Abstract Brain networks that govern parental response to infant signals have been studied with imaging techniques over the last 15 years. The complex interaction of thoughts and behaviors required ...for sensitive parenting enables the formation of each individual׳s first social bonds and critically shapes development. This review concentrates on magnetic resonance imaging experiments which directly examine the brain systems involved in parental responses to infant cues. First, we introduce themes in the literature on parental brain circuits studied to date. Next, we present a thorough chronological review of state-of-the-art fMRI studies that probe the parental brain with a range of baby audio and visual stimuli. We also highlight the putative role of oxytocin and effects of psychopathology, as well as the most recent work on the paternal brain. Taken together, a new model emerges in which we propose that cortico-limbic networks interact to support parental brain responses to infants. These include circuitry for arousal/salience/motivation/reward, reflexive/instrumental caring, emotion response/regulation and integrative/complex cognitive processing. Maternal sensitivity and the quality of caregiving behavior are likely determined by the responsiveness of these circuits during early parent-infant experiences. The function of these circuits is modifiable by current and early-life experiences, hormonal and other factors. Severe deviation from the range of normal function in these systems is particularly associated with (maternal) mental illnesses – commonly, depression and anxiety, but also schizophrenia and bipolar disorder. Finally, we discuss the limits and extent to which brain imaging may broaden our understanding of the parental brain given our current model. Developments in the understanding of the parental brain may have profound implications for long-term outcomes in families across risk, resilience and possible interventions. This article is part of a Special Issue entitled Oxytocin and Social Behav.
Preconception, prenatal and postnatal maternal stress is associated with increased offspring psychopathology, but findings are inconsistent and need replication. We estimated associations between ...maternal bereavement stress and offspring autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, suicide attempt and completed suicide.
Using Swedish registers, we conducted the largest population-based study to date examining associations between stress exposure in 738,144 offspring born 1992-2000 for childhood outcomes and 2,155,221 offspring born 1973-1997 for adult outcomes with follow-up to 2009. Maternal stress was defined as death of a first-degree relative during (a) the 6 months before conception, (b) pregnancy or (c) the first two postnatal years. Cox proportional survival analyses were used to obtain hazard ratios (HRs) in unadjusted and adjusted analyses.
Marginal increased risk of bipolar disorder and schizophrenia following preconception bereavement stress was not significant. Third-trimester prenatal stress increased the risk of ASD adjusted HR (aHR) 1.58, 95% confidence interval (CI) 1.15-2.17 and ADHD (aHR 1.31, 95% CI 1.04-1.66). First postnatal year stress increased the risk of offspring suicide attempt (aHR 1.13, 95% CI 1.02-1.25) and completed suicide (aHR 1.51, 95% CI 1.08-2.11). Bereavement stress during the second postnatal year increased the risk of ASD (aHR 1.30, 95% CI 1.09-1.55).
Further research is needed regarding associations between preconception stress and psychopathological outcomes. Prenatal bereavement stress increases the risk of offspring ASD and ADHD. Postnatal bereavement stress moderately increases the risk of offspring suicide attempt, completed suicide and ASD. Smaller previous studies may have overestimated associations between early stress and psychopathological outcomes.
Problem:
Transgender and nonbinary (TNB) older adults endure discrimination from medical providers and expect it in institutional long-term care. Gender identity–based discrimination is connected to ...negative health outcomes and reluctance to access needed care.
Objective:
The aim of this study is to explore how gender identity affects TNB older adults’ fears, hopes, and plans for use of institutional long-term care.
Method:
Co-investigators conducted semi-structured interviews with 24 TNB older adults in Minnesota, collaboratively analyzed the results using reflexive thematic analysis, and member-checked emergent themes.
Findings:
Oppression is central to participants’ consideration of future long-term care. They fear mistreatment and loss of authentic gender expression and recognition in long-term care facilities. Fears of oppression factor into consideration of suicide and physical transition, although some participants hope societal shifts will lead to unbiased long-term care.
Conclusion:
Creation of anti-oppressive institutional and community-based long-term care options is critical to effectively serve TNB people as they age into dependence.
Medicine finally has discovered fatigue. Recent articles about various diseases conclude that fatigue has been underrecognized, underdiagnosed, and undertreated. Scholars in the social sciences and ...humanities have also ignored the phenomenon. As a result, we know little about what it means to live with this condition, especially given its diverse symptoms and causes. Emily K. Abel offers the first history of fatigue, one that is scrupulously researched but also informed by her own experiences as a cancer survivor. Abel reveals how the limits of medicine and the American cultural emphasis on productivity intersect to stigmatize those with fatigue. Without an agreed-upon approach to confirm the problem through medical diagnosis, it is difficult to convince others that it is real. When fatigue limits our ability to work, our society sees us as burdens or worse. With her engaging and informative style, Abel gives us a synthetic history of fatigue and elucidates how it has been ignored or misunderstood, not only by medical professionals but also by American society as a whole.
Urinary tract infections (UTI) account for major proportion of outpatient load and hospital admission globally. In most of the clinical microbiology laboratories MacConkey agar (MAC) and Cystine ...lactose electrolyte-deficient (CLED) agar are being used for identification of uropathogens. The main objective of the present study was to evaluate the usefulness of HiCrome
UTI by comparing isolation rate and presumptive identification of uropathogens against CLED and MAC agar.
This study was conducted over a period of three months on 672 non-duplicate midstream and/or catheter-catch urine samples. All samples were inoculated on to HiCrome
UTI, CLED agar and MacConkey agar.
Among the 672 samples received for culture, 113 (16.8%) showed significant growth. Among the 672 samples, 95 (14.1%) showed growth of a single organism while 18 (2.7%) showed polymicrobial growth. The rate of isolation and presumptive identification of the isolates and polymicrobial growth was found significantly higher on HiCrome
UTI Agar.
HiCrome
UTI Agar has the potential to streamline processing of samples for urine culture in a way that will reduce the workload for technicians, reduce turnaround time which in turn will benefit the laboratory ultimately leading to better patient care.
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Since their initial characterization as abundant brain proteins more than 5 decades ago, a resurgence into understanding the cellular functions of 14-3-3 proteins has emerged. While ...one of the earliest functions attributed to this eukaryotic scaffold protein family was the activation of enzymes involved in catecholamine and serotonin biosynthesis, 14-3-3 proteins have since been implicated in the regulation of several cellular processes including cell-cycle control, apoptosis, and metabolism. Moreover, increasing lines of evidence demonstrate links between changes in 14-3-3 protein function and the pathogenesis of chronic diseases. As a result, this has raised the question of whether 14-3-3 proteins represent viable targets for pharmacological intervention against diseases such as obesity, diabetes and cancer. In addition to providing an overview of the 14-3-3 protein family, we will discuss their connections to metabolism and metabolic diseases. We will also elaborate on the potential of targeting 14-3-3 proteins, as well as components of their interactomes, for developing novel therapies for treating metabolic diseases, including diabetes and obesity.
To date, projections of human migration induced by sea-level change (SLC) largely suggest large-scale displacement away from vulnerable coastlines. However, results from our model of Bangladesh ...suggest counterintuitively that people will continue to migrate toward the vulnerable coastline irrespective of the flooding amplified by future SLC under all emissions scenarios until the end of this century. We developed an empirically calibrated agent-based model of household migration decision-making that captures the multi-faceted push, pull and mooring influences on migration at a household scale. We then exposed ∼4800 000 simulated migrants to 871 scenarios of projected 21st-century coastal flooding under future emissions pathways. Our model does not predict flooding impacts great enough to drive populations away from coastlines in any of the scenarios. One reason is that while flooding does accelerate a transition from agricultural to non-agricultural income opportunities, livelihood alternatives are most abundant in coastal cities. At the same time, some coastal populations are unable to migrate, as flood losses accumulate and reduce the set of livelihood alternatives (so-called 'trapped' populations). However, even when we increased access to credit, a commonly-proposed policy lever for incentivizing migration in the face of climate risk, we found that the number of immobile agents actually rose. These findings imply that instead of a straightforward relationship between displacement and migration, projections need to consider the multiple constraints on, and preferences for, mobility. Our model demonstrates that decision-makers seeking to affect migration outcomes around SLC would do well to consider individual-level adaptive behaviors and motivations that evolve through time, as well as the potential for unintended behavioral responses.
Abstract
Retinal drusen are deposits of inflammatory proteins that are found in macular degeneration and glomerulonephritis and result, in part, from complement activation. This was a cross-sectional ...observational study of individuals with inflammatory bowel disease (IBD) recruited from a Gastroenterology clinic who underwent non-mydriatic retinal photography. Deidentified images were examined for drusen, and drusen counts and size were compared with matched controls, and examined for clinical associations. The cohort with IBD comprised 19 individuals with ulcerative colitis, 41 with Crohn’s disease and three with indeterminate colitis, including 34 males (54%) and an overall median age of 48 (IQR 23) years. Their median IBD duration was 7 (IQR 10) years, median CRP level was 7 (IQR 14) mg/L, and 28 (44%) had complications (fistula, stricture, bowel resection etc.), while 28 with Crohn’s disease (68%) had colonic involvement. Drusen counts were higher in IBD than controls (12 ± 34, 3 ± 8 respectively,
p =
0.04). Counts ≥ 10 were also more common (14, 22%, and 4, 6%,
p
= 0.02, OR 4.21, 95%CI 1.30 to 13.63), and associated with longer disease duration (
p
= 0.01, OR 1.06, 95%CI 1.00 to 1.13), an increased likelihood of complications (
p
= 0.003, OR 6.90, 95%CI 1.69 to 28.15) and higher CRP levels at recruitment (
p
= 0.008, OR1.02, 95%CI 1.00 to 1.05). Increased retinal drusen were found in all four individuals with Crohn’s disease and IgA glomerulonephritis. IBD and drusen may share pathogenetic mechanisms and underlying risk factors such as complement activation.
Tanzania is one of the countries that has embarked on a national programme under the United Nations collaborative initiative on Reducing Emissions from Deforestation and forest Degradation (REDD). ...Tanzania is currently developing the capacity to enter into a carbon monitoring REDD+ regime. In this context spatially representative soil carbon datasets and accurate predictive maps are important for determining the soil organic carbon pool. The main objective of this study was to model and map the SOC stock for the 0–30-cm soil layer to provide baseline information for REDD+ purposes. Topsoil data of over 1400 locations spread throughout Tanzania from the National Forest Monitoring and Assessment (NAFORMA), were used, supplemented by two legacy datasets, to calibrate simple kriging with varying local means models. Maps of SOC concentrations (g kg−1) were generated for the 0–10-cm, 10–20-cm, 20–30-cm, 0–30-cm layers, and maps of bulk density and SOC stock (kg m−2) for the 0–30-cm layer. Two approaches for modelling SOC stocks were considered here: the calculate-then-model (CTM) approach and the model-then-calculate approach (MTC). The spatial predictions were validated by means of 10-fold cross-validation. Uncertainty associated to the estimated SOC stocks was quantified through conditional Gaussian simulation. Estimates of SOC stocks for the main land cover classes are provided. Environmental covariates related to soil and terrain proved to be the strongest predictors for all properties modelled. The mean predicted SOC stock for the 0–30-cm layer was 4.1 kg m−2 (CTM approach) translating to a total national stock of 3.6 Pg. The MTC approach gave similar results. The largest stocks are found in forest and grassland ecosystems, while woodlands and bushlands contain two thirds of the total SOC stock. The root mean squared error for the 0–30-cm layer was 1.8 kg m−2, and the R2-value was 0.51. The R2-value of SOC concentration for the 0–30-cm layer was 0.60 and that of bulk density 0.56. The R2-values of the predicted SOC concentrations for the 10-cm layers vary between 0.46 and 0.54. The 95% confidence interval of the predicted average SOC stock is 4.01–4.15 kg m−2, and that of the national total SOC stock 3.54–3.65 Pg. Uncertainty associated with SOC concentration had the largest contribution to SOC stock uncertainty. These findings have relevance for the ongoing REDD+ readiness process in Tanzania by supplementing the previous knowledge of significant carbon pools. The soil organic carbon pool makes up a relatively large proportion of carbon in Tanzania and is therefore an important carbon pool to consider alongside the ones related to the woody biomass. Going forward, the soil organic carbon data can potentially be used in the determination of reference emission levels and the future monitoring, reporting and verification of organic carbon pools.
•SOC stock was mapped and uncertainty assessed using a recent, nationwide dataset.•Two mapping methods were compared: calculate-then-model and model-then-calculate.•Average SOC stock was is 4.1 kg m−2, translating to a total stock of 3.6 Pg.•Uncertainty about SOC concentration contributed most to SOC stock uncertainty.•The SOC maps provide baseline information to prepare Tanzania for REDD+.
Hospices have played a critical role in transforming ideas about death and dying. Viewing death as a natural event, hospices seek to enable people approaching mortality to live as fully and ...painlessly as possible. Award-winning medical historian Emily K. Abel provides insight into several important issues surrounding the growth of hospice care. Using a unique set of records,Prelude to Hospiceexpands our understanding of the history of U.S. hospices. Compiled largely by Florence Wald, the founder of the first U.S. hospice, the records provide a detailed account of her experiences studying and caring for dying people and their families in the late 1960s and early 1970s. Although Wald never published a report of her findings, she often presented her material informally. Like many others seeking to found new institutions, she believed she could garner support only by demonstrating that her facility would be superior in every respect to what currently existed. As a result, she generated inflated expectations about what a hospice could accomplish. Wald's records enable us to glimpse the complexities of the work of tending to dying people.
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