Maternal neighbourhood-level social determinants of health and their association with paediatric hepatitis C screening among children exposed to hepatitis C in pregnancy.

BACKGROUND: Current guidelines recommend HCV screening by 18 months of age for those exposed to HCV in utero; yet, screening occurs in the minority of children. OBJECTIVES: To evaluate the association between maternal neighbourhood-level social determinants of health (SDOH) and paediatric HCV screening in the general population in a publicly funded healthcare system in Canada. METHODS: Retrospective cohort study using administrative healthcare data held at ICES. Children born to individuals positive for HCV RNA in pregnancy from 2000 to 2016 were identified and followed for 2 years. Major SDOH were identified, and the primary outcome was HCV screening in exposed children (HCV antibody and/or RNA). Associations between SDOH and HCV screening were determined using multivariate Poisson regression models adjusting for confounding. RESULTS: A total of 1780 children born to persons with +HCV RNA were identified, and 29% (n = 516) were screened for HCV by age two. Most mothers resided in the lowest income quintile (42%), and most vulnerable quintiles for material deprivation (41%), housing instability (38%) and ethnic diversity (26%) with 11% living in rural locations. After adjustment for confounding, maternal rural residence (risk ratio [RR] 0.82, 95% confidence interval [CI] 0.62, 1.07) and living in the highest dependency quintile (RR 0.83, 95% CI 0.65, 1.07) were the SDOH most associated with paediatric HCV screening. Younger maternal age (RR 0.98 per 1-year increase, 95% CI 0.97, 0.99), HIV co-infection (RR 1.69, 95% CI 1.16, 2.48) and GI specialist involvement (RR 1.18, 95% CI 1.00, 1.39) were associated with higher probabilities of screening. CONCLUSIONS: Among children exposed to HCV during pregnancy, rural residences and living in highly dependent neighbourhoods showed a potential association with a lower probability of HCV screening by the age of 2. Future work evaluating barriers to paediatric HCV screening among rural residing and dependent residents is needed to enhance the screening.

Geography is more important than life history in the recent diversification of the tiger salamander complex.

The North American tiger salamander species complex, including its best-known species, the Mexican axolotl, has long been a source of biological fascination. The complex exhibits a wide range of variation in developmental life history strategies, including populations and individuals that undergo metamorphosis; those able to forego metamorphosis and retain a larval, aquatic lifestyle (i.e., paedomorphosis); and those that do both. The evolution of a paedomorphic life history state is thought to lead to increased population genetic differentiation and ultimately reproductive isolation and speciation, but the degree to which it has shaped population- and species-level divergence is poorly understood. Using a large multilocus dataset from hundreds of samples across North America, we identified genetic clusters across the geographic range of the tiger salamander complex. These clusters often contain a mixture of paedomorphic and metamorphic taxa, indicating that geographic isolation has played a larger role in lineage divergence than paedomorphosis in this system. This conclusion is bolstered by geography-informed analyses indicating no effect of life history strategy on population genetic differentiation and by model-based population genetic analyses demonstrating gene flow between adjacent metamorphic and paedomorphic populations. This fine-scale genetic perspective on life history variation establishes a framework for understanding how plasticity, local adaptation, and gene flow contribute to lineage divergence. Many members of the tiger salamander complex are endangered, and the Mexican axolotl is an important model system in regenerative and biomedical research. Our results chart a course for more informed use of these taxa in experimental, ecological, and conservation research.

Trends in the proportion of women speakers at North American Allergy and Immunology conferences, 2008 to 2020.

BACKGROUND: Women in medicine continue to be underrepresented at medical conferences. Previous studies have evaluated the proportion of invited female speakers across multiple specialties and evaluated factors that may have led to this disparity. The field of Allergy and Immunology has often been excluded and analyses have not illustrated how the trends have changed over the past decade. OBJECTIVE: To evaluate the distribution of invited speakers by gender over time at the 3 largest North American Allergy and Immunology conferences. METHODS: This retrospective longitudinal analysis used conference programs from 2008 to 2020 from the American Academy of Allergy, Asthma, and Immunology (AAAAI), the American College of Allergy, Asthma, and Immunology (ACAAI), and the Canadian Society of Allergy and Clinical Immunology (CSACI). The gender (binary definition, man or woman, based on names, photos, pronouns, from conference programs and institutional profiles) of invited speakers was analyzed as the primary outcome, and planning committee members, and multispeaker sessions as secondary outcomes. These data were compared with publicly available data on the composition of the specialty by gender in the United States and Canada. RESULTS: Women speakers at AAAAI, ACAAI, and CSACI conferences have historically been lower than male speakers and underrepresented compared with specialty composition. However, there has been a significant increase in the proportion of women speakers over time for all 3 conferences individually (AAAAI: 23.7% in 2008, 41.1% by 2020; ACAAI: 16.7% in 2008, 37.3% by 2020; CSACI: 19.4% in 2008, 54.8% by 2020; P < .001 for each) and combined (21.3% in 2008, 40.7% by 2020, P < .001). This trend coincides with a significant increase in women on the planning committee (all conferences: 20% in 2008, 50.6% by 2020; P < .001). There is also a decreasing trend over time for men-only multispeaker sessions. CONCLUSION: This study sheds light on the trends of women speaker representation at Allergy and Immunology conferences and provides clarity on future needs to reach equal representation in this field.

Promoting reflective practice in an infant and early childhood training program.

Reflective practices provide a supportive base through which preservice infant and early childhood teachers and allied professionals can achieve knowledge, skills, and professional dispositions to support young children and their families. This paper is a program description that describes the rationale for infusing reflective practices into the learning goals for preservice early childhood training, highlighting the specific reflection skills from the Infant and Early Childhood Mental Health Competency Guidelines. We describe how one university early childhood training program promotes student reflection skills referencing three distinct perspectives: (1) why reflection is essential to developing knowledge and skills; (2) the role group reflection plays in sustaining deep knowledge and skill development for students and faculty; (3) how faculty promote students' awareness of the connection between personal experience and professional dispositions through reflection during practicum experiences. The benefits and challenges of embedding reflective practices in preservice early childhood training are also discussed.

Las prácticas de reflexionar proveen una base de apoyo a través de la cual los maestros y profesionales aliados en el pre-servicio de infantes y la temprana niñez pueden lograr conocimientos, habilidades y disposiciones profesionales para apoyar a los pequeños niños y sus familias. Este ensayo es la descripción de un programa que describe la razón fundamental para incluir las prácticas de reflexionar dentro de los objetivos de aprendizaje para el entrenamiento del pre-servicio en la temprana niñez, subrayando las habilidades de reflexionar específicas que parten de los Preceptos Guías para la Competencia en la Salud Mental de la Infancia y la Temprana Niñez. Describimos cómo el programa de entrenamiento en la temprana niñez en una universidad promueve las habilidades de reflexionar en el estudiante, haciendo referencia a tres perspectivas distintas: 1. Por qué el reflexionar es esencial para desarrollar el conocimiento y las habilidades; 2. El papel que juega el grupo de reflexión para sostener el profundo desarrollo del conocimiento y las habilidades para estudiantes y profesores; 3. Cómo el profesorado promueve la concienciación de los estudiantes sobre la conexión entre la experiencia personal y las disposiciones profesionales a través de la reflexión durante las experiencias de práctica. También se discuten los beneficios y retos de incluir prácticas de reflexión en el entrenamiento del pre-servicio en la temprana niñez.

Les pratiques de réflexion offrent une base de soutien au travers de laquelle les enseignants et professionnels allies de la petite enfance et des services aux nourrissons peuvent développer et acquérir des connaissances, des compétences et des dispositions professionnelles afin de soutenir les jeunes enfants et leurs familles. Cet article est une description qu'un programme qui décrit la rationnelle pour l'infusion de compétences de réflexions dans les objectifs d'apprentissage pour la formation pré-service de la petite enfance, mettant en évidence les compétences de réflexion spécifiques qui se trouvent dans les Grandes Lignes de Compétence en Santé Mentale de la Petite Enfance. Nous décrivons la manière dont le programme de formation pour la petite enfance d'une université promeut des compétences de réflexion des étudiants en faisant référence à trois perspectives distinctes: 1. Pourquoi la réflexion est essentielle au développement des connaissances et des compétences; 2. Le rôle que joue la réflexion de groupe pour le maintien de connaissances profondes et le développement des compétences pour les étudiants et les professeurs; 3. La manière dont les professeurs promeuvent la prise de conscience de la part des étudiants du lien entre l'expérience personnelle et les dispositions professionnelles au travers de la réflexion durant les expériences en stages. Les bénéfices et les défis qu'il y a à intégrer des pratiques de réflexion dans la formation pré-service de la petite enfance sont aussi discutés.

The role of goals and outcomes in young children's memory for actions.

Four- to six-year-old children participated in three experiments designed to investigate action features that may contribute to the self-enactment effect and help clarify contradictory findings in the literature. Although activity is important in young children's learning and development, preschoolers' memory for self-actions is often found to be no better than memory for another person's actions. In the few studies in which the self-enactment effect has been found for this age group, the actions included as test materials differ markedly from those in the studies in which no differences occur. Specifically, the actions in studies finding the effect are goal-directed and enable outcomes whereas the actions in studies that don't find the effect have no instrumental goals, other than to perform the action, and often do not enable outcomes external to the action carried out. In Experiment 1 source memory and in Experiment 2 free recall were better for children's own actions than those of the experimenter when children participated in actions that produced outcomes in a game-like context. Findings from these two studies suggested that action outcomes were particularly important in these self-enactment effects which were then verified in Experiment 3. Our results support the role of self-directed actions for learning in early childhood classrooms, but highlight the contribution of goal-based activities that lead to instrumental and enabling outcomes in that learning.

Is it all in the details? Description content and false recognition errors.

In three experiments, we examined the effect of embellished content on memory errors for thematically related items as well as whether an encoding manipulation, specifically instructions to visualize content, further affects those errors. Using a modified Deese-Roediger-McDermott (DRM) paradigm, participants listened to subsets of DRM items embedded within scene descriptions. Some descriptions embellished item connections, weaving them into cohesive scenes. Other descriptions only made general reference to scenes, mentioning the items in list-like format. Listening to more detailed descriptions, compared to general scene references, elicited higher false recognition errors (Experiments 1 and 3). However, when description details varied within the same encoding series, as expected, false recognition errors did not differ significantly (Experiments 2 and 3). Results further suggest that more detailed content was more vividly imagined, providing one possible mechanism for increases in false recognition (Experiment 3). Implications for theoretical discussions of encoding task effects on false recognition errors are discussed.

Microbial assemblages reflect environmental heterogeneity in alpine streams.

Alpine streams are dynamic habitats harboring substantial biodiversity across small spatial extents. The diversity of alpine stream biota is largely reflective of environmental heterogeneity stemming from varying hydrological sources. Globally, alpine stream diversity is under threat as meltwater sources recede and stream conditions become increasingly homogeneous. Much attention has been devoted to macroinvertebrate diversity in alpine headwaters, yet to fully understand the breadth of climate change threats, a more thorough accounting of microbial diversity is needed. We characterized microbial diversity (specifically Bacteria and Archaea) of 13 streams in two disjunct Rocky Mountain subranges through 16S rRNA gene sequencing. Our study encompassed the spectrum of alpine stream sources (glaciers, snowfields, subterranean ice, and groundwater) and three microhabitats (ice, biofilms, and streamwater). We observed no difference in regional (γ) diversity between subranges but substantial differences in diversity among (ß) stream types and microhabitats. Within-stream (α) diversity was highest in groundwater-fed springs, lowest in glacier-fed streams, and positively correlated with water temperature for both streamwater and biofilm assemblages. We identified an underappreciated alpine stream type-the icy seep-that are fed by subterranean ice, exhibit cold temperatures (summer mean <2°C), moderate bed stability, and relatively high conductivity. Icy seeps will likely be important for combatting biodiversity losses as they contain similar microbial assemblages to streams fed by surface ice yet may be buffered against climate change by insulating debris cover. Our results show that the patterns of microbial diversity support an ominous trend for alpine stream biodiversity; as meltwater sources decline, stream communities will become more diverse locally, but regional diversity will be lost. Icy seeps, however, represent a source of optimism for the future of biodiversity in these imperiled ecosystems.

Kindergarten children's event memory: the role of action prediction in remembering.

In two studies, kindergarteners participated in a series of staged events immediately preceded by pre-event interactions that were designed to identify factors relevant to improving recall. The events were based on preschool science-related activities and the experimental pre-event involved predicting actions to occur during a target event, manipulating types of cues available to support these predictive inferences. Action prediction did improve free recall, and effects may have influenced attentional processes evoked by actions generated and enacted. Although children effectively used outcome cues to predict actions, a one-to-one relation between pre-event action prediction patterns and recall did not occur. In combination with other findings, this result may suggest that increased attention during the target event may have supported the pre-event effect rather than integration of information between the pre-event and target event. Early childhood teachers engaging children in science activities should provide explicit cues to enhance usefulness of preparatory activities for recall.

Reflecting on how we remember the personal past: missing components in the study of memory appraisal and theoretical implications.

The current paper offers a selective review of the study of memory appraisal, focusing on recollections of the personal past, with the goal to bring attention to a missing component in this study. To date, memory appraisal studies have concentrated on participants' assessments of the content of their personal recollections (e.g., their perceptual detail and story-like feel), including beliefs about the accuracy of that content. Participants' assessments of reflection processes accompanying their recollections (e.g., a sense of piecing-together recollection fragments) have yet to be extensively examined. The lack of information on process-based appraisals is related to prior studies' procedural constraints (e.g., kinds of cue prompts and their timing, minimal opportunities for reflection). Reasons for addressing this missing component provide the central themes of the paper. The reasons emerge from the analysis of autobiographical cueing studies, including integration of narrative research studies and autobiographical works. The analysis leads to suggestions for future research involving the use of personal narratives that are intended to address critiques of reconstruction accounts and unresolved questions in the study of memory appraisal.

Palliative care for Parkinson's disease: Patient and carer's perspectives explored through qualitative interview.

BACKGROUND: Palliative care is recommended for non-malignant illnesses, including Parkinson's disease. However, past research with healthcare workers highlights unmet palliative needs in this population and referral rates to Specialist Palliative Care are low. Some healthcare workers perceive a 'fear' in their patients about introducing palliative care. However, less is known about the views of people with Parkinson's disease and their carers about palliative care. AIM: (1) To explore the palliative care and related issues most affecting people with Parkinson's disease and their families and (2) to examine perceptions about/understanding of palliative care. DESIGN: This was a qualitative study; semi-structured interviews were conducted, transcribed and analysed using thematic analysis. SETTING/PARTICIPANTS: A total of 31 people participated, both people with Parkinson's disease ( n = 19) and carers ( n = 12), across three Movement Disorder Clinics in the Republic of Ireland. RESULTS: People with Parkinson's disease and their carers were unfamiliar with the term palliative care. When informed of the role of palliative care, most felt that they would benefit from this input. People with Parkinson's disease and carers experienced a high illness burden and wanted extra support. Crises requiring Specialist Palliative Care involvement may occur at diagnosis and later, with advancing illness. Participants wanted more information about palliative care and especially further supports to address their psychosocial needs. CONCLUSION: A holistic palliative care approach could address the complex physical and psychosocial symptoms experienced by people with Parkinson's disease and their carers, and people with Parkinson's disease and their carers are open to palliative care. Further research needs to explore how palliative care can be introduced into the routine care for people with Parkinson's disease.

Species discovery and validation in a cryptic radiation of endangered primates: coalescent-based species delimitation in Madagascar's mouse lemurs.

Implementation of the coalescent model in a Bayesian framework is an emerging strength in genetically based species delimitation studies. By providing an objective measure of species diagnosis, these methods represent a quantitative enhancement to the analysis of multilocus data, and complement more traditional methods based on phenotypic and ecological characteristics. Recognized as two species 20 years ago, mouse lemurs (genus Microcebus) now comprise more than 20 species, largely diagnosed from mtDNA sequence data. With each new species description, enthusiasm has been tempered with scientific scepticism. Here, we present a statistically justified and unbiased Bayesian approach towards mouse lemur species delimitation. We perform validation tests using multilocus sequence data and two methodologies: (i) reverse-jump Markov chain Monte Carlo sampling to assess the likelihood of different models defined a priori by a guide tree, and (ii) a Bayes factor delimitation test that compares different species-tree models without a guide tree. We assess the sensitivity of these methods using randomized individual assignments, which has been used in bpp studies, but not with Bayes factor delimitation tests. Our results validate previously diagnosed taxa, as well as new species hypotheses, resulting in support for three new mouse lemur species. As the challenge of multiple researchers using differing criteria to describe diversity is not unique to Microcebus, the methods used here have significant potential for clarifying diversity in other taxonomic groups. We echo previous studies in advocating that multiple lines of evidence, including use of the coalescent model, should be trusted to delimit new species.

The Impact of Risk-Based Care on Early Childhood and Youth Populations.

This quality improvement project explored dental caries risk among children residing in El Monte, Calif., a low-income area 16 miles east of Los Angeles. In an attempt to decrease oral health disparities, Western University of Health Sciences, College of Dental Medicine established school-based oral health centers in El Monte and implemented a modified caries risk assessment protocol. Results showed a statistically significant decrease in caries risk following disease management interventions.

Source misattributions and false recognition errors: examining the role of perceptual resemblance and imagery generation processes.

In three experiments, we examine the extent to which participants' memory errors are affected by the perceptual features of an encoding series and imagery generation processes. Perceptual features were examined by manipulating the features associated with individual items as well as the relationships among items. An encoding instruction manipulation was included to examine the effects of explicit requests to generate images. In all three experiments, participants falsely claimed to have seen pictures of items presented as words, committing picture misattribution errors. These misattribution errors were exaggerated when the perceptual resemblance between pictures and images was relatively high (Experiment 1) and when explicit requests to generate images were omitted from encoding instructions (Experiments 1 and 2). When perceptual cues made the thematic relationships among items salient, the level and pattern of misattribution errors were also affected (Experiments 2 and 3). Results address alternative views about the nature of internal representations resulting in misattribution errors and refute the idea that these errors reflect only participants' general impressions or beliefs about what was seen.

Screening for Cognitive Impairment in Movement Disorders: Comparison of the Montreal Cognitive Assessment and Quick Mild Cognitive Impairment Screen in Parkinson's Disease and Lewy Body Dementia.

Background: The Montreal Cognitive Assessment (MoCA) is recommended by the Movement Disorder Society for cognitive testing in movement disorders including Parkinson's disease (PD) and lewy body dementia. Few studies have compared cognitive screening instruments in these diseases, which overlap clinically. Objective: To compare the MoCA and Quick Mild Cognitive Impairment (Qmci) screen in this population. Methods: Patients attending memory and movement disorder clinics associated with a university hospital had the MoCA and Qmci screen performed and diagnostic accuracy compared with the area under the receiver operating characteristic curve (AUC). Duration and severity of movement disorders was assessed using the Unified PD Rating Scale (UPDRS). Results: In total, 133 assessments were available, median age 74±5. Median education was 11±4 years and 65% were male. Median total UPDRS score was 37±26. Median Qmci screen was 51±27, median MoCA was 19±10. There were statistically significant differences in test scores between those with subjective symptoms but normal cognition, mild cognitive impairment (MCI) and dementia (p < 0.001). The Qmci screen had significantly greater accuracy differentiating normal cognition from MCI versus the MoCA (AUC 0.90 versus 0.72, p = 0.01). Both instruments had similar accuracy in identifying cognitive impairment and separating MCI from dementia. The median administration time for the Qmci screen and MoCA were 5.19 and 9.24 minutes (p < 0.001), respectively. Conclusions: Both the MoCA and Qmci screen have good to excellent accuracy in a population with movement disorders experiencing cognitive symptoms. The Qmci screen was significantly more accurate for those with early symptoms and had a shorter administration time.

Improving Access to Care, Patient Costs, and Environmental Impact Through a Community Outreach Lung Cancer Rapid Assessment Clinic.

PURPOSE: In Southeastern Ontario, increased patient distance from the regional lung cancer diagnostic assessment program (LDAP) is associated with a lower likelihood of patient care via LDAP while receiving care via LDAP is associated with improved survival. We implemented an LDAP outreach clinic to provide specialist assessment for patients with suspected lung cancer at a regional community hospital and assessed the impact on timeliness and accessibility of care. MATERIALS AND METHODS: The Kingston Health Sciences Centre LDAP team engaged with community hospital partners to develop and launch the LDAP outreach clinic. We performed a retrospective chart review of LDAP patients (N = 1,070) before (August-November 2021; n = 234) and after implementation of the outreach clinic (November 2021-October 2022; n = 836). Descriptive data are reported as No. (%). Unpaired t tests and statistical process control charts assess for significance. A cost analysis of out-of-pocket patient costs related to travel and parking is presented in 2022 Canadian dollars (CAD). RESULTS: Compared with a 3-month matched time period before (August-October 2021) and after outreach clinic (August-October 2022), the mean time from referral to assessment and time from referral to diagnosis decreased from 20.3 to 14.4 days (P = .0019) and 40.0 to 28.9 days (P = .0007), respectively. Over 12 months, the total patient travel was reduced by 8,856 km, which combined with parking cost-savings, resulted in patient out-of-pocket savings of CAD $5,755.60 (CAD $47.60/patient). Accounting for physician travel, the total travel saved was 5,688 km, corresponding to reduced CO2 emissions by 1.9 tCO2. CONCLUSION: Implementation of a lung cancer outreach clinic led to improved timeliness of care, patient cost-savings, and reduced carbon footprint while serving patients in their community.

Fpa (YlaN) is an iron(II) binding protein that functions to relieve Fur-mediated repression of gene expression in Staphylococcus aureus.

Iron (Fe) is a trace nutrient required by nearly all organisms. As a result of the demand for Fe and the toxicity of non-chelated cytosolic ionic Fe, regulatory systems have evolved to tightly balance Fe acquisition and usage while limiting overload. In most bacteria, including the mammalian pathogen Staphylococcus aureus, the ferric uptake regulator (Fur) is the primary transcriptional regulator controlling the transcription of genes that code for Fe uptake and utilization proteins. Fpa (formerly YlaN) was demonstrated to be essential in Bacillus subtilis unless excess Fe is added to the growth medium, suggesting a role in Fe homeostasis. Here, we demonstrate that Fpa is essential in S. aureus upon Fe deprivation. Null fur alleles bypassed the essentiality of Fpa. The absence of Fpa abolished the derepression of Fur-regulated genes during Fe limitation. Bioinformatic analyses suggest that fpa was recruited to Gram-positive bacteria and, once acquired, was maintained in the genome as it co-evolved with Fur. Consistent with a role for Fpa in alleviating Fur-dependent repression, Fpa and Fur interacted in vivo, and Fpa decreased the DNA-binding ability of Fur in vitro. Fpa bound Fe(II) in vitro using oxygen or nitrogen ligands with an association constant that is consistent with a physiological role in Fe homeostasis. These findings have led to a model wherein Fpa is an Fe(II) binding protein that influences Fur-dependent regulation through direct interaction.IMPORTANCEIron (Fe) is an essential nutrient for nearly all organisms. If Fe homeostasis is not maintained, Fe may accumulate in the cytosol, which can be toxic. Questions remain about how cells efficiently balance Fe uptake and usage to prevent overload. Iron uptake and proper metalation of proteins are essential processes in the mammalian bacterial pathogen Staphylococcus aureus. Understanding the gene products involved in the genetic regulation of Fe uptake and usage and the physiological adaptations that S. aureus uses to survive in Fe-depleted conditions provides insight into pathogenesis. Herein, we demonstrate that the DNA-binding activity of the ferric uptake regulator transcriptional repressor is alleviated under Fe limitation, but uniquely, in S. aureus, alleviation requires the presence of Fpa.

Use of an interactive computer agent to support breastfeeding.

Mothers need consistent, sustained information and support to develop and meet personal breastfeeding goals, but often receive insufficient assistance and conflicting and incorrect advice. The use of technology may be helpful in supplementing existing health care professional breastfeeding education and support efforts. We developed and evaluated a computer-based animated, interactive agent designed to provide breastfeeding information and support to mothers interested in breastfeeding. A randomized controlled study of a first-generation system was conducted to determine the feasibility of (1) use of the Computer Agent; (2) the recruitment plan; and (3) the planned outcome evaluation (assessing the impact of the intervention on intent to breastfeed, attitudes towards breastfeeding, and breastfeeding self-efficacy). The pilot study (N = 15) showed that the use of the Computer Agent, the recruitment plan, and the planned outcome evaluation were all feasible. Mothers who used the Computer Agent had greater intentions to exclusively breastfeed after exposure to the Agent (intent to exclusively breastfeed for 6 months 1-7 scale score of 6.14 (post) vs. 5.14 (pre); p < 0.05). Non-statistically significant trends in improvement with use of the Computer Agent breastfeeding support system were also seen in the between subjects analyses of intent to breastfeed and breastfeeding self-efficacy. The pilot study demonstrated the feasibility of using a Computer Agent to support breastfeeding mothers and informed the design of a larger randomized clinical trial. An interactive Computer Agent may be helpful in improving rates of exclusive breastfeeding, particularly when there is not adequate health care professional support.

Imagery encoding and false recognition errors: exploring boundary conditions of imagery's enhancing effects.

After generating images based on descriptions of object interactions, false recognition errors can be substantially reduced in the Deese-Roediger-McDermott (DRM) task. Boundary conditions for this effect were examined in three experiments by testing imagery encoding tasks against encoding tasks used previously to alter false recognition levels. False recognition errors were lowest following imagery encoding whether comparisons involved an object interaction encoding task used previously (Experiments 1 and 2) or a new version of the task (Experiment 2). In addition reductions in false recognition errors were observed in a new imagery-encoding task (Experiment 3). Generating descriptions had differential effects on "remember" responses to falsely recognised items (Experiment 2). In combination with content analyses on participants' descriptions, these findings speak to alternative explanations for the effects of imagery encoding on false recognition errors. The findings also have implications for the use of DRM results in developing recommendations regarding the use of guided imagery in applied contexts.

Acts of generating and their sources: predicting the effects of imagery encoding on false recognition errors.

In the two experiments reported here the basis of the beneficial effects of generating images on false recognition errors is investigated. Acts of generating (descriptions, images, or both) were manipulated while examining the effects of the source of descriptions guiding imagery generations (participant vs peer). False recognition errors were relatively high across encoding conditions except when imagery generations were based on participants' own descriptions (Experiments 1 and 2). These differences in the acts of generating were not attributable to differences in the cohesiveness of descriptions themselves. Acts of generating led to greater "remember" responses than "know" responses only when participants were not the source of the descriptions used to generate images (Experiment 2). Results highlight the importance of examining the effects of the source of descriptions for guiding imagery (participant or peer) when testing predictions about the effects of imagery encoding on false recognition errors.

Early time points perfusion imaging.

The aim was to investigate the feasibility of making relative cerebral blood flow (rCBF) maps from MR images acquired with short TR by measuring the initial arrival amount of Gd-DTPA evaluated within a time window before any contrast agent has a chance to leave the tissue. We named this rCBF measurement technique utilizing the early data points of the Gd-DTPA bolus the "early time points" method (ET), based on the hypothesis that early time point signals were proportional to rCBF. Simulation data were used successfully to examine the ideal behavior of ET while monkey's MRI results offered encouraging support to the utility of ET for rCBF calculation. A better brain coverage for ET could be obtained by applying the Simultaneous Echo Refocusing (SER) EPI technique. A recipe to run ET was presented, with attention paid to the noise problem around the time of arrival (TOA) of the contrast agent.