The objective of this study was to understand the relationship between the early adverse childhood experiences (ACEs) of parents and their later parenting stress and practices. At the baseline visit ...of an 8-week course of cognitive behavioral therapy, parenting women completed the Parenting Stress Index-Short Form (PSI-SF) and the Positive Parenting Practices (PPP) scale. Linear regression procedures were used to assess the relationship between a parent’s own early experience of ACEs and current parenting stress and practices, including if there was a dose–response relationship. For the PSI-SF, significant dose–response relationships were observed between ACEs and the PSI Total Stress score (p < 0.05) and the difficult child subscale (p < 0.05). Additionally, a relationship was suggested with the parental distress subscale (p < 0.10). No significant relationships were found between ACEs and the parent–child dysfunctional interaction subscale of the PSI-SF or the PPP scale. Given the association observed between ACEs and parenting stress, it is important that future psychosocial interventions and policy initiatives preventing ACEs are developed.
•Parental stress was significantly related to maternal sensitivity.•Mother’s report of baby’s behavior and temperament was related to interactive quality.•Mother’s perception of baby not meeting her ...expectations related to sensitivity.•Major depression –in pregnancy or postpartum- had no effect on maternal sensitivity.•Fetal attachment did not predict sensitivity, intrusiveness and positive regard.
The current study aimed to examine the impact of maternal depression, maternal fetal attachment (MFA) and parenting stress on maternal sensitivity, intrusiveness and positive regard for the child with a sample of 36 low-income, mothers-infant dyads that were followed from pregnancy through the first year postpartum. Maternal depression and parenting stress were expected to have a negative impact on maternal sensitivity, intrusiveness and positive regard, while high MFA was hypothesized to have a positive impact on these three outcomes. Our data provide partial support for our hypotheses. Findings from this study add to the literature by examining the stability of the maternal prenatal and postpartum bond with her infant as well as by looking at the impact of parenting stress on maternal behaviors and processes that may lead to later attachment security differences, such as maternal sensitivity and responsiveness.
Recurrent Kawasaki disease: USA and Japan Maddox, Ryan A; Holman, Robert C; Uehara, Ritei ...
Pediatrics international,
December 2015, Letnik:
57, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Background
Descriptive epidemiologic studies of recurrent and non‐recurrent Kawasaki disease (KD) may identify other potentially important differences between these illnesses.
Methods
Data from the ...USA and Japan, the Centers for Disease Control and Prevention (CDC) national KD surveillance(1984–2008) and the 17th Japanese nationwide survey (2001–2002), respectively, were analyzed to examine recurrent KD patients <18 years of age meeting the CDC KD case or atypical KD case definition. These patients were compared with non‐recurrent KD patients.
Results
Of the 5557 US KD patients <18 years of age during 1984–2008, 97 (1.7%) were identified as having had recurrent KD. Among the US Asian/Pacific Islander KD patients, 3.5% had recurrent KD, which was similar to the percentage identified among KD patients (3.5%) in the Japanese survey. Compared with non‐recurrent KD patients, KD patients with recurrent KD were more likely to be older, fulfill the atypical KD case definition, and have coronary artery abnormalities (CAA) despite i.v. immunoglobulin (IVIG) treatment.
Conclusions
Differences in the age, race, and frequency of CAA exist between recurrent and non‐recurrent KD patients. The increased association of CAA with recurrent KD suggests that more aggressive treatment strategies in conjunction with IVIG may be indicated for the second episode of KD.
A small percentage of persons with leptospirosis, a reemerging zoonosis, experience severe complications that require hospitalization. The number of leptospirosis cases in the United States is ...unknown. Thus, to estimate the hospitalization rate for this disease, we analyzed US hospital discharge records for 1998-2009 for the total US population by using the Nationwide Inpatient Sample. During that time, the average annual rate of leptospirosis-associated hospitalizations was 0.6 hospitalizations/1,000,000 population. Leptospirosis-associated hospitalization rates were higher for persons >20 years of age and for male patients. For leptospirosis-associated hospitalizations, the average age of patients at admission was lower, the average length of stay for patients was longer, and hospital charges were higher than those for nonleptospirosis infectious disease-associated hospitalizations. Educating clinicians on the signs and symptoms of leptospirosis may result in earlier diagnosis and treatment and, thereby, reduced disease severity and hospitalization costs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The authors sought to evaluate the acceptability, feasibility, and initial outcomes of the delivery of a group cognitive-behavioral therapy (CBT) mental health intervention for mothers in the ...Temporary Assistance for Needy Families (TANF) program.
An 8-week group CBT program was made available to parenting women (N=40) in a large, urban TANF system from April to August 2019. Participants completed baseline and endpoint measures to assess depressive symptoms, perceived stress, social support, employment, and program acceptability. TANF administrative data were examined to assess TANF engagement.
TANF staff were successfully trained to deliver CBT. The participants reported significantly reduced depressive symptoms and perceived stress; perceived social support significantly increased from the beginning to the end of the intervention.
A model that fully embedded CBT delivery in a TANF system was acceptable to low-income parenting women and TANF staff and reduced depressive symptoms among the women. The scalability of interventions to address maternal depression among low-income women has presented a challenge. Delivering mental health interventions in the U.S. TANF system may offer a scalable method to reduce depression and increase employment in a population bearing a high mental health burden.
Death from Rocky Mountain spotted fever (RMSF) is preventable with prompt, appropriate treatment. Data from two independent sources were analyzed to estimate the burden of fatal RMSF and identify ...risk factors for fatal RMSF in the United States during 1999-2007. Despite increased reporting of RMSF cases to the Centers for Disease Control and Prevention, no significant changes in the estimated number of annual fatal RMSF cases were found. American Indians were at higher risk of fatal RMSF relative to whites (relative risk RR = 3.9), and children less than 10 years of age (RR=5.1) corrected and adults ≥ 70 years of age (RR = 3.0) were also at increased risk relative to other ages. Persons with cases of RMSF with an immunosuppressive condition were at increased risk of death (RR = 4.4). Delaying treatment of RMSF was also associated with increased deaths. These results may indicate a gap between recommendations and practice.
Objective To examine dog bites among American Indian (AI) and Alaska Native (AN) children visiting Indian Health Service and tribal health facilities. Study design We retrospectively analyzed ...hospitalizations and outpatient visits with a diagnosis of dog bite between 2001 and 2008 in AI/AN children aged <20 years. Rates of dog bite hospitalizations and outpatient visits were estimated by age group, sex, region, and number and location of open wounds using Indian Health Service data. Analyses of hospitalizations for the general US population aged <20 years used the Nationwide Inpatient Sample. Results The average annual dog bite hospitalization rate was higher among AI/AN children in Alaska (6.1/100 000 population) and the Southwest region (5.3/100 000) compared with the general US child population (3.1/100 000; 95% CI, 2.9-3.3/100 000). The average annual outpatient visit rate in AI/AN children was highest in the Alaska (596.4/100 000), Southwest (540.0/100 000), and Northern Plains West (537.6/100 000) regions. The hospitalization rate was highest in both AI/AN and US males aged <5 years, and outpatient visit rates were highest in AI/AN males aged 5-9 years. Open wounds diagnoses were most commonly seen on the head, neck, and face in hospitalized children (45.5% of open wounds in AI/AN children, 59.3% in US children; SE, 1.0%) and on the leg in AI/AN outpatients (35.6%). Conclusion Dog bites represent a significant public health threat in AI/AN children in the Alaska, the Southwest, and Northern Plains West regions of the US. Enhanced animal control and education efforts should reduce dog bite injuries and associated problems with pets and stray dogs, such as emerging infectious diseases.
We analyzed US multiple cause-of-death data for 2003-2006 for demographic and clinical determinants for autopsy in unexplained deaths possibly resulting from infectious causes. For 96,242 deaths, the ...definition for unexplained death was met and autopsy status was recorded. Most decedents were male, 40-49 years of age, and white. To identify factors associated with unexplained death, we used data from Arizona records. Multivariate analysis of Arizona records suggested that decedents of races other than white and black and decedents who had clinicopathologic syndromes in the cardiovascular, sepsis/shock, and multisyndrome categories recorded on the death certificate were least likely to have undergone autopsy; children with unexplained death were the most likely to have undergone autopsy. Improved understanding of unexplained deaths can provide opportunities for further studies, strengthen collaboration between investigators of unexplained deaths, and improve knowledge and awareness of infectious diseases of public health concern.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Kawasaki syndrome (KS) occurs in children <18 years of age and is the leading cause of acquired heart disease among children in the United States. Understanding the epidemiology of KS and factors ...associated with coronary artery abnormalities (CAA) may lead to timely diagnosis and treatment of KS and could limit CAA.
Epidemiologic characteristics, including risk factors for the development of CAA, among KS and incomplete KS patients <18 years of age with onset during 2000-2009 reported by the California Department of Public Health to the Centers for Disease Control and Prevention's national KS surveillance system were analyzed.
A total of 2056 KS and incomplete KS patients <18 years of age were reported during 2000-2009. The median age of patients was 2 years; 60% of patients were male. Of 1818 patients with race information reported, 56% were white and 28% were Asian/Pacific Islander. Ninety-eight percent of patients received intravenous immunoglobulin. Of 1843 patients with information on cardiac complications, 89 (5%) had coronary artery aneurysms and 341 (19%) had CAA. Characteristics associated with the occurrence of CAA in KS patients were male sex, Asian/Pacific Islander race, age <1 year or 9-17 years, and not receiving intravenous immunoglobulin treatment before the fifth day of illness.
This study suggests that intravenous immunoglobulin treatment before the fifth day of illness may reduce CAA among KS patients. Timely diagnosis and treatment of KS continue to be important in reducing the occurrence of cardiac complications.
In California, the 2010 annual Kawasaki disease hospitalization rate for children <5 years of age was higher than the rate in 2003. An increasing trend during 2003–2010 appears to be driven by an ...increase from 2003 to 2006, whereas the Kawasaki disease hospitalization rate remained stable through 2010.
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