Quantitative orientation analysis by sum frequency generation in the presence of near-resonant background signal: acetonitrile on rutile TiO2 (110).

Sum frequency generation (SFG) spectroscopic techniques are used to investigate the molecular orientation of adsorbed acetonitrile on rutile TiO2 (110) at the solid-vapor interface. Generally, most molecular orientation analyses using SFG have been performed on dielectric substrates, to avoid the spectral interference between resonant and the near-resonant background signal. Although rutile crystal can be treated as a dielectric substrate, its electronic state contributes to the intensity and interferes with the resonant signal when the SFG frequency is close to its band gap energy. In addition, the rutile crystal is a uniaxial birefringent material, and the (110) surface is anisotropic, which further complicates the spectral analysis. In this study, various SFG measurement techniques were applied, and quantitative analytical methods were established to interpret the surface orientation of an adsorbed molecule. SFG vibrational spectra of acetonitrile on rutile TiO2 (110) surface have been measured using distinct polarization combinations, polarization mapping, and null angle method. By varying the polarization combinations of SFG, the magnitude and shape of the spectra undergo substantial change, which originate from the interference between the near-resonant signal from the rutile substrate and the resonance signal from the acetonitrile. Theory, simulation, and analytical methods for obtaining quantitative orientation information of a molecule on an anisotropic semiconductor substrate in the presence of a near-resonant signal are presented.

Adolescent and parent perceptions of patient-centered communication while managing type 1 diabetes.

OBJECTIVE: To examine whether adolescents' and parents' perceptions of patient-centered communication (PCC) with the physician may be associated with aspects of patient empowerment (e.g., perceptions of competence) and diabetes management (i.e., adherence and HbA1c). METHODS: One hundred and ninety adolescents with type 1 diabetes and their parents rated perceptions of PCC following a clinic visit and completed measures of competence, illness perceptions, self-efficacy, and adherence in the weeks following their clinic visit, and again 6 months later. Metabolic control was indexed from medical records. RESULTS: Higher levels of PCC with physicians were associated cross-sectionally and longitudinally with greater perceptions of control and competence for both adolescents and parents. Mediation analyses indicated that PCC was indirectly related to subsequent adherence and metabolic control through perceptions of the adolescent's competence in diabetes management. CONCLUSIONS: Perceptions of PCC with healthcare providers may empower adolescents and parents in their diabetes management.

Parental involvement buffers associations between pump duration and metabolic control among adolescents with type 1 diabetes.

OBJECTIVES: To examine pump duration associations with adolescents' metabolic control and whether parental involvement moderated this association. METHODS: This study used a cross-sectional sample of 10- to 14-year-olds with diabetes (N = 252, 53.6% female) and parents' reported parental involvement; HbA1c was obtained from medical records. Half (50.8%) were on an insulin pump (continuous subcutaneous insulin infusion, CSII), with the remainder prescribed multiple daily injections (MDI). RESULTS: Adolescents on CSII displayed better HbA1c than those on MDI. A curvilinear association revealed that participants on CSII for <2 years showed a positive pump duration-HbA1c association, while those on CSII longer showed no association. Parental involvement interacted with pump duration to predict HbA1c. Pump duration was associated with poorer HbA1c only when parents were relatively uninvolved. CONCLUSIONS: Within the limitations of a cross-sectional design, data suggest that adolescents on CSII have better HbA1c than those on MDI, but may experience a period of deterioration that can be offset by parental involvement.

Mothers', fathers', and children's perceptions of parental diabetes responsibility in adolescence: examining the roles of age, pubertal status, and efficacy.

OBJECTIVES: To examine how perceptions of parental responsibility for diabetes management are associated with age, pubertal status, adolescents' self-efficacy, and parental perceptions of adolescents' efficacy, and if parental responsibility is associated with better metabolic control as a function of adolescents' self-efficacy and parental perceptions of adolescents' efficacy. METHODS: Questionnaires assessing parental responsibility, pubertal status, adolescents' self-efficacy, and parental perceptions of adolescents' efficacy were given to 185 adolescents with type 1 diabetes, 185 mothers, and 145 fathers. RESULTS: Greater parental responsibility was negatively associated with age, perceptions of pubertal status, and efficacy for all reporters. Interactions between parental responsibility and parental perceptions of adolescents' efficacy indicated that parental responsibility was associated with better metabolic control when adolescents were perceived to have lower efficacy. CONCLUSIONS: Adolescents' and parents' perceptions of parental responsibility are related to multiple factors. Metabolic control is best when high parental responsibility is maintained among adolescents with lower efficacy.

Evaluating the support needs of injured workers in managing occupational transitions after injury.

BACKGROUND: Historically the supports available to help injured workers transition back to pre-injury jobs focused primarily on the medical treatment of the injury and modifications in the workplace. However, for many injured workers, with chronic disabilities, the need for support extends to learning to live with newly exposed disabilities, managing changes within family and social life as well as meeting new expectations in claims and health management. Supports that many injured workers require to resume employment are not adequately addressed. OBJECTIVE: A critical social perspective was used to engage a partnership with injured worker group members in the design, implementation and evaluation of injured worker needs to promote social change. This paper reflects a program of research established in partnership with the Canadian Injured Worker Alliance to develop and examine a conceptual framework of supports for use in meeting the transitional needs of injured workers with chronic disabilities. Occupational and educational perspectives were used to develop a conceptual framework comprised of 8 dimensions of support. METHOD: A regional needs assessment using multi-methods, including surveys, interviews and focus groups, was conducted in British Columbia (BC). Priorities of three stakeholder groups were mapped to the 8 dimensions of support. This conceptual framework was also tested nationally to evaluate the distribution of supports that exist and identify further needs for support to help injured workers manage multiple transitions. FINDINGS: Access to the range of supports that injured workers need in transitioning to and from work is inconsistent and inequitable across Canada. CONCLUSION: Collaborative approaches and a broader spectrum of resources and supports are needed to help injured workers and their families in resuming meaningful participation in daily, social and productive occupations.

Relationships and the development of transition readiness skills into early emerging adulthood for individuals with type 1 diabetes.

The study examined how 'transition readiness' skills develop from relationship processes with parents, friends, and healthcare providers. During their senior year of high school and one year later, participants (N = 217) with type 1 diabetes completed measures of transition readiness skills (Self-Management; Self-Advocacy), adherence, HbA1c, and relationships with providers (patient-centered communication), parents (monitoring/knowledge), and friends (knowledge/helpfulness) surrounding diabetes. Self-Management skills increased across time. Higher friend knowledge/helpfulness during emerging adulthood was associated with increased Self-Management skills. Adherence improved when relationships with providers and friends matched transition readiness skills, indicating that these relationships may facilitate transition skills in early emerging adulthood.

Knowledge brokering with injured workers: Perspectives of injured worker groups and health care professionals.

OBJECTIVE: The aim of this study is to understand the barriers and facilitators in brokering knowledge brokering knowledge to help injured workers make informed decisions about recovery and to support their transitions to return to work (RTW). PARTICIPANTS: Perceptions of 63 Injured Worker Groups (IWGs) and 43 Health Care Professionals (HCPs) in facilitating and brokering knowledge were examined. METHODS: Critical theory and participatory action research approaches informed the development of a multi-stakeholder research team and the study design to support an exploration into knowledge exchange and transfer. Data was analyzed using a critical occupational perspective to reveal the source of barriers and to identify the facilitators of the knowledge exchange and transfer process. RESULTS: Barriers in transferring knowledge included system barriers, a lack of information accessibility, and problems with variations in injured worker capacity and experience using information. IWG and HCP participants lacked expertise in knowledge transfer. Findings also revealed the interactive knowledge transfer processes that IWGs and HCPs use to help injured workers understand and use information. CONCLUSIONS: Change is required to improve knowledge exchange and transfer of information for and to persons with injuries and disabilities. Suggested changes include the development of a sustainable knowledge transfer community of practice, a best practice guide for knowledge brokers such as IWGs and HCPs, and a process for ongoing assessment and evaluation of injured worker information needs and preferences.

Physician recommendations about maternal involvement in adolescent diabetes management.

OBJECTIVE: The purpose of this study was to examine whether perceptions of physician recommendations about maternal involvement in adolescent diabetes management are associated with children's reports of mothers' involvement during the subsequent week. RESEARCH DESIGN AND METHODS: Youth with type 1 diabetes (aged 10-15 years) and mothers completed scales measuring perceptions of physician recommendations about maternal involvement. At their appointment, and again 1 week later, children reported mothers' involvement in diabetes over the preceding week. RESULTS: A total of 53 dyads provided usable data at both time points. Perceived recommendations to increase involvement were associated with children's reports of increased maternal collaboration during the subsequent week (B = 0.81, P < 0.05), an effect that was stronger among boys (B = -1.21, P < 0.005). Increased maternal collaboration correlated with better A1C (r = -0.39, P < 0.005). CONCLUSIONS: Physicians may facilitate adaptive forms of maternal involvement during adolescence by conveying messages about involvement to patients and families.

Role of parental monitoring in understanding the benefits of parental acceptance on adolescent adherence and metabolic control of type 1 diabetes.

OBJECTIVE: This study examined 1) whether the benefits of mothers' and fathers' accepting relationships with their adolescents regarding diabetes control were due to parental monitoring and 2) how parents together may provide sufficient acceptance and monitoring for diabetes management. RESEARCH DESIGN AND METHODS: Adolescents aged 10-14 years with type 1 diabetes (n = 185) and their mothers (n = 185) and fathers (n = 145) completed assessments of parental acceptance and monitoring of diabetes tasks. Adolescents completed a modified version of the Self-Care Inventory (1) to measure adherence. A1C scores were used as a marker of glycemic control. RESULTS: Mediational analyses revealed that the benefits of adolescents' reports of fathers' acceptance on A1C and mothers' and fathers' acceptance on better adherence were partially mediated by monitoring. Both mothers' and fathers' monitoring and fathers' acceptance had independent effects in predicting adherence. However, only fathers' monitoring had an independent effect on A1C. The effect of fathers' monitoring on A1C occurred as fathers were monitoring at a lower level than mothers. Mothers' and fathers' reports of their own acceptance and monitoring were not associated with A1C or adherence. CONCLUSIONS: Results reveal the importance of fathers' acceptance and monitoring in diabetes management, a role that should be encouraged, despite the little attention it has received.

Mother child appraised involvement in coping with diabetes stressors and emotional adjustment.

OBJECTIVE: To examine how children's and mother's appraisals of each other's involvement in coping with diabetes events are associated with emotional adjustment. METHODS: One hundred and twenty-seven children (ages 10-15 years) with type 1 diabetes and their mothers reported on their own emotional adjustment and how each other was involved in coping strategies surrounding diabetes stressful events. RESULTS: Appraisals that mothers and children were uninvolved with each other's stressors were associated with greater depressive symptoms and less positive mood; children's appraisals of mother's supportive involvement with children's less depressive symptoms, and appraisals of collaborative involvement with less depressive symptoms and more positive mood for both mothers and children. Appraised control was most detrimental for children for older females and for mothers of younger children. CONCLUSIONS: Collaborative involvement in coping efforts may be an important resource for addressing negative emotions that both children and mothers experience surrounding type 1 diabetes, especially across adolescence.

Children's appraisals of maternal involvement in coping with diabetes: enhancing our understanding of adherence, metabolic control, and quality of life across adolescence.

OBJECTIVE: To examine how children's appraisals of maternal involvement in coping with diabetes are associated with adherence, metabolic control, and quality of life across adolescence. METHODS: Children (N = 127, ages 10-15 years) with type 1 diabetes completed measures of adherence, quality of life, and appraisals of mothers' involvement in dealing with diabetes problems (i.e., mother appraised as uninvolved, controlling, or collaborative). Metabolic control was indexed through medical records. RESULTS: Regardless of age or sex of child, appraised maternal uninvolvement was associated with poorer adherence and quality of life, while appraised collaboration was associated with better adherence and metabolic control. There was evidence that the association between appraised collaboration and metabolic control was partially mediated by adherence. Appraised control was associated with poorer adherence among older, but not younger, children and with poorer quality of life among older females but not among older males or younger children of either sex. CONCLUSIONS: Maintaining maternal involvement in diabetes care is important across ages 10 to 15, but the optimal form of this involvement may need to be adjusted to be consistent with the child's level of development. The present findings suggest that better adherence is seen across age when mothers are viewed as collaborating with, as opposed to controlling, their child when dealing with diabetes problems.

The role of autonomy and pubertal status in understanding age differences in maternal involvement in diabetes responsibility across adolescence.

OBJECTIVE: To examine how autonomy and pubertal status explain age decreases in maternal involvement in type 1 diabetes management across adolescence, how they relate to metabolic control, and the reasons that guide declines in maternal involvement. METHODS: One hundred twenty-seven children ages 10-15 years with type 1 diabetes and their mothers participated. Data included maternal and child report of diabetes management, child report of autonomy level, maternal report of pubertal status, maternal reports of reasons for transfer of diabetes responsibility, and glycosylated hemoglobin (Hba(1c)) values. RESULTS: Autonomy and pubertal status partially mediated age effects on reports of maternal involvement. Mothers' reasons for transferring responsibility included responding to the child's competence, promoting competence and maturity in their child, and minimizing hassles and conflict. The transfer of diabetes responsibility from mother to child without sufficient autonomy and when pubertal status was low was related to higher Hba(1c) values. CONCLUSIONS: The importance of chronological age for changes in maternal involvement suggests the need to examine mothers' and adolescents' developmental expectations for diabetes management. The reasons for transferring responsibility from mother to child suggest many avenues for intervention.