Feasibility of Using Child Maltreatment Measurement Instruments in the Primary Care Setting: A Systematic Review.

PROBLEM: Child maltreatment is a devastating epidemic affecting millions of children and adolescents in the United States (U.S.) every year. Primary care providers (PCPs) encounter these victims but need resources to aid in the recognition of maltreatment. The purpose of this review is to evaluate child maltreatment measurement instruments and determine feasibility of use by U.S. PCPs. ELIGIBILITY CRITERIA: A systematic search was conducted in the PubMed, CINAHL, and PsycInfo databases from 2014 until 2020. Eligibility criteria included articles conducted in the U.S., with use of a child maltreatment measurement instrument, and subjects less than 18 years old. Eligible articles were reference searched to find the original studies for each instrument and were included if they were published in a peer-reviewed paper, could be located, and addressed the development or validation of the instrument. SAMPLE: Of the 3816 articles, 111 used a child maltreatment measurement instrument. Sixteen of the 27 identified instruments were evaluated for feasibility using a quality rating with criteria including psychometrics, construct measurement, administration, availability, and cost. RESULTS: Six instruments were recommended for use by PCPs. CONCLUSIONS: This is the first review evaluating the use of child maltreatment measurement instruments by PCPs and it highlights the combination of psychometric evaluation and other pertinent feasibility criteria to recommend several instruments for use by PCPs. IMPLICATIONS: Use of these instruments by PCPs may serve to identify children and families who are at risk for or suffering from maltreatment.

Overexpression of eIF5 or its protein mimic 5MP perturbs eIF2 function and induces ATF4 translation through delayed re-initiation.

ATF4 is a pro-oncogenic transcription factor whose translation is activated by eIF2 phosphorylation through delayed re-initiation involving two uORFs in the mRNA leader. However, in yeast, the effect of eIF2 phosphorylation can be mimicked by eIF5 overexpression, which turns eIF5 into translational inhibitor, thereby promoting translation of GCN4, the yeast ATF4 equivalent. Furthermore, regulatory protein termed eIF5-mimic protein (5MP) can bind eIF2 and inhibit general translation. Here, we show that 5MP1 overexpression in human cells leads to strong formation of 5MP1:eIF2 complex, nearly comparable to that of eIF5:eIF2 complex produced by eIF5 overexpression. Overexpression of eIF5, 5MP1 and 5MP2, the second human paralog, promotes ATF4 expression in certain types of human cells including fibrosarcoma. 5MP overexpression also induces ATF4 expression in Drosophila The knockdown of 5MP1 in fibrosarcoma attenuates ATF4 expression and its tumor formation on nude mice. Since 5MP2 is overproduced in salivary mucoepidermoid carcinoma, we propose that overexpression of eIF5 and 5MP induces translation of ATF4 and potentially other genes with uORFs in their mRNA leaders through delayed re-initiation, thereby enhancing the survival of normal and cancer cells under stress conditions.

High isolation rate of MDR group B streptococci with reduced penicillin susceptibility in Japan.

OBJECTIVES: In Japan, the isolation rate of group B Streptococcus (GBS) with reduced penicillin susceptibility (PRGBS) was 2.3% between 2005 and 2006. However, no data on this have been available since then; moreover, the isolation rate of MDR-PRGBS has never been reported. The aim of this study was to obtain recent data on the PRGBS isolation rate and to investigate, for the first time, the isolation rate of MDR-PRGBS. METHODS: We collected 306 clinical GBS isolates from various regions in Japan between January 2012 and July 2013. The MICs of penicillin G, oxacillin, ceftizoxime and ceftibuten for all GBS isolates and the MICs of erythromycin and levofloxacin for PRGBS isolates were determined by the agar dilution method. The mutations in the genes involved in antibiotic resistance and antibiotic resistance genes were analysed by PCR and DNA sequencing. RESULTS: We detected 45 clinical PRGBS isolates, with a PRGBS isolation rate among GBS of 14.7% (45/306). Among the PRGBS isolates, 32 (32/45, 71.1%) and 43 (43/45, 95.6%) were resistant/non-susceptible to erythromycin and levofloxacin, respectively. Furthermore, 31 PRGBS isolates, which constituted 68.9% of the PRGBS (31/45) and 10.1% of the GBS (31/306), respectively, were resistant/non-susceptible to both macrolides and fluoroquinolones, indicating multidrug resistance. CONCLUSIONS: These results suggest that the number of clinical PRGBS isolates with a tendency to multidrug resistance increased rapidly between 2005-06 and 2012-13 in Japan.

Central venous oxygen saturation: analysis, clinical use and effects on mortality.

AIMS AND OBJECTIVES: The aim of this literature review was to provide a clear definition of central venous oxygen saturation (ScvO2), highlight the differences between ScvO2 and mixed venous oxygen saturation (SvO2), show how it can be used clinically and the effect central venous oxygen saturation has on mortality. BACKGROUND: Many articles concentrate on the individual aspects of ScvO2, such as its use in early goal-directed therapy, but few provide a full overview of what it means, how to interpret results and how it can be used clinically. SEARCH STRATEGIES: Keywords were searched for including central venous oxygen saturation ScvO2 mixed venous oxygen saturations ScvO2 early goal-directed therapy sepsis and mortality. Where possible only publications within the last 10 years were used but key publications were not excluded if they were out with this time frame. CONCLUSIONS: Central venous oxygen saturation (ScvO2) is a very important measurement which can be easily taken in a critical care environment by both medical and nursing staff. It provides an understanding of the patient's oxygen delivery, oxygen consumption and cardiac output. It has a key role within early goal-directed therapy and has been shown to decrease mortality when taken and analysed appropriately. RELEVANCE TO CLINICAL PRACTICE: This literature review will highlight to nursing staff within the critical care environment the importance of central venous oxygen saturation measurement and interpretation. By raising awareness of the importance of this measurement it is hoped nursing staff will be proactive in both taking this test and analysing the results, therefore facilitating better care for the septic, critically ill patient and improving outcomes for these patients.

Efficacy of a 5-day, intensive, multidisciplinary, outpatient physical and occupational therapy protocol in the treatment of functional movement disorders: A retrospective study.

BACKGROUND: The use of rehabilitation services has been shown to be beneficial for patients with functional movement disorders (FMD). However, there is great variability in the type of rehabilitation services utilized. In the present study we aimed at determining the efficacy of an intense outpatient physical rehabilitation program as a treatment modality for patients with FMD. METHODS: Eighteen participants underwent treatment in a specialized outpatient rehabilitation program utilizing a multidisciplinary approach for the treatment of FMD. Participants completed a series of tests on day one and day five of the program. RESULTS: Results indicated statistically significant improvements in all but one motor and gait outcomes in patients with functional movement disorders treated with physical rehabilitation. CONCLUSION: These results provide support for the continued use of physical and occupational therapy for functional movement disorder patients. Further research is needed to fully validate these findings and there remains a need for further study into multidisciplinary approaches that may be even more efficacious.

Communicating news of a patient's death to relatives.

Breaking the news of the death of a patient to their relatives is one of the most difficult and dreaded aspects of nursing. While it is not an aspect of the job that nurses relish, it is key that nursing staff have full understanding of their role during this time to allow them to communicate this difficult news in a sensitive manner. This article will examine the role of the nurse in communicating the news of a patient's death to their next of kin and relatives. Staff education and training to deal with the bereaved will be assessed, as will the nurse's perceptions of their role. The impact of the nurse's presence on the bereaved will be looked at, and finally the role of the nurse in bereavement follow up will conclude this article.

Breaking news of death to relatives.

Breaking news of death can have a significant impact on bereaved relatives if it is not carried out appropriately. This article explores best practice on breaking news of death, and discusses why it is so important for nurses to get it right.

The agentic Self and uncontrollable body: Young people's management of chronic illness at university.

Young people's experiences of living with a long-term health condition have been largely investigated from the perspective of developing autonomy and optimal self-management of treatment regimens. Little existing research explores how young people adjust to the experience of chronic illness within everyday social contexts. Drawing on sociocultural theories of healthism, in this article, we examine the everyday strategies students employed to manage their health condition at university. Data were drawn from a qualitative study with 16 undergraduate students in Australia. Findings from interviews highlight how participants took up discourses of the (hard-working, diligent) Self to discursively position themselves as 'health conscious' and 'in control'. This positioning was maintained through separating the controlled Self from the (uncontrollable) body. The unpredictability of the body posed a threat to young people's abilities to maintain control and denied them opportunities to exercise personal agency. Yet, participants also described a number of subversive strategies in order to take back control and resist the experience of ill health. These potential agentic practices often held unintended consequences, including loss of optimal medical control or (self) exclusion from university life - offering new insights into the differing ways young people concomitantly take-up, rework and resist the pursuit of healthism to 'successfully' manage their health conditions.

Family Transitions in Cohabiting Families: a Longitudinal Investigation of the Role of Parent Depressive Symptoms in Youth Problem Behaviors.

Cohabiting family structures are becoming increasingly prevalent in the United States but are less stable than married family unions. In this longitudinal study we examine the change in psychosocial adjustment of adolescents when a non-biologically related male cohabiting partner (MCP) transitions out of the family home. Of particular interest, the role of maternal and MCP depressive symptoms was examined as a moderator. At wave 1, the sample was comprised of 111 low-income urban Black families, consisting of an adolescent (42.3 % male; Mage = 13), a biological mother, and a non-biologically-related male cohabiting partner (MCP). Wave 2 and 3 assessments occurred over the course of the subsequent 29 months, with 38 % of MCPs transitioning out of the home. We used latent growth curve modeling to characterize trajectories of youth internalizing and externalizing symptom change across the 3 waves. Both maternal and MCP depressive symptoms interacted with whether a transition occurred, consistent with the notion that adolescent problem behaviors are shaped by the dynamic interplay of individual- and family-characteristics.

The Superstrong Black Mother.

Baltimore mother Toya Graham became a viral video sensation after being filmed yelling at and hitting her teen son. Graham, who is Black, was trying to stop her son from joining the protests following Freddie Gray's death in police custody in Baltimore in April 2015. Dubbed "mother of the year," news outlets applauded Graham for her fierce determination to keep her son out of harm's way by any means necessary. The media and ensuing public response to the video are illuminating for what they say about cultural notions of Black motherhood: the good Black mom should be superstrong to protect her children, but she is also responsible for controlling her children and preventing them from getting into trouble. In celebrating Graham, the media was implicitly condemning all the other mothers whose children participated in the protests-that is, the mothers who did not prevent their children from "senseless" rioting against institutional racism in policing.

Vetting and Letting: Cohabiting Stepfamily Formation Processes in Low-Income Black Families.

The authors examined cohabiting union formation processes by analyzing in-depth interview data collected from 30 individuals in cohabiting relationships: 15 low-income Black mothers of adolescents and their partners. Prior research suggests that cohabiting union formation is a gradual, nondeliberative process. In contrast, most couples in this study described a gradual but highly deliberative process. Mothers focused primarily on vetting their partners to ensure child well-being and less on when and how their partners officially came to live with them, a process the authors call vetting and letting. Mothers delineated 4 strategies to ensure their child's well-being when vetting their partners, and their partners reported that they understood the importance of participating in this process. The authors argue that vetting and letting is a child-centered family formation process, not a partner-centered union formation process, and that cohabiting union processes may vary substantially by subpopulation.

Cohabitation and Repartnering among Low-Income Black Mothers.

Serial cohabitation has increased dramatically in the U.S., especially in the low-income Black population. The purpose of the study is to understand cohabiting and co-parenting relationships among unmarried cohabiting low-income urban Black families on their own terms, identifying the strengths, challenges, and unique needs of these families. Though cohabitation patterns varied widely, most participants had extensive periods living without a partner. This finding provides more support for the unbalanced marriage markets explanation than the serial cohabitation explanation. Indeed, most participants' children (83%) had none or only one resident father prior to the current cohabitation. Implications for having a new resident father and child development are discussed.

Male Cohabiting Partners as Primary Coparents in Low-Income Black Stepfamilies.

Male cohabiting partners in low-income urban Black single mother families may represent an extreme case of stepfathers who have been characterized as "polite strangers" in the household. The purpose of this study was twofold: To examine who serves as a coparent in these families; and to determine if identification of a coparent in addition to or instead of the MCP would be associated with the level of MCP involvement in the family. Participants were 121 mothers and adolescents from cohabiting families. The MCP was identified as a coparent in 75% of the families, an additional coparent was identified in only 30% of the families, and, when the MCP did not serve as a coparent, another individual was identified in this role in only 24% of the families. The identification of an MCP as a coparent was associated with higher levels of MCP childrearing activities, coparenting support provided by the MCP, and relationship quality with the mother relative to no coparent being identified. The identification of another coparent in addition to the MCP was not associated with changes in the higher levels of family involvement found when the MCP was a coparent. The importance of a male cohabiting partner for coparenting of an adolescent is emphasized in the discussion of the findings.

Involvement in Child Rearing and Firm Control Parenting by Male Cohabiting Partners in Black Low-Income Stepfamilies: Forecasting Adolescent Problem Behaviors.

Cohabitation is a family structure that is rapidly increasing in the United States. The current longitudinal study examined the interplay of involvement in a youth's daily activities and firm control parenting by male cohabiting partners (MCPs) on change in adolescents' internalizing and externalizing problems. In a sample of 111 inner-city African American families, adolescents reported on involvement and parenting by MCPs at Wave 1 and biological mothers reported on adolescent problem behaviors at Waves 1 and 2. A significant interaction indicated that low involvement and low firm control by MCPs at Wave 1 were associated with the highest level of internalizing problems at Wave 2. An interaction did not emerge when externalizing problems served as the outcome. The findings indicate that male partners play an important role in parenting adolescents in cohabiting families and should be considered potential participants in prevention and intervention programs.

Cohabitating Partners and Domestic Labor in Low-Income Black Families.

This article examines the division of domestic labor in low-income cohabiting Black stepfamilies. We analyze survey data collected from 136 such families in order to understand how stepparent gender and relationship length impact the distribution of domestic labor. We hypothesize that women do more domestic work than men across all three family types, and that stepfathers are more involved in domestic labor in established relationships compared to new relationships. Findings indicate that cohabiting stepfathers in both new and established cohabiting Black stepfamilies make substantial contributions to domestic labor. These families demonstrate a division of labor consistent with traditional gender roles, though both partners agree on how much work each does. Parents, regardless of gender, are more involved in domestic labor than stepparents.

Correlates of male cohabiting partner's involvement in child-rearing tasks in low-income urban Black stepfamilies.

Cohabitation is a family structure experienced by many Black children. This study examines the link between family relationships (child relationship with mother and the cohabiting partner; parent and cohabiting partner relationship) and involvement of biologically unrelated male cohabiting partners (MCP) in child rearing. The participants were 121 low-income urban Black families consisting of a single mother, MCP, and an adolescent (56% female, M age = 13.7). Assessments were conducted individually with mothers, MCPs, and adolescents via measures administered by interview. MCPs were involved in both domains of child rearing assessed (daily child-related tasks and setting limits) and those identified as coparents by the mother were more involved in child-rearing tasks than those not identified as coparents. Using structural equation modeling (SEM), the mother-MCP relationship (both support and conflict) and the adolescent-MCP relationship were related to MCP's involvement in both domains of child rearing. The findings indicate that MCPs are actively involved in child rearing and family relationship variables are associated with their involvement in these tasks.

Parental Mindfulness and Dyadic Relationship Quality in Low-income Cohabiting Black Stepfamilies: Associations with Parenting Experienced by Adolescents.

Cohabitation is a family structure experienced by many Black children; yet, we have limited understanding of how personal and interpersonal processes operate within these families to influence the parenting provided to these children. Informed by both family systems theory and the spillover hypothesis and utilizing a model to account for the interdependence of the mother and her partner, the current study sought to understand the direct and indirect associations among parental mindfulness, the mother-partner relationship quality, and firm parenting practices in a sample of 121 Black cohabiting low-income stepfamilies. Assessment consisted of standardized measurements of maternal and male cohabiting partner reports on mindfulness (i.e., acting with awareness) and relationship quality (i.e., relationship satisfaction, ability to resolve conflict, and coparenting conflict) as well as adolescent report on parenting (i.e., parent's firm control). Mindfulness was directly related to each individual's own perceptions of relationship quality and some support emerged for a cross-informant link (e.g., mother's mindfulness related to partner report of relationship quality). Furthermore, maternal perceptions of relationship quality, as well as mindfulness operating through relationship quality, were related to youth reports of maternal firm parenting. The results suggest that both mindfulness and the relationship quality of adults are variables deserving attention when studying the parenting received by children in cohabiting stepfamilies. Clinical implications of the findings are considered.

Cohabitation Duration and Transient Domesticity.

Research finds that many impoverished urban Black adults engage in a pattern of partnering and family formation involving a succession of short cohabitations yielding children, a paradigm referred to as transient domesticity. Researchers have identified socioeconomic status, cultural adaptations, and urbanicity as explanations for aspects of this pattern. We used longitudinal data from the 2001 Survey of Income and Program Participation to analyze variation in cohabitation and marriage duration by race/ethnicity, income, and urban residence. Proportional hazards regression indicated that separation risk is greater among couples that are cohabiting, below 200% of the federal poverty line, and Black but is not greater among urban dwellers. This provides empirical demographic evidence to support the emerging theory of transient domesticity and suggests that both socioeconomic status and race explain this pattern. We discuss the implications of these findings for understanding transient domesticity and make recommendations for using the Survey of Income and Program Participation to further study this family formation paradigm.

Interaction between 25S rRNA A loop and eukaryotic translation initiation factor 5B promotes subunit joining and ensures stringent AUG selection.

In yeast, 25S rRNA makes up the major mass and shape of the 60S ribosomal subunit. During the last step of translation initiation, eukaryotic initiation factor 5B (eIF5B) promotes the 60S subunit joining with the 40S initiation complex (IC). Malfunctional 60S subunits produced by misfolding or mutation may disrupt the 40S IC stalling on the start codon, thereby altering the stringency of initiation. Using several point mutations isolated by random mutagenesis, here we studied the role of 25S rRNA in start codon selection. Three mutations changing bases near the ribosome surface had strong effects, allowing the initiating ribosomes to skip both AUG and non-AUG codons: C2879U and U2408C, altering the A loop and P loop, respectively, of the peptidyl transferase center, and G1735A, mapping near a Eukarya-specific bridge to the 40S subunit. Overexpression of eIF5B specifically suppressed the phenotype caused by C2879U, suggesting functional interaction between eIF5B and the A loop. In vitro reconstitution assays showed that C2879U decreased eIF5B-catalyzed 60S subunit joining with a 40S IC. Thus, eIF5B interaction with the peptidyl transferase center A loop increases the accuracy of initiation by stabilizing the overall conformation of the 80S initiation complex. This study provides an insight into the effect of ribosomal mutations on translation profiles in eukaryotes.