, assessed at ages 4 and 5 years. We examined parent (mother and father) and child delay status (ID and TD) in relation to measures of both observed and self-reported unsupportive, negative parenting. Utilising moderation models, we examined the relationship between parental depression, unsupportive/negative parenting and child internalising behaviour problems. RESULTS: Unsupportive, negative parenting differed based on parent gender and child delay status. In addition, father depression was a significant moderator of the relationship between unsupportive parenting and child internalising behaviour problems. CONCLUSIONS: Children with ID were found to be at higher risk of experiencing unsupportive, negative parenting than children with TD. Children of depressed fathers were especially vulnerable to developing internalising behaviour problems in an unsupportive parenting context.
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Trastornos de la Conducta Infantil/psicología , Hijo de Padres Discapacitados/psicología , Depresión/psicología , Discapacidad Intelectual/psicología , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Padres/psicología , Problema de Conducta/psicología , Adulto , Preescolar , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVE: The purpose of this study was to test the hypothesis that a standardized multidisciplinary treatment approach in patients with morbidly adherent placenta, which includes accreta, increta, and percreta, is associated with less maternal morbidity than when such an approach is not used (nonmultidisciplinary approach). STUDY DESIGN: A retrospective cohort study was conducted with patients from 3 tertiary care hospitals from July 2000 to September 2013. Patients with histologically confirmed placenta accreta, increta, and percreta were included in this study. A formal program that used a standardized multidisciplinary management approach was introduced in 2011. Before 2011, patients were treated on a case-by-case basis by individual physicians without a specific protocol (nonmultidisciplinary group). Estimated blood loss, transfusion of packed red blood cells, intraoperative complications (eg, vascular, bladder, ureteral, and bowel injury), neonatal outcome, and maternal postoperative length of hospital stay were compared between the 2 groups. RESULTS: Of 90 patients with placenta accreta, 57 women (63%) were in the multidisciplinary group, and 33 women (37%) were in the nonmultidisciplinary group. The multidisciplinary group had more cases with percreta (P = .008) but experienced less estimated blood loss (P = .025), with a trend to fewer blood transfusions (P = .06), and were less likely to be delivered emergently (P = .001) compared with the nonmultidisciplinary group. Despite an approach of indicated preterm delivery at 34-35 weeks of gestation, neonatal outcomes were similar between the 2 groups. CONCLUSION: The institution of a standardized approach for patients with morbidly adherent placentation by a specific multidisciplinary team was associated with improved maternal outcomes, particularly in cases with more aggressive placental invasion (increta or percreta), compared with a historic nonmultidisciplinary approach. Our standardized approach was associated with fewer emergency deliveries.
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Cesárea/métodos , Protocolos Clínicos , Histerectomía/métodos , Placenta Accreta/cirugía , Retención de la Placenta/cirugía , Adulto , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Estudios de Cohortes , Transfusión de Eritrocitos/estadística & datos numéricos , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Persona de Mediana Edad , Embarazo , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Parents of children with developmental delays (DD) have been found to use more controlling behaviour with their children than parents of children with typical development (TD). While controlling behaviour is related to poorer developmental outcomes in TD children, there is little research on how it predicts outcomes in DD children. Furthermore, existing research tends to use inconsistent or non-specific definitions of controlling behaviour, often combining parent control which follows the child's goal (e.g. supportive direction) and that which interferes with the child's goal (e.g. interference). METHODS: Participants were 200 mother-child dyads observed at child age 3, with follow-up assessments of adaptive behaviour and social skills administered at child ages 5 and 6, respectively. We coded the frequency of both types of controlling behaviour based on mothers' interactions with their children with TD (n = 113) or DD (n = 87) at age 3. RESULTS: Mothers in the DD group used more interfering but not more supportive directive acts compared to mothers in the TD group. Adaptive behaviour was assessed at child age 5 and social skills were assessed at age 6. Higher frequency of supportive directive acts predicted better adaptive functioning for the TD group and better social skills for the DD group. Higher frequency of interfering acts predicted lower adaptive and social skills for children with DD but not with TD. CONCLUSIONS: Results are discussed in terms of the differential developmental needs of children with and without DD as well as implications for early intervention.
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Adaptación Psicológica/fisiología , Desarrollo Infantil/fisiología , Discapacidades del Desarrollo/psicología , Relaciones Madre-Hijo , Responsabilidad Parental/psicología , Habilidades Sociales , Adulto , Niño , Preescolar , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: Social difficulties are closely linked to emotion dysregulation among children with typical development (TD). Children with developmental delays (DD) are at risk for poor social outcomes, but the relationship between social and emotional development within this population is not well understood. The current study examines the extent to which emotion dysregulation is related to social problems across middle childhood among children with TD or DD. METHOD: Children with TD (IQ ≥ 85, n = 113) and children with DD (IQ ≤ 75, n = 61) participated in a longitudinal study. Annual assessments were completed at ages 7, 8 and 9 years. At each assessment, mothers reported on children's emotion dysregulation, and both mothers and teachers reported on children's social difficulties. RESULTS: Children with DD had higher levels of emotion dysregulation and social problems at each age than those with TD. Emotion dysregulation and social problems were significantly positively correlated within both TD and DD groups using mother report of social problems, and within the TD group using teacher report of social problems. Among children with TD, emotion dysregulation consistently predicted change in social problems from one year to the next. However, among children with DD, emotion dysregulation offered no unique prediction value above and beyond current social problems. CONCLUSIONS: Results suggested that the influence of emotion regulation abilities on social development may be a less salient pathway for children with DD. These children may have more influences, beyond emotion regulation, on their social behaviour, highlighting the importance of directly targeting social skill deficits among children with DD in order to ameliorate their social difficulties.
Asunto(s)
Conducta Infantil/fisiología , Desarrollo Infantil/fisiología , Discapacidades del Desarrollo/fisiopatología , Emociones/fisiología , Habilidades Sociales , Niño , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
OBJECTIVE: To examine differences in child social competence and parent-child interactions involving children with intellectual disability (ID) or typical development (TD) during a Parent-Child Problem-Solving Task. DESIGN: Mothers and their 9-year-old children (n = 122) participated in a problem-solving task in which they discussed and tried to resolve an issue they disagreed about. The interactions were coded on child and mother problem solving and affect behaviours, as well as the dyad's problem resolution. RESULTS: Children with ID (n = 35) were rated lower on expression/negotiation skills and higher on resistance to the task than children with TD (n = 87). Mothers in the ID group (vs. TD group) were more likely to direct the conversation. However, there were no group differences on maternal feeling acknowledgement, engagement, warmth or antagonism. The ID dyads were less likely to come to a resolution and to compromise in doing so than the TD dyads. These group differences were not attributable to differences in children's behaviour problems. CONCLUSIONS: Children with ID and their mothers had more difficulty resolving problems, and this increased difficulty was not explained by greater behaviour problems. Additionally, with the exception of directiveness, mothers of children with ID displayed similar behaviours and affect towards their children during problem solving as mothers of children with TD. Results suggest that the Parent-Child Problem-Solving Task is a useful way to assess social skills and associated parental behaviours in middle childhood beyond self-report. Implications for future research and intervention are discussed.
Asunto(s)
Desarrollo Infantil , Discapacidad Intelectual/psicología , Relaciones Madre-Hijo/psicología , Solución de Problemas , Niño , Conducta Infantil/psicología , Femenino , Humanos , Control Interno-Externo , Estudios Longitudinales , Masculino , Madres/psicología , Negociación/psicología , Conducta SocialRESUMEN
BACKGROUND: Given the great benefits of effective parenting to child development under normal circumstances, and the even greater benefits in the face of risk, it is important to understand why some parents manage to be effective in their interactions with their child despite facing formidable challenges. This study examined factors that promoted effective parenting in the presence of child developmental delay, high child behaviour problems, and low family income. METHOD: Data were obtained from 232 families at child age 3 and 5 years. Using an adapted ABCX model, we examined three risk domains (child developmental delay, child behaviour problems, and low family income) and three protective factors (mother's education, health, and optimism). The outcome of interest was positive parenting as coded from mother-child interactions. RESULTS: Levels of positive parenting differed across levels of risk. Education and optimism appeared to be protective factors for positive parenting at ages 3 and 5, and health appeared to be an additional protective factor at age 5. There was an interaction between risk and education at age 3; mothers with higher education engaged in more positive parenting at higher levels of risk than did mothers with less education. There was also an interaction between risk and optimism at age 3; mothers with higher optimism engaged in more positive parenting at lower levels of risk than did mothers with less optimism. The risk index did not predict change in positive parenting from age 3-5, but the protective factor of maternal health predicted positive changes. CONCLUSIONS: This study examined factors leading to positive parenting in the face of risk, a topic that has received less attention in the literature on disability. Limitations, future directions, and implications for intervention are discussed.