The Feeding Practices and Structure Questionnaire: development and validation of age appropriate versions for infants and toddlers.

BACKGROUND: In order to measure and understand trajectories of parental feeding practices and their relationship with child eating and weight, it is desirable to perform assessment from infancy and across time, in age-appropriate ways. While many feeding practices questionnaires exist, none is presently available that enables tracking of feeding practices from infancy through childhood. The aim of the study was to develop a version of the Feeding Practices and Structure Questionnaire (FPSQ) for parents with infants and toddlers (< 2 years) to be used in conjunction with the original FPSQ for older children (≥2 years) to measure feeding practices related to non-responsiveness and structure across childhood. METHODS: Constructs and items for the FPSQ for infants and toddlers were derived from the existing and validated FPSQ for older children and supplemented by a review of the literature on infant feeding questionnaires. Following expert review, two versions of the questionnaire were developed, one for milk feeding parents and one for solid feeding parents. Data from two studies were combined (child ages 0-24 months) to test the derived constructs with Confirmatory Factor Analysis for the milk feeding (N = 731) and solid feeding (N = 611) versions. RESULTS: The milk feeding version consisted of four factors (18 items) and showed acceptable model fit and good internal reliability: 'feeding on demand vs. feeding routine' (α = 0.87), 'using food to calm' (α = 0.87), 'persuasive feeding' (α = 0.71), 'parent-led feeding' (α = 0.79). The same four factors showed acceptable model fit for the solid feeding version (21 items), likewise with good internal reliability (α = 0.74, 0.86, 0.85, 0.84 respectively). Two additional factors (13 items) were developed for the solid feeding version that appeared developmentally appropriate only for children aged 12 months or older: 'family meal environment' (α = 0.81) and 'using (non-)food rewards' (α = 0.92). The majority of factor-factor correlations were in line with those of the original FPSQ. CONCLUSIONS: The FPSQ milk and solid feeding versions are the first measures specifically developed as precursors to the FPSQ to measure parental feeding practices in children < 2 years, particularly practices related to non-responsiveness and structure. Further validation in more diverse samples is required.

The influence of different stages of pregnancy on group B streptococcal infection in mice.

Eight-day pregnant mice were found to be more resistant to the lethal effects of group B streptococci than those which were 17 days pregnant. From studies on the multiplication of the organisms in vivo it is suggested that the apparent enhancement of the infection in the 17-day pregnant animals is due to the lethal effects of the greater number of streptococci found in their tissues.

Vestibular influences on hypoglossal nerve activity in the cat.

The purpose of the present study was to determine if selective activation of vestibular receptors during movement produces changes in hypoglossal nerve activity. Responses were recorded from the hypoglossal nerves during trapezoidal and sinusoidal head rotations in cats with extensive denervations to eliminate non-labyrinthine inputs that could be produced by the movements. Large (50 degrees) nose-up trapezoidal tilts produced an increase in nerve discharge; ear-down tilt was also effective in one-fourth of the animals. The responses to nose-up tilt were abolished following intracranial transections of the VIIIth cranial nerves. Smaller (20 degrees) sinusoidal head rotations in the roll, pitch and yaw planes were ineffective in producing responses. These data suggest that vestibular inputs elicited by nose-up pitch contribute to tongue protrusion and participate in maintaining airway patency by preventing the tongue from falling to the back of the mouth.

Vestibular influences on cat lumbar paravertebral muscles.

Recordings were made from nerves innervating ventral lumbar paravertebral muscles (quadratus lumborum) during natural vestibular stimulation in vertical planes. The best direction of vestibular stimulation for producing an increase in nerve activity was near nose-up pitch in two-thirds of the animals, but was near nose-down pitch in the others. The response gain (re. position) was flat across the frequency range of 0.05-1 Hz, and the responses persisted throughout 11-s static tilts. These data suggest that otolith organs activated by pitch influence activity in the lumbar paravertebral muscles. These responses may serve to stabilize the vertebral column during movements involving body pitch, such as vertical climbing.

Group interventions to support family caregivers: a review and analysis.

A review of 29 evaluative studies published through 1987 reveals that no clear link has yet been established between participants' satisfaction and such other important outcomes for caregivers as improving coping skills, preventing psychological disturbances, increasing caregiver support systems, or improving caregivers' ability to care for themselves.

The effectiveness of peer-led and professionally led groups to support family caregivers.

Participants in both professionally led and peer-led groups experienced significant improvements in psychological functioning, increases in informal support networks, and positive personal changes in handling of the caregiving role when compared with control participants. Professionally led groups produced the greatest improvement in psychological functioning, and peer-led groups produced the greatest increases in informal support networks.

Man-made mineral fibers and lung cancer. Epidemiologic evidence regarding the causal hypothesis.

Reviews of the epidemiologic literature point to a causal connection between lung cancer and exposure to airborne man-made mineral fibers. The present critical re-review starts with the requirements for epidemiologic evidence to be informative regarding a hypothesis on cancer etiology. The previous reviews relate lung cancer mortality to exposure that is too recent to be relevant. The relation to relevant (distant) exposure in the available data involves notable confounding by coexposure to other agents in the work environment, by the lower socioeconomic status of the exposed workers, and possibly by smoking. Moreover, analyses of trends in standardized mortality ratios according to timing and duration of exposure involve a lack of mutual comparability between the ratios. Given these problems, the available evidence is inadequate for testing the causal hypothesis. However, reanalyses of the available data, augmentation of the data with reanalyses, and new studies could eliminate the existing inadequacies.

Pooled fecal culture sampling for Mycobacterium avium subsp. paratuberculosis at different herd sizes and prevalence.

A stochastic spreadsheet model was developed to obtain estimates of the costs of whole herd testing on dairy farms for Mycobacterium avium subsp. paratuberculosis (Map) with pooled fecal samples. The optimal pool size was investigated for 2 scenarios, prevalence (a low-prevalence herd [< or = 5%] and a high-prevalence herd [> 5%]) and for different herd sizes (100-, 250-, 500- and 1,000-cow herds). All adult animals in the herd were sampled, and the samples of the individuals were divided into equal sized pools. When a pool tested positive, the manure samples of the animals in the pool were tested individually. The individual samples from a negative pool were assumed negative and not tested individually. Distributions were used to model the uncertainty about the sensitivity of the fecal culture at farm level and Map prevalence. The model randomly allocated a disease status to the cows (not shedding, low Map shedder, moderate Map shedder, and heavy Map shedder) on the basis of the expected prevalence in the herd. Pooling was not efficient in 100-cow and 250-cow herds with low prevalence because the probability to detect a map infection in these herds became poor (53% and 88%) when samples were pooled. When samples were pooled in larger herds, the probability to detect at least 1 (moderate to heavy) shedder was > 90%. The cost reduction as a result of pooling varied from 43% in a 100-cow herd with a high prevalence to 71% in a 1,000-cow herd with a low prevalence. The optimal pool size increased with increasing herd size and varied from 3 for a 500-cow herd with a low prevalence to 5 for a 1,000-cow herd with a high prevalence.

Association of Mycobacterium paratuberculosis infection with reduced mastitis, but with decreased milk production and increased cull rate in clinically normal dairy cows.

Approximately 45 Holstein cows that were Mycobacterium paratuberculosis-positive on the basis of fecal culture results were maintained at any one time in a 210-cow dairy herd. Farm management participated in the New York State Paratuberculosis Eradication Program. Paratuberculosis-positive cows were grouped separately from paratuberculosis-negative cows, but they were otherwise managed identically. During a 1-year study, 180 paratuberculosis-negative cows and 113 clinically normal paratuberculosis-positive cows were identified. Quarter milk samples (n = 6,100) were aseptically collected for microbiologic culture of mastitis pathogens from paratuberculosis-negative cows, and 3,129 quarter samples were obtained from paratuberculosis-positive cows. Dairy Herd Improvement Association (DHIA) records were used to monitor milk somatic cell count linear scores, mature equivalent milk production, new mastitis infections, and chronic mastitis infections. For second-lactation cows greater than 100 days in milk production, and increasing with age beyond that point, paratuberculosis-positive cows had lower mature equivalent milk production than did negative herdmates. Rates of new and chronic mastitis infections, as measured by DHIA linear scores were significantly (P < 0.05, P = 0.05, respectively) lower in cows with nonclinical paratuberculosis. Infected cows were culled from the herd at a faster rate than were paratuberculosis-negative herdmates. Therefore, paratuberculosis was associated with financial loss attributable to reduced milk production and increased culling of infected cows.

Farm-specific approach to paratuberculosis (Johne's disease) control.

Uncertainties in the understanding of Johne's disease make the pursuit of disease control confusing for producers and veterinarians. Genetic control recommendations have limited adoption or success because they fail to account for the unique circumstances of individual farms. A systematic and pragmatic approach for developing farm control plans is presented. It targets the development of plans that are adapted to individual farm circumstances and are thus more likely to be implemented and effective.

Paratuberculosis: a potential zoonosis?

Available literature on the controversial role of Mycobacterium paratuberculosis as an etiologic agent in human Crohn's disease is reviewed. Despite almost 15 years of investigation, the question of causal or consequential association between Johne's disease and Crohn's disease continues to linger.

Royal Naval dockyards asbestosis research project: nine-year follow-up study of men exposed to asbestos in Devonport Dockyard.

Progression of asbestos-related disease was assessed in a group of 253 dockyard workers examined in 1966 and 1975. Despite the almost complete protection from exposure to asbestos since 1966, radiographic parenchymal abnormalities increased and occurred more frequently during the next 9 years in those men who had been more heavily exposed to asbestos. Lung function values were lower in those most heavily exposed and were declining at a faster rate than in those with less dust exposure. The most sensitive lung function index was the transfer factor.Those men with persistent crackles in 1966 exhibited a restrictive pattern of lung function, whereas an obstructive pattern was seen in men with wheezes in 1966. The men with irregular small opacities of category 1/1 or more or with diffuse pleural change in 1966 and who survived to 1975 had worse lung functions than any other groups.Progression of disease was greater for smokers than non-smokers, with those who gave up smoking between 1966 and 1975 suffering the greatest changes. This latter group showed most increase in small opacities and included almost all new cases of diffuse pleural changes. They also showed the greatest declines in forced expiratory volume and forced vital capacity.

The effectiveness of three group intervention strategies to support family caregivers.

Participants in two types of professionally-led groups and one peer-led group reported significant changes in personal problems related to caregiving as compared to controls. No significant changes were found on measures of psychological status and caregiving burden.

Lung function consequences of dust exposure in asbestos cement manufacturing plants.

A comprehensive study of health effects associated with the mixed dust exposure in this industry has included the collection of clinical, radiographic, lung function, and dust exposure data on 859 workers in two plants. Evidence is presented supporting a dose-response relationship between indexes of dust exposure and lung function, similar to the previously reported relationship with extent of x-ray film changes using the ILO U/C classification. Lung volumes and maximum expiratory flow rates decrease in relation to increasing cumulative dust exposure while pulmonary diffusing capacity (DL) is not dust-dose related. Worders who had crocidolite exposure had smaller lung volumes, lower expiratory flow rates, and reduced DL when compared with those having only chrysotile exposure. When the study population is divided into exposure groups, data thus far analyzed suggest that the chest x-ray film will reveal small opacities as early as significant functional changes can be detected, but individuals may have functional reduction prior to the appearance of x-ray film changes.

Therapeutic processes in peer led and professionally led support groups for caregivers.

A comparison of peer led and professionally led support groups for caregivers of frail older persons living in the community demonstrates that both types of groups are effective. Findings reveal that it was the opportunity to ventilate pent-up feelings and emotions, the validation of caregiving experiences, the affirmation of coping abilities, the encouragement for continuing to provide care and cope with the situation, the exploration of alternative caregiving arrangements, the mutual support, and the mutual sharing of information about community resources and coping strategies that appeared to be the most helpful therapeutic ingredients of both types of groups. The greater attention to problem solving work and the learning of specific coping skills in the professionally led groups was not reflected in differential outcomes in the two support group conditions.