A transactional approach to preventing early childhood neglect: The Family Check-Up as a public health strategy.

This study examined the hypothesis that a brief, strengths-based home visiting strategy can promote positive engagement between caregiver and child and thereby reduce various forms of early childhood neglect. A total of 731 low-income families receiving services through the Women, Infants, and Children nutritional supplement program were randomized to the Women, Infants, and Children as usual or the Family Check-Up intervention. Assessments and intervention services were delivered in the home environment at ages 2, 3, 4, and 5. During the assessments, staff videotaped caregiver-child interactions and rated various features of the home environment, including the physical appropriateness of the home setting for children. Trained observers later coded the videotapes, unaware of the family's intervention condition. Specific caregiver-child interaction patterns were coded and macroratings were made of the caregiver's affection, monitoring, and involvement with the child. An intention to treat design revealed that randomization to the Family Check-Up increased duration of positive engagement between caregivers and children by age 3, which in turn was prognostic of less neglect of the child at age 4, controlling for family adversity. It was also found that family adversity moderated the impact of the intervention, such that the families with the most adverse circumstances were highly responsive to the intervention. Families with the highest levels of adversity exhibited the strongest mediation between positive engagement and reduction of neglect. Findings are discussed with respect to developmental theory and their potential implications for a public health approach to the prevention of early childhood maltreatment.

Bilirubin as an antioxidant in micelles and lipid bilayers: its contribution to the total antioxidant capacity of human blood plasma.

The antioxidant capacities, antioxidant activities, k(inh), and stoichiometric factors, n, of water-soluble derivatives of bilirubin (BR), BR-human serum albumin (BR-HSA), and BR-ditaurate disodium conjugate (BRC) were determined in aqueous/lipid dispersions of sodium dodecyl sulfate (SDS) micelles/methyl linoleate and in bilayers of dilinoleoylphosphatidylcholine (DLPC) during initiation by water-soluble azo-bis-amidinopropane dihydrochloride (ABAP). The inhibition rate constants for BRC and BR-HSA were similar in micelles (k(inh) approximately 1.3 x 10(4) M(-1) s(-1)), where n approximately 2, whereas the k(inh) for BR-HSA dropped by (1/2) in bilayers. The dimethyl ester of bilirubin (BRDE) gave a k(inh) only one-tenth that of the vitamin E analog, pentamethylhydroxychroman (PMHC) in SDS micelles/methyl linoleate when initiated by lipid-soluble azo-bis-2,4-dimethylvaleronitrile (DMVN). Biliverdin hydrochloride (BVHCl) was NOT an effective peroxyl radical-trapping agent in the micellar phase during initiation by ABAP or DMVN containing methyl linoleate but it inhibited oxygen uptake in the aqueous phase. Both BRC and BR-HSA extended the total radical antioxidant parameter (TRAP) of human blood plasma and their contribution to TRAP was in the range of 5-10% of the natural TRAP of blood plasma, depending on the BR content determined in the blood plasma.

Daily cortisol activity, loneliness, and coping efficacy in late adolescence: A longitudinal study of the transition to college.

Many late adolescents who transition to the college environment perceive changes in psychosocial stress. One such stressor, loneliness, has been associated with numerous health problems among adolescents and adults. The hypothalamic-pituitary-adrenal axis is one mechanism through which loneliness may affect health. Guided by a risk and resilience framework, the present study investigated the association between longitudinal changes in loneliness from high school to college and diurnal cortisol activity (waking levels, cortisol awakening response, diurnal slope) by sampling saliva intensively 5 times a day for 3 weekdays in a US sample of late adolescents in their first semester of college (N = 70; Mage = 18.49, SD = 0.38). The present study also explored how the link between loneliness and cortisol might depend on coping efficacy-one's belief in successfully coping with future stressors or novel situations. Results from hierarchical linear growth curve models demonstrated that an increase in loneliness across this contextual transition was associated with steeper cortisol slopes in college. Coping efficacy at baseline (in high school) significantly moderated the relation between changes in loneliness and diurnal slopes, such that late adolescents with low levels of coping efficacy who reported increased loneliness across the transition exhibited significantly flatter diurnal slopes in college. Higher levels of coping efficacy at baseline also significantly predicted lower waking cortisol levels during the first semester of college. These results suggest that coping efficacy may serve as a protective factor by contributing to regulation of daily physiological stress activity for late adolescents as they struggle with loneliness across the transition to college.