Group Of Dyads Research Articles

Nonverbal face-to-face interactions in macaques and humans: A translational pilot study.

Human and nonhuman primate mother-infant dyads engage in face-to-face interactions critical for optimal infant development. In semi-free-ranging rhesus macaques (Macaca mulatta), maternal primiparity and infant sex influence the expression of nonverbal face-to-face mother-infant interactions. However, whether similar patterns of variation exist in laboratory-housed macaques or human mothers is not well understood. Comparing both species would yield information regarding the translational validity of macaques to humans in this important social/developmental domain. In this pilot study, we first compared semi-free-ranging (n=39) and laboratory-housed (n=20) macaques, finding that laboratory-housed dyads, first-time mothers, and mothers of sons engaged in higher rates of face-to-face interactions regardless of housing. After translating the nonhuman primate coding scheme for use in a small but diverse group of human mother-infant dyads (N=27; 44.4% African American, 18.5% American Indian, 7.4% Asian/Asian American, and 29.6% White), we found that, like macaques, human mothers of sons engaged in more face-to-face interactions; however, experienced (vs. first-time) mothers engaged in more interactions. Macaques and humans also engaged in species-specific interactions with their infants. We conclude that components of caregiver-infant nonverbal face-to-face interactions are translatable across human and nonhuman primate species and represent an exciting avenue for future caregiving work.

Caregiver and Child Distress as Predictors of Dyadic Physiological Attunement During Vaccination.

Previous research discerned three groups of caregiver-toddler dyads that differed in their physiological co-regulatory patterns, also known as physiological attunement, during routine vaccinations in the second year of life. One group of dyads (80% of sample) displayed an attuned regulatory pattern and two groups of dyads (20% of sample) showed maladaptive attunement patterns (i.e., a lack of attunement or misattunement). The objective of the current study was to examine how well pain-related distress of children and caregivers during vaccination predicted these patterns. Caregiver-toddler dyads (N = 189) were part of a longitudinal cohort observed at either 12-, 18-, or 24-month vaccination appointments. Caregiver self-report of worry was assessed before and after the needle and child behavioural pain-related distress was also measured during the vaccination appointment. Logistic regression was used to determine how well these variables predicted caregiver-child physiological attunement patterns, as indexed by high-frequency heart rate variability. Higher behavioural pain-related distress at various timepoints after the needle were associated with membership in the dyad groups that showed misattunement or lack of attunement. Further, caregivers with higher pre-needle worry and lower post-needle worry had a greater likelihood of belonging to groups that showed a maladaptive attunement pattern. Findings suggest that caregivers who experience distress associated with their toddlers' vaccination experience more difficulty co-regulating with their child during vaccination, and these children are at risk of experiencing higher levels of pain-related distress. This research highlights the need to help caregivers support their children's regulation during vaccination.

Implementing a group-based multi-component early child development intervention through the government health system in rural Bangladesh: A feasibility study.

Children in low- and middle-income countries face an increased risk of impaired cognitive development due to contaminated environments, poor nutrition, and inadequate responsive stimulation from caregivers. Implementing multi-component, community-level interventions may reduce these risks; however, there is little evidence supporting implementation of these interventions at scale. We assessed the feasibility of implementing a group-based intervention that included responsive stimulation, maternal and child nutrition, water and sanitation, and childhood lead exposure prevention through the government health system in Chatmohar, Bangladesh. After implementation, we conducted 17 in-depth interviews with frontline health service providers and 12 key informant interviews with their supervisors and managers to explore the facilitators and difficulties implementing such a complex programme within the health system. Factors facilitating implementation included: high quality training and skill level of providers, support from community members, family, and supervisors, positive relationships between providers and participants, and provision of children's toys and books free of cost. Difficulties included increased workload of the providers, complicated group-based yet stage-specific delivery where providers had to manage a large group of mother-child dyads representing many different child age-groups at once, and logistics difficulties in providing toys and books through a centralised health system process. Key informants made suggestions to ensure effective government-level scale-up including engaging relevant NGOs as partners, identifying feasible ways to make toys available, and offering providers meaningful even if non-monetary rewards. These findings can be used to shape the design and delivery of multi-component child development interventions to be delivered through the health system.

Development of an Individualized Responsive Feeding Intervention-Learning Early Infant Feeding Cues: Protocol for a Nonrandomized Study.

Responsive infant feeding occurs when a parent recognizes the infant's cues of hunger or satiety and responds promptly to these cues. It is known to promote healthy dietary patterns and infant weight gain and is recommended as part of the Dietary Guidelines for Americans. However, the use of responsive infant feeding can be challenging for many parents. Research is needed to assist caregivers recognize infant hunger or satiety cues and overcoming barriers to using responsive infant feeding. The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach, SS-OO-PP-RR ("super," Setting the Stage, Observation and Opportunities, Problem Solving and Planning, Reflection and Review), to promote responsive infant feeding. Guided by the Obesity-Related Behavioral Intervention Trials model, this study aims to test the feasibility and fidelity of the LEIFc intervention in a group of mother-infant dyads. This pre-post quasi-experimental study with no control group will recruit mothers (N=30) in their third trimester (28 weeks and beyond) of pregnancy from community settings. Study visit 1 will occur prenatally in which written and video material on infant feeding and infant hunger and satiety cues is provided. Demographic information and plans for infant feeding are also collected prenatally via self-report surveys. The use of responsive infant feeding via subjective (survey) and objective (video) measures is recorded before (study visit 2, 1 month post partum) and after (study visit 5, 4 months post partum) intervention. Coaching on responsive infant feeding during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR approach at study visits 3 (2 months post partum) and 4 (3 months post partum). Infant feeding practices are recorded via survey, and infant weight and length are measured at each postpartum study visit. Qualitative data on the LEIFc intervention are provided by the interventionist and mother. Infant feeding videos will be coded and tabulated for instances of infant cues and maternal responses. Subjective measures of responsive infant feeding will also be tabulated. The use of responsive infant feeding pre-post intervention will be analyzed using matched t tests. Qualitative data will be examined to guide intervention refinement. This study initially began in spring 2020 but was halted because of the COVID-10 pandemic. With new funding, recruitment, enrollment, and data collection began in April 2022 and will continue until April 2023. After refinement, the LEIFc intervention will be tested in a pilot randomized controlled trial. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs that serve vulnerable populations-those that often have infant feeding practices that do not align with recommendations and are less likely to use responsive infant feeding. DERR1-10.2196/44329.

Maternal and infant touching behaviours during perturbed interactions: Associations with maternal depressive symptomatology and infant crying

Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal and infant touching behaviours among 41 mother-infant dyads, some of whom were deemed at-risk due to maternal depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability; SF) and Separation (maternal physical unavailability; SP) procedures. Infant crying was examined across procedures and investigated as a brief period of perturbation. Results revealed that mothers and infants displayed a positive pattern of tactile synchrony (coordinated, analogous changes in touch) during infant crying episodes. However, dyads in the high depression group displayed significantly less affectionate touch during instances of infant crying. Furthermore, more depressive symptoms were associated with less maternal and infant touch and lower rates of infant crying. This group of dyads may be less expressive via touch, be less affected by disruptions in their interactions, have impaired regulatory abilities, or simply require minimal amounts of touch to mutually regulate following social stressors and during brief perturbation periods. These findings enrich our limited knowledge about the dynamic interplay of maternal and infant touch and inform preventative intervention programs for at-risk groups.

A psychometric study of the Emotional Availability Scales: Construct validity and measurement invariance between depressed and nondepressed mother-infant dyads.

The Emotional Availability Scales (EAS) are the most widely reported observational assessment measure of parent-child relationships and has been of particular interest in understanding differences between samples of depressed and nondepressed mothers and their offspring. Despite its widespread use, psychometric validation of the factor structure in normative samples and the measurement of invariance within clinical samples has not been published. We evaluated the internal structure (dimensionality, reliability, convergent, and discriminant validity) of the EAS fourth edition using a nondepressed sample of 157 Australian women and their infants aged 6 months, including testing the measurement invariance of the EAS between the same nondepressed sample (n = 157), and a depressed group (n = 185) of mother-infant dyads, using MPlus. Participants were recruited from tertiary hospitals, and depression status was established using a diagnostic measure. Higher-order confirmatory factor analyses on the EAS' six dimensions supported a unidimensional factor solution in our data. Full measurement invariance was not demonstrated due to metric noninvariance of the maternal nonintrusiveness and child responsiveness dimensions. Full scalar invariance supported mean comparisons, and a medium effect of .78SD lower mean emotional availability for the depressed group was found; Cohen's d = .63, 95% CI [.41, .85]. While arguments exist for the clinical utility of differentiating between multiple dimensions of emotional availability, the current findings do not support a multidimensional factor structure or full multigroup measurement invariance of the EAS. Similar psychometric investigations of the EAS in clinical and nonclinical samples are needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Development and preliminary validation of the Adolescent Food Parenting Questionnaire: Parent and adolescent version

Suitable instruments for measuring Food Parenting Practices (FPP) among adolescents and their parents that also measure the perception of adolescents about their parent's FPP are rare. The current study describes the development and preliminary testing of a short 16-item Adolescent Food Parenting Questionnaire (AFPQ) for parents (AFPQ-p) and adolescents (AFPQ-a) that may enable future large-scale research on potentially eminent parent-child FPP discrepancy. Participants included 381 parents (73.8 % mothers; Mage 45.9, 26.2% fathers; Mage 49.1) and their adolescent children (aged 12–16) who participated in the Dutch “G(F)OOD together” study. Most parents finished higher professional education (mothers: 44.3 %; fathers: 34.4 %) and performed a paid job of 32 h per week or more (mothers: 22.1 %; fathers: 60.0 %). The theoretical framework of Vaughn (2016) was leading in the development of the AFPQ. Exploratory factor analysis (EFA) was performed on a random split sample of parent-adolescent dyads and confirmatory factor analysis (CFA) was performed on the other half. The EFA in both parent and adolescent samples resulted in a clear 5 factor solution explaining 61.6 % (AFPQ-p) and 64.2 % (AFPQ-a) of the variance respectively, representing the factors Autonomy Support (α = 0.79/.82), Coercive Control (α = 0.85/.83), Snack Structure (α = 0.79/75), Healthy Structure (α = 0.78/74) and Modelling (α = 0.69/85). CFA confirmed good model fit for the AFPQ-p and the AFPQ-a. Associations with adolescent self-reported food intake were in the expected direction, confirming the preliminary convergent validity of the instrument among a moderate to highly educated group of parent-adolescent dyads. Although the AFPQ provides a promising short instrument, future research in more diverse samples is needed to build evidence on the instrument's psychometric characteristics in other groups.

INTERINDIVIDUAL PERFORMANCE IN METACONTINGENCIES

The primary unit of analysis in metacontingencies are interlocking- behavioral contingencies (IBCs) measured by their aggregate product (AP). The experimental literature has demonstrated selection APs by factors external to the group (also known as “cultural consequences”). By contrast, social interactions occurring inside of IBCs have received little examination, although they constitute a key element to understand different types of social dynamics. In this study interindividual performance and verbal interactions of individuals inside of IBCs were examined. Communication between participants in dyads was experimentally manipulated such that some dyads wore noise-cancelling headphones while working together and other group of dyads used headsets to talk to each other during the experimental session. Verbal interactions were measured using video/audio digital recordings. Three type of rules were presented to dyads to assess their effects on dyads performance under ambiguous circumstances throughout the task. Rules varied in their degree of ambiguity in each condition: high- (A), medium- (B), and low-explicit instructions (C). The order of rule presentation was alternated between groups. Our finding demonstrated significant differences in interpersonal performance between groups (verbal dyads vs nonverbal dyads). Overall, dyads spent more time engaging in cooperative verbal interactions than in any other type of verbal interaction, and similar acquisition patterns of these interactions were observed across dyads.

Adaptation and evaluation of a child-friendly patient reported outcome measure for use in Australia

<h2>ABSTRACT</h2><h3>Background</h3> Use of Patient Reported Outcomes (PROs) to assess symptoms in children are not routinely used in clinical practice, yet children with complex conditions experience a significant number of symptoms. <h3>Aim</h3> To adapt and evaluate the Symptom Screening in Pediatrics Tool (SSPedi), a PRO measure developed in Canada for use with Australian children. <h3>Methods</h3> SSPedi wording was adapted and item relevance assessed by an expert clinical group (N = 7) resulting in the Australian version (SSPedi-Aus). Cognitive interviewing with children with cancer (N = 10, 8–18 years) established understanding and difficulty with completing. A second group of child-parent dyads (N = 30) were recruited to evaluate psychometric properties (content validity, test-retest reliability, and parent-proxy) measured with Intraclass Correlation Coefficients (ICC) with 95% Confidence Intervals (CI). Acceptability and usefulness of SSPedi-Aus were also assessed. <h3>Findings</h3> Construct validity was confirmed across all items by 30 children. Child test-retest achieved excellent concordance (ICC 0.98, 95% CI 0.91 to 0.99). Symptoms causing the most distress as reported by children were different to those identified by parents. Although children and parents returned a similar mean total score (13.43 vs. 13.80), there was weak overall interrater reliability (ICC 0.37, 95% CI −0.26 to 0.70, p=0.12). <h3>Conclusion</h3> Children are distressed by symptoms that may not be identified by parents or reported to clinicians, yet these symptoms are amendable to intervention. The SSPedi-Aus is useful to assess the level of distress caused by symptoms in children.

A longitudinal study of maternal feeding and children's picky eating

This study aimed to estimate the rate of persistent picky eating (PE) in children 3–8 years of age, and to characterize children with PE and their mothers. From a base sample of 1055 mothers of children 3.4 ± 1.3 years old, we selected those who described their children as picky eaters (PEs; n = 185, 17.5%) for a longitudinal study. 109 PE dyads participated, as well as a matched comparison group of dyads without PE (n = 106). At T1 mothers self-reported on trait anxiety, perfectionism, attachment style; as well as on the child's behavioral problems, their temperament, and their executive function. The participants were re-evaluated twice, at two-year intervals (T2 and T3). At T2 the mothers self-reported on their personality, on their child feeding practices, and reported their child's eating behavior. At T3 the mothers self-reported on their feeding style and the children self-reported on a pictorial frequent food questionnaire. PE persisted throughout T2 and T3 in 22.5% of T1 PE children in the longitudinal study, or in 3.94% of the base sample. The child characteristics that distinguished the PE and non-PE groups at T1 predicted 9–10% of the variance of T3 PE. Maternal feeding practices at T2 contributed 1–2% to the explained variance. It can be concluded that for the overwhelming majority of children, PE is a passing phase. Maternal feeding practices have limited long-term influence on children's PE. Unless PE is persistent and severe, parents would best be advised to relax their feeding efforts.

TENTATIVE LANGUAGE IN MIXED-GENDER CONVERSATIONS OF JORDANIANS: THE INFLUENCE OF GENDER AND SOCIAL STATUS

Purpose of Study: This paper evaluated the validity of self-categorization theory (Turner, 1987; Turner &amp; Reynolds, 2011) in predicting the relationship between tentative language use and the prominent power of the speaker’s gender and social status in Jordanian society. Methodology: Eighteen adult Jordanian dyads participated in dyadic conversations. Each dyad consisted of high-status females and low-status males. Before recording their mixed-gender conversations, dyad’s gender; status and national identity were primed one at a time using Palomares’ manipulation method (2004, 2008). One group of dyads read a passage about the patriarchal nature of Arab society, another dyadic group read a passage about the importance of education in obtaining high-level jobs, and a third group read a passage about Jordanians’ patriotism. Results: Results showed that Jordanian high-status women tend to use more tentative language than Jordanian low-status men within and across the three primed contexts: gender-salient, status-salient and national- identity-salient contexts. Findings are inconsistent with the prediction of the self-categorization theory. The discrepancies between these findings and the outcomes of the Western research were ascribed to the patriarchic and gender-segregated nature of Jordanian society. Implications: This paper concluded that sociolinguistic practices are not universal. Research on language and gender should take socio-cultural peculiarities into account to reach a comprehensive view of how social power is communicated through language. Novelty/Originality of this study: This study emphasizes the role of socio-cultural practices in determining the relationship between speech style and the prominent power of the speaker's gender and social status. In Arab Jordanian society, tentative language is mainly gender-based language; less influenced by social identities other than gender.

L1 vs L2 synchronous text-based interaction in computer-mediated L2 writing

This study investigates the quality of the L2 written outcome and the interactions produced in synchronous text-based L1 and L2 collaboration. On the one hand, it explores fluency, accuracy, and complexity measures in order to compare participants’ L2 performance in a task-based writing assignment using Google Docs. On the other hand, it examines the areas of negotiation in their L1 and L2 synchronous interactions in order to assess possible differences. Eighty-five intermediate students of Spanish were randomly assigned to four different dyadic writing groups: a control group, a collaborative L1 text-based chat group, a collaborative L2 text-based chat group, and a group of dyads who collaborated on Google Docs but were not permitted to chat. ANOVA analyses of the L2 writing measures under scrutiny showed that the dyads that collaborated in their L1 had a significant advantage in the accuracy measure utilized. Additionally, analyses of the interactions produced by the dyads in both chat groups showed that the L1 chat group conversed more but focused less on the L2. These results are discussed in relation to the relevant previous literature and should continue the discussion on translanguaging and how L1 can be of use in L2 writing.

An Examination of Downstream Effects of Bereavement on Healthcare Utilization for Surviving Spouses in a National Sample of Older Adults.

While bereavement is associated with increased mortality, it is unclear how bereaved families utilize the healthcare system after the death of their loved ones. The aim of this study was to examine the association between bereavement and healthcare expenditures for surviving spouses. We used data from the Health and Retirement Study, a nationally representative cohort study of older adults linked to Medicare claims. We determined a spouse's total Medicare expenditures 2years before and after their partner's death across six biennial interview waves. Using coarsened exact matching, we created a comparison group of non-bereaved dyads. Costs were wage index- and inflation-adjusted to 2017 dollars. We used generalized linear models and difference-in-differences (DID) analysis to calculate the average marginal effects of bereavement on Medicare spending by gender. We also examined subgroup differences based on caregiver status, cause of death, and length of terminal illness. Our sample consisted of 941 bereaved dyads and a comparison group of 8899 matched dyads. Surviving female spouses (68% of the sample) had a $3500 increase in spending 2years after death (p < 0.05). Using DID analyses, bereavement was associated with a $625 quarterly increase in Medicare expenditures over 2years for women. There was no significant increase in post-death spending for male bereaved surviving spouses. Results were consistent for spouses who survived at least 2years after the death of their spouse (70% of the sample) CONCLUSIONS: Bereavement is associated with increased healthcare spending for women regardless of their caregiving status, the cause of death, or length of terminal illness. Further study is required to examine why men and women have different patterns of healthcare spending relative to the death of their spouses.

Parents' and Youths' Solicitation and Disclosure of Information in Today's Digital Age

Extensive research has identified parental monitoring to be a protective factor for youth. Parental monitoring includes parents’ solicitation of information from their child and the child’s voluntary disclosure of information. In today’s digital society, parental monitoring can occur using technology, such as text messaging, email, and social networking sites. The current study describes parents’ and youths’ communication technology use explicitly to solicit and share information with each other in a sample of 56 parent–youth dyads from the same family (youth were 13 to 25 years old). We also examined associations between in-person parental monitoring, parental monitoring using technology, parental knowledge, and youth substance use initiation. Results revealed great variability in frequency of parental monitoring using technology, with a subgroup of parents and youth reporting doing these behaviors very frequently. Parental monitoring using technology was not associated with greater parental knowledge or youth substance use initiation after controlling for youth age group (adolescent or emerging adult) and gender composition of dyads. However, in-person communication between youth and parents remained an important variable and was positively associated with parental knowledge. Youth workers could empower parents to focus on in-person communication, and not rely solely on communication using technology.

Design and implementation of a parent guide for coaching teen drivers

IntroductionTeens beginning to drive independently are at significant increased risk of motor-vehicle crashes relative to their other life stages. There is, however, little guidance for parents as to how best to supervise learning to drive. MethodThis study sought to undertake an informed approach to development and implementation of a Parent Guide. We included a multi-stage development process, using theory, findings from a Delphi-study of young driver traffic-safety experts, and parent focus groups. This process informed the development of a Guide that was then evaluated for feasibility and acceptability, comparing a group that received the Guide with a control group of parent and teen dyads. Both members of the dyads were surveyed at baseline, again at the approximate time teens would be licensed to drive independently (post-test), and again three months later. ResultsWe found no difference in the proportion of teens who became licensed between those given the new Guide and control teens (who received the state-developed booklet); that is the Guide did not appear to promote or delay licensure. Teens in the Guide group reported that their parents were more likely to use the provided resource compared with control teens. Responses indicated that the Parent Guide was favorably viewed, that it was easy to use, and that the logging of hours was a useful inclusion. Parents noted that the Guide helped them manage their stress, provided strategies to keep calm, and helped with planning practice. In contrast, control parents noted that their booklet helped explain rules. Among licensed teens there was no significant difference in self-reported risky driving at the three-month follow-up. We discuss the challenges in providing motivation for parents to move beyond a set number of practice hours to provide diversity of driving practice.

Feeding style of adolescent mothers and complementary feeding practice of their infants

ABSTRACT Objective To evaluate feeding styles of adolescent mothers and complementary feeding practices of their infants. Methods A cross-sectional study comparing a group of dyads of 50 adolescent mothers (ages 15 to 19) with 62 adult mothers (ages 24 to 44) and their infants (9 to 24 months) was performed. All mothers and infants were assisted by three basic health family units in the city of Recife, Brazil. Data were collected through a structured interview on socioeconomic conditions, maternal styles of feeding the child, and evaluation of infant feeding practices. The food styles were classified as responsive, authoritative, and passive, according to the adapted form of Carvalhaes, Perosa and Silveira of 2009. The frequency of food intake was calculated for six food groups (1. Bread and cereals; 2. Fruits and vegetables; 3. Meat, eggs, and beans; 4. Milk and dairy products; 5. Sugars, sweets, and fats; 6. Industrialized food). Children’s anthropometry and body mass index by age were classified into Z-score according to the World Health Organization Standard Curves, 2006. Results Adolescent mothers began complementary feeding more frequently before the seventh month (.=0,02), presented less responsive (.=0.04) and more authoritarian feeding styles (.=0.01), and their children received more foods with sugars, oils, and fats (.=0.02), and less meat, eggs, and beans (.=0.06) than the children of adult mothers. Conclusion Adolescent mothers adopt less responsive eating styles and offer more inadequate complementary feeding for their infants.

Randomized controlled trial of an early child obesity prevention intervention: Impacts on infant tummy time.

ObjectiveTo describe infant activity at 3 months old and to test the efficacy of a primary care-based child obesity prevention intervention on promoting infant activity in low-income Hispanic families.MethodsRandomized controlled trial (n=533) comparing a control group of mother-infant dyads receiving standard prenatal and pediatric primary care with an intervention group receiving “Starting Early”, with individual nutrition counseling and nutrition and parenting support groups coordinated with prenatal and pediatric visits. Outcomes included infant activity (tummy time, unrestrained floor time, time in movement restricting devices). Health literacy assessed using the Newest Vital Sign.Results456 mothers completed 3-month assessments. Infant activity: 82.6% ever practiced tummy time; 32.0% practiced tummy time on the floor; 34.4% reported unrestrained floor time; 56.4% reported >1 hour/day in movement restricting devices. Inadequate health literacy was associated with reduced tummy time and unrestrained floor time. The intervention group reported more floor tummy time (OR 2.16, 95% CI 1.44–3.23) and unrestrained floor time (OR 1.69, 95% CI 1.14–2.49) compared to controls. No difference in the time spent in movement restricting devices was found.ConclusionsTummy time and unrestrained floor time were low. Primary care-based obesity prevention programs have potential to promote these activities.

Development of a measure of therapy provision for spasticity management in the paretic lower limb – the Leg Therapy recording Schedule (LegTS)

Purpose: In rehabilitation studies, it is critical to understand the constituents of interventions. First, to enable replication of the work and second, to identify what treatments work best. The development of a tool to describe and quantify therapy interventions in the context of focal spasticity management is presented.Methods: Potential intervention categories were identified from: (a) retrospective analysis of prospectively collected data from a cohort of patients (n = 62) receiving physical interventions in the context of botulinum toxin (BoNT) injection for leg spasticity and (b) cognitive de-briefing with Patient and Carer Advisory Group (PCAG) of patient and carer dyads (n = 8). Item reduction was achieved through consultation with a purposively-selected group of physiotherapists and occupational therapists (n = 16) in a two-round Delphi process. This was followed by review of findings by PCAG members.Results: A list of 24 possible therapy categories were identified and then reduced, resulting in a tool with two domains: (1) postural management; four categories and (2) exercise and retraining; four categories. The Leg Therapy recording Schedule (LegTS) wording and presentation were refined for clinical and research use.Conclusions: The LegTS is designed to record therapy interventions for the paretic lower limb in the context of spasticity intervention. Content and face validity have initially been addressed within the development process.Implications for RehabilitationClinicians need to understand intervention effectiveness, and to do so, it is critical to capture all the components of a complex intervention.In clinical practice or research, patient experience measures are required to capture the complexity of intervention provided and monitor intervention effectiveness on a case by case basis.Clinicians involved in rehabilitation and management of focal spasticity in the leg can use the Leg Therapy recording Schedule (LegTS) to enable an understanding of the entirety of the intervention package provided.

Experiential avoidance in the vulnerability to depression among adolescent females

BackgroundAlthough various mechanisms in the maternal transmission of Major Depressive Disorder (MDD) have been investigated, it is unknown whether experiential avoidance (EA) is a vulnerability factor in the development of depression or a consequence of the illness. The present study utilized a high-risk design to determine if EA indeed poses vulnerability to adolescent MDD. Secondly, we examined the means by which adolescent EA may come to pose vulnerability, namely that it explains the relation between maternal EA and adolescent depressive symptoms. MethodsOne-hundred and forty-six biological mother/adolescent daughter dyads comprised three diagnostic groups: mothers with a history of MDD and their depressed daughters (MDD; n=21), mothers with a history of MDD and their never-depressed daughters (high-risk, HR; n=69), and healthy controls (HCs; n=56). ResultsGroups differed on daughter EA such that the MDD group reported greater EA than the HR group, which in turn reported greater EA than HCs. Daughter EA mediated the relation between maternal EA and daughter depressive symptoms after controlling for maternal depressive symptoms. LimitationsStrengths aside, this study included a relatively small group of depressed mother-daughter dyads and relied on cross-sectional self-report data. ConclusionsEA appears to serve as a vulnerability factor for adolescent MDD, and the mechanistic role of daughter EA highlights the significance of intergenerational EA in the maternal transmission of depression. Therapeutic approaches may therefore consider reducing the transmission of EA from mothers to daughters.

The Effect Of Maternal Supplementation With A Lipid‐Based Nutrient Supplement On Infant Micronutrient Intake In Guatemalan Women And Infants

BACKGROUNDAccording to the World Health Organization (WHO), infants should be exclusively breastfed for the first 6 months of life. Despite the high adherence to the WHO guidelines in Guatemala, there is a high prevalence of malnutrition during early life, which increases during the first 6 months of age. This suggests that breast milk quality may be suboptimal with regard to provision of micronutrients. Our objective was to evaluate whether maternal supplementation with a lipid based nutrient supplement (LNS) would increase infant micronutrient intake from breast milk.METHODSThe randomly‐allocated, cross‐over design included 30 mother‐infant dyads 4–6 months postpartum in Quetzaltenango, Guatemala. In three 8‐hour milk collection visits the participating mother received a single bolus dose of 30 g LNS (B), 10 g of LNS divided over 3 time points (D), or no LNS (C). Mid‐feed milk samples were collected at each infant feed and total milk consumption measured. Maternal blood was collected at baseline, maternal dietary intake was assessed, and maternal and infant anthropometry was measured. The primary outcome was infant B‐complex vitamin intake from breast milk, estimated using micronutrient analyses and infant milk consumption. Analysis of variance and pair‐wise comparisons were used to examine the effect of dosing regimen. Clinicaltrials.gov (NCT02464111on).FINDINGSOf 26 dyads completing the study, results for 8 are included in this preliminary data analysis. On average, during 8 hours infants consumed more riboflavin when their mother received LNS (B or D), compared to C (9±6 μg, treatment p=0.012). B increased infant riboflavin intake by 28±21 μg, (p=0.005) whereas D increased intake by 19±14 μg (p=0.018). Neither B nor D increased infant pyridoxal (B 37±29 μg, D 44±36 μg, C 23±10 μg, p=0.328), niacin (B 41±31 μg D 37±30 μg, C 30±17 μg, p= 0.490) or thiamin (B 4±2 μg, D 6±6 μg, C 4±3 μg, p= 0.408) intake compared to no‐supplement. Compared to C, over 8 hours B provided an extra 6%, 0%, 14%, 1% of the Adequate Intake for infants under 6 months for riboflavin, thiamin, pyridoxal, and niacin, respectively, whereas D provided an extra 3%, 1%, 21%, 0%, respectively.INTERPRETATIONMaternal supplementation with LNS as a bolus dose or divided dose increased infant riboflavin intake, with the bolus dose proving more efficacious at increasing infant riboflavin intake from milk. In this initial group of dyads, maternal supplementation with LNS did not significantly impact infant pyridoxal, niacin, or thiamin intake.Support or Funding InformationUC Global Health Initiative, Blum Center for Developing Economies, UC Davis, USDA ARS Western Human Nutrition Research Center.