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Evidence-based insertion and maintenance bundles are effective in reducing the incidence of central line-associated bloodstream infections (CLABSI) in intensive care unit (ICU) settings. We studied the adoption and compliance of CLABSI prevention bundle programs and CLABSI rates in ICUs in a large network of acute care hospitals across Canada.
This multi-method longitudinal study sought to investigate linkage in parental neuroendocrine functioning – indicated by cortisol – over two measurement occasions. In addition, we examined how parental cortisol linkage may operate as an intermediate factor in the cascade of contextual risks and parenting. Participants were 235 families with a young child (Mage = 33.56, 36.00 years for mothers and fathers respectively), who were followed for two annual measurement occasions. Parental cortisol linkage was measured around a laboratory conflict discussion task at both measurement occasions (i.e., pre-discussion, 20- and 40-minute post-discussion for each measurement occasion). Maternal and paternal parenting behavior was observed during a parent-child discipline discussion task. Findings indicated similar levels of cortisol linkage between parents over the two measurement occasions. Furthermore, cortisol linkage between parents operated as an intermediate factor between contextual risks and more compromised parenting behavior. That is, greater contextual risks, indicated by greater neighborhood risk and interparental conflict, were linked to greater cortisol linkage between parents over time, which was in turn linked to greater authoritarian parenting during parent-child interaction. Findings highlighted the importance of understanding physiological-linkage processes with respect to the impact of contextual risks on family functioning and may have crucial implications for clinical work.
This multi-method longitudinal study evaluated how changes in maternal sensitive parenting may operate as an indirect factor linking family instability and the development of child externalizing problems over time. This study also investigated how mothers’ stress reactivity within the sympathetic nervous system (SNS) may moderate the association between family instability and the development of maternal sensitivity. Participants were 235 families with a young child (Mage = 2.97 years at the first measurement occasion) and these families were followed for two annual measurement occasions. Maternal sensitivity was observed during two discipline tasks (i.e., forbidden toy, discipline discussion tasks), and maternal SNS stress reactivity was indicated by their salivary alpha-amylase (sAA) reactivity to an interpersonal stressor. Findings revealed significant direct effects of family instability and family instability-x-sAA reactivity interaction in association with the change in maternal sensitivity over time. For both tasks, mothers with greater sAA reactivity exhibited stronger associations between family instability and the growth of their sensitivity. Tests of indirect effects indicated that change in maternal sensitivity operated as an indirect factor between family instability-x-sAA reactivity interaction and the change in child externalizing problems. The present findings have important implications for understanding parental and child sequelae associated with unstable family contexts.
Building on Ellis et al.’s theorization for potent dimensions of environmental adversity, the present work sought to evaluate how environmental harshness and unpredictability might function directly and in interaction with child sensory processing sensitivity (SPS) to shape the development of child socioemotional functioning. Participants were 235 young children (Mage = 2.97 at the first measurement occasion) and their parents, who were followed for two consecutive annual measurement occasions. Child SPS was measured through behavioral observation across multiple tasks within the laboratory setting. Greater environmental unpredictability was significantly associated with the development of children’s externalizing problems over a year only for children with high SPS. Follow-up analyses indicated that the unpredictability-x-SPS interaction was consistent with differential susceptibility, such that high SPS children showed greater increases in externalizing problems under high unpredictability, but also lower increases/greater decreases in externalizing problems under low unpredictability. Such association did not apply to children with low SPS.
Guided by the evolutionary perspective and specialization hypothesis, this multi-method (behavioral observation, questionnaire) longitudinal study adopted a person-centered approach to explore children’s problem-solving skills within different contexts. Participants were 235 young children (M age = 2.97 years at the first measurement occasion) and their parents assessed in two measurement occasions spaced one year apart. Latent profile analyses revealed four unique problem-solving profiles, capturing variability in children’s performance, and observed engagement in abstract vs. reward-oriented (RO) problem-solving tasks at wave one. The four profiles included: (a) a high-abstract-high-RO, (b) a high-abstract-low-RO, (c) a low-abstract-high-RO, and (d) a low-abstract-low-RO classes. Contextual risks within and outside families during wave one, including greater neighborhood crime, impoverishment, and observed lower maternal sensitivity were linked to the elevated likelihood for children from the two profiles with low-abstract problem-solving, particularly those from the low-abstract-high-RO problem-solving profile. Furthermore, child problem-solving profiles were linked to meaningful differences in their socioemotional functioning one year later. The present finding has important implications in revealing the heterogeneity in child problem-solving within different contexts that responded differently to contextual risks. In addition, this study advanced the understanding of the developmental implications of child problem-solving capacity.
Although social and structural inequalities associated with COVID-19 have been documented since the start of the pandemic, few studies have explored the association between pandemic-specific risk factors and the mental health of minority populations.
Aims
We investigated the association of exposure to the virus, COVID-19-related discrimination and stigma with mental health during the COVID-19 pandemic, in a culturally diverse sample of adults in Quebec (Canada).
Method
A total of 3273 residents of the province of Quebec (49% aged 18–39 years, 57% women, 51% belonging to a minority ethno-cultural group) completed an online survey. We used linear and ordinal logistic regression to identify the relationship between COVID-19 experiences and mental health, and the moderating role of ethno-cultural identity.
Results
Mental health varied significantly based on socioeconomic status and ethno-cultural group, with those with lower incomes and Arab participants reporting higher psychological distress. Exposure to the virus, COVID-19-related discrimination, and stigma were associated with poorer mental health. Associations with mental health varied across ethno-cultural groups, with exposed and discriminated Black participants reporting higher mental distress.
Conclusions
Findings indicate sociocultural inequalities in mental health related to COVID-19 in the Canadian context. COVID-19-related risk factors, including exposure, discrimination and stigma, jeopardise mental health. This burden is most noteworthy for the Black community. There is an urgent need for public health authorities and health professionals to advocate against the discrimination of racialised minorities, and ensure that mental health services are accessible and culturally sensitive during and in the aftermath of the pandemic.
The overarching goal of this work is to support creative ideation in engineering design with the aim of overcoming design fixation. We study the impact of abstract representations and ways to frame the problem in design briefs on the creativity of concept sketches. Framing/Reframing involves shifting perspectives on the design purpose and to reveal insights and opportunities. Two Framing/Reframing techniques are tested: the Ishikawa/Fishbone Diagram to identify root causes and a blend of Parnes’ Restatement/SCAMPER method to encourage divergence in problem perception. Abstract representations of requirements were used as stimuli to foster transfer and associative thinking. Using a full-factorial experimental design with brief variations, C-Sketch ideas developed by first-year engineering/architecture students were evaluated for their creativity. Our results showed a positive interaction effect for novelty and usefulness when the Fishbone Reframing method was used with abstract representation, but there was no difference in creativity scores when comparing the two Framing/Reframing methods between each other.
The parent-child relationship undergoes substantial reorganization over the transition to adolescence. Navigating this change is a challenge for parents because teens desire more behavioral autonomy as well as input in decision-making processes. Although it has been demonstrated that changes in parental socialization approaches facilitates adolescent adjustment, very little work has been devoted to understanding the underlying mechanisms supporting parents’ abilities to adjust caregiving during this period. Guided by self-regulation models of parenting, the present study examined how parental physiological and cognitive regulatory capacities were associated with hostile and insensitive parent conflict behavior over time. From a process-oriented perspective, we tested the explanatory role of parents’ dysfunctional child-oriented attributions in this association. A sample of 193 fathers, mothers, and their early adolescent (ages 12–14) participated in laboratory-based research assessments spaced approximately 1 year apart. Parental physiological regulation was measured using square root of the mean of successive differences during a conflict task; cognitive regulation was indicated by set-shifting capacity. Results showed that parental difficulties in vagal regulation during parent-adolescent conflict were associated with increased hostile conflict behavior over time; however, greater set-shifting capacity moderated this association for fathers only. In turn, father's dysfunctional attributions regarding adolescent behavior mediated the moderating effect. The results highlight how models of self-regulation and social cognition may explain the determinants of hostile parenting with differential implications for fathers during adolescence.
Subcutaneous immunotherapy is an effective and safe treatment for allergic rhinitis and allergic asthma. Different symptom scores are used to evaluate the efficacy of subcutaneous immunotherapy in clinical trials.
Method
A total of 58 allergic rhinitis patients sensitised to house dust mites, with or without mild asthma, were included. Symptom score, medication score, visual analogue scale score and quality of life were assessed before and after 6, 12 and 24 months of subcutaneous immunotherapy.
Results
After two years of subcutaneous immunotherapy, asthma symptom scores nearly reached zero, whereas the scores remained higher for nasal symptoms. The changes in asthma symptom scores were markedly different (p < 0.05) and occurred faster than the changes in nasal symptom scores when compared between monosensitised and polysensitised groups. Significant reductions in visual analogue scale score and medication score were demonstrated after subcutaneous immunotherapy.
Conclusion
Two-year subcutaneous immunotherapy with house dust mite vaccine is an effective treatment for both monosensitised and polysensitised allergic patients. The changes in asthma symptom scores were markedly different and occurred quicker than the changes in nasal symptom scores in Chinese house dust mite allergic patients.
Ship and iceberg drifts, along with data from modern satellite-tracked drifting buoys, portray generally northward flow in the southwest Ross Sea. Less is known, however, about the ocean variability in this region. Here we use Defense Meteorological Satellite Program (DMSP) Operational Linescan System (OLS) imagery to describe a cyclonically rotating gyre in Terra Nova Bay, Antarctica (75° S, 165° E). The image sequence is taken from an exceptionally clear, calm period during winter 1998. Surface currents, derived from tracking drifting ice with a maximum cross-correlation algorithm, were found to be ∼ 20 to 30 cm s−1 Based on scaling arguments, the observed currents appear to be best explained as an oceanic response to a rapidly changing, offshore, katabatic windjet.
To investigate lung function in Chinese patients suffering from chronic rhinosinusitis with nasal polyps and examine its association with histopathological features.
Methods:
The lung function of 99 patients with nasal polyps was measured. Haematoxylin and eosin and immunohistochemistry staining were performed to evaluate any inflammatory cells and epithelial tissue remodelling.
Results:
Predicted maximal expiratory flow rate at 25 per cent vital capacity was reduced (p < 0.05) in epithelial hyperplasia, and predicted maximal expiratory flow rate at 50 per cent vital capacity was reduced (p < 0.05) in goblet cell hyperplasia. Both peripheral blood eosinophilia and tissue eosinophilia nasal polyps manifested significantly reduced: forced expiratory volume in 1 second/forced vital capacity ratio, predicted maximal expiratory flow rate at 25, 50 and 75 per cent of vital capacity, and predicted maximal mid-expiratory flow. Peripheral blood eosinophils were negatively correlated with predicted maximal expiratory flow rate at 25 and 50 per cent of vital capacity, and predicted maximal mid-expiratory flow. Eosinophils in tissue were negatively correlated with all lung function parameters investigated except predicted forced vital capacity.
Conclusion:
Clinicians should be aware of lung function decline in nasal polyps patients, especially in those with tissue eosinophilia.
In many cells throughout the body, vitamin D is converted into its active form calcitriol and binds to the vitamin D receptor (VDR), which functions as a transcription factor to regulate various biological processes including cellular differentiation and immune response. Vitamin D-metabolising enzymes (including CYP24A1 and CYP27B1) and VDR play major roles in exerting and regulating the effects of vitamin D. Preclinical and epidemiological studies have provided evidence for anti-cancer effects of vitamin D (particularly against colorectal cancer), although clinical trials have yet to prove its benefit. In addition, molecular pathological epidemiology research can provide insights into the interaction of vitamin D with tumour molecular and immunity status. Other future research directions include genome-wide research on VDR transcriptional targets, gene–environment interaction analyses and clinical trials on vitamin D efficacy in colorectal cancer patients. In this study, we review the literature on vitamin D and colorectal cancer from both mechanistic and population studies and discuss the links and controversies within and between the two parts of evidence.
In the present paper, the phylogeographies of two monogenean species, Pseudokuhnia minor and Kuhnia scombri, on the same species of host, Scomber japonicus, were studied. Fragments of the mitochondrial cytochrome c oxidase subunit 1 gene were sequenced for 264 individuals of P. minor and 224 individuals of K. scombri collected from 10 localities along the coast of China. Genetic diversity of K. scombri was higher than that of P. minor, which may imply that P. minor has a lower evolution rate and/or is a younger species. The neighbour-joining (NJ) trees of both parasites were comprised of two clades without association to sample sites, which is the signature of remixing populations following past division. Analyses of molecular variance and pairwise fixation index revealed different genetic structures for the populations of these two closely related species along the coast of China: P. minor without significant genetic structure, while K. scombri has some genetic differentiation. Both neutrality tests and mismatch distribution suggested that the populations of these two species of parasites experienced population expansion in the late Pleistocene era due to the glacial–interglacial cycles induced by climatic oscillations.
Background: Global variation in the incidence of multiple sclerosis (MS) is generally ascribed to differences in genetic and environmental risk factors. Here we investigate temporal trends in the incidence of MS and related disorders in British Columbia, Canada, from 1986 to 2010, focusing particularly on the Asian ethnic subpopulation.Methods: A longitudinal database was screened to identify newly diagnosed cases of MS and related disorders, including neuromyelitis optica and clinically isolated syndromes. Age-standardized, sex-specific mean annual incidence was calculated for the Asian and non-Asian population of British Columbia for 5-year intervals from 1986 to 2010. Temporal changes and cohort differences in incidence rates and demographic characteristics were evaluated. Results: During this period, the incidence of MS and related disorders in the non-Asian population remained relatively unchanged, from 10.41 (95% confidence interval [CI]: 9.87-10.97) to 9.91 (95% CI: 9.46-10.39) per 100,000 (p=0.167). In contrast, incidence in the Asian population doubled during the same period. This increase was driven by a precipitous rise in the incidence of MS in females from 0.71 (95% CI: 0.01-1.50) to 2.08 (95% CI: 1.43-2.91) per 100,000 (p=0.004), including both Canadian-born and immigrant Asians. The incidence of neuromyelitis optica did not change significantly during this period. Conclusions: The incidence of MS may be increasing among females in the Asian ethnic population of British Columbia.
To evaluate the accuracy of real-time polymerase chain reaction (PCR) for Clostridium difficile–associated disease (CDAD) detection, after hospital CDAD rates significantly increased following real-time PCR initiation for CDAD diagnosis.
Design.
Hospital-wide surveillance study following examination of CDAD incidence density rates by interrupted time series design.
Setting.
Large university-based hospital.
Participants.
Hospitalized adult patients.
Methods.
CDAD rates were compared before and after real-time PCR implementation in a university hospital and in the absence of physician and infection control practice changes. After real-time PCR introduction, all hospitalized adult patients were screened for C. difficile by testing a fecal specimen by real-time PCR, toxin enzyme-linked immunosorbent assay, and toxigenic culture.
Results.
CDAD hospital rates significantly increased after changing from cell culture cytotoxicity assay to a real-time PCR assay. One hundred ninety-nine hospitalized subjects were enrolled, and 101 fecal specimens were collected. C. difficile was detected in 18 subjects (18%), including 5 subjects (28%) with either definite or probable CDAD and 13 patients (72%) with asymptomatic C. difficile colonization.
Conclusions.
The majority of healthcare-associated diarrhea is not attributable to CDAD, and the prevalence of asymptomatic C. difficile colonization exceeds CDAD rates in healthcare facilities. PCR detection of asymptomatic C. difficile colonization among patients with non-CDAD diarrhea may be contributing to rising CDAD rates and a significant number of CDAD false positives. PCR may be useful for CDAD screening, but further study is needed to guide interpretation of PCR detection of C. difficile and the value of confirmatory tests. A gold standard CDAD diagnostic assay is needed.
With the ATNF Mopra telescope we are performing a survey in the 12CO(1–0) line to map the molecular gas in the Large Magellanic Cloud. For some regions we also obtained interferometric maps of the high density gas tracers HCO+ and HCN with the Australia Telescope Compact Array. Here we discuss the properties of the elongated molecular complex that stretches about 2 kpc southward from 30 Doradus. Our data suggest that the complex, which we refer to as the ‘molecular ridge’, is not a coherent feature but consists of many smaller clumps that share the same formation history. Likely triggers of molecular-cloud formation are shocks and shearing forces that are present in the surrounding south-eastern Hi overdensity region, a region influenced by strong ram pressure and tidal forces. The molecular ridge is at the western edge of the the overdensity region where a bifurcated velocity structure transitions into a single disk velocity component. We find that the 12CO(1–0) and Hi emission peaks in the molecular ridge are typically near each other but never coincide. A likely explanation is the conversion of warmer, low-opacity Hi to colder, high-opacity Hi from which H2 subsequently forms. On smaller scales we find that very dense molecular gas, as traced by interferometric HCO+ and HCN maps, is associated with star formation along shocked filaments and with rims of expanding shell-like structures, both created by feedback from massive stars.
Mg@ZnO thin films were prepared by DC/RF magnetron co-sputtering in (N2+O2) ambient conditions using metallic Mg and Zn targets. We present a comprehensive study of the effects of film thickness, variation of O2 content in the working gas and annealing temperature on the structural, optical and magnetic properties. The band gap energy of the films is found to increase from 4.1 to 4.24 eV with the increase of O2 partial pressures from 5 to 20 % in the working gas. The films are found to be ferromagnetic at room temperature and the saturation magnetization increases initially with the film’s thickness reaching a maximum value of 14.6 emu/cm3 and then decreases to finally become diamagnetic beyond 95 nm thickness. Intrinsic strain seems to play an important role in the observed structural and magnetic properties of the Mg@ZnO films. On annealing, the as-obtained ‘mostly amorphous’ films in the temperature range 600 to 800°C become more crystalline and consequently the saturation magnetization values reduce.
We report on preliminary studies of low (14 at.%) and high (53at.%) concentration Mn doped MgO films deposited by co-sputtering from metallic Mn and Mg targets. The structural, surface morphologies and magnetic properties of the films of different thickness were studied. All the as grown films are found to be amorphous and film surfaces are found to be flawless and homogeneous. We observe at room temperature robust ferromagnetic loops with a saturation magnetization value that is a function of film thickness reaching a maximum of ∼38.5 emu/cm3 in the Mn0.53Mg0.47O film at a thickness of ∼92 nm. In thicker films room-temperature ferromagnetic ordering is suppressed and eventually at a thickness around 120nm the expected diamagnetism of the bulk appears. The origin of ferromagnetism may be attributed to cation defects at the Mg-site.
Background: The genetic region coding for low-density lipoprotein receptor-related protein1 (LRP1) is considered an intriguing susceptibility locus for Alzheimer's disease (AD). Amnestic mild cognitive impairment (aMCI) is characterized by episodic memory impairment and represents the prodromal stage of AD. Our aim in this study is to investigate the relationship between LRP1 genetic variation and aMCI, and the influence of LRP1 on cognitive performance.
Methods: We performed a case-control association study analyzing five polymorphisms in LRP1 gene by TaqMan Assays-on-Demand SNP Genotyping. All samples were derived from Chinese subjects (109 cases, 104 healthy controls) and assessed using multi-dimension neuropsychological instruments.
Results: We identified haplotypes within the region containing the LRP1 gene. Of these, haplotype TAA (T: rs1800194; A: rs11837145; A: rs10876967) was significantly associated with aMCI, being over-represented in aMCI versus healthy controls. Haplotype TAA was associated with poor performance on episodic memory in all subjects.
Conclusions: This study confirms the association between genetic variants in LRP1 and aMCI. Moreover, we have identified a relationship between LRP1 genetic variation and specific aspects of neurocognitive function. Our convergent results suggest that LRP1 plays an important role in cognitive function and possibly in the pathogenesis of aMCI.