Regular Family Research Articles

Brief psychodynamic psychotherapy for adolescents and their families in crisis: a pilot study

ABSTRACT The global rise in adolescent self-harm and suicidal behaviours has intensified the demand for mental health services in the UK. This has further strained already underfunded and understaffed resources, resulting in longer waiting times and increased emergency department visits among teenagers. To address the overwhelming need for effective community-based emergency support, a brief psychodynamic crisis therapeutic intervention was developed within a CAMHS adolescent crisis team, inspired by child psychotherapist Ruth Schmidt Neven’s work on time-limited psychotherapy with adolescents and their families. This 12-session intervention offers both individual therapy for the adolescent and sessions for their parents, along with regular family reviews. Two psychotherapists work closely together on each case – one with the young person, the other with the parents. The brief model views crises as opportunities for deeper understanding, moving beyond diagnostic and symptom-centred approaches, as well as standard risk management and safety-planning strategies, and underlines the centrality of parent involvement in adolescent crisis work. This paper outlines the intervention’s theoretical foundation, guiding principles, and practical design, and presents preliminary findings from a pilot study of 22 cases, run over two and a half years. Early results suggest broad potential for this psychodynamic crisis approach in various adolescent crises, and merit further investigation.

Prevalence of anxio-depressive disorders, insomnia and self-esteem in a Moroccan population addicted to cannabis and/or alcohol: a cross-sectional study

ABSTRACT Background Addiction to cannabis and alcohol is a global public health concern, linked to significant mental health impairments such as anxiety, depression, insomnia, and low self-esteem. This study, conducted in Marrakech’s addiction treatment centers, aims to assess the prevalence of mental health disorders, insomnia, and self-esteem among individuals seeking treatment for alcohol and/or cannabis addiction. Methods This cross-sectional study was conducted from January 1 2023 to January 1 2024. Depression, anxiety, insomnia, and self-esteem were assessed using the HADS, ISI, and Rosenberg scale. Results Anxiety prevalence for cannabis, alcohol, and both substances was 57.9%, 55.2%, and 59.2%, respectively. Depression prevalence was 71.7% (cannabis), 73.1% (alcohol), and 75% (both substances). Sub-clinical insomnia (mild) prevalence for the three groups was 65.4%, 71.6%, and 77.6%. Low self-esteem was observed at 59.1%, 64.2%, and 60.5% for cannabis, alcohol, and both substances, respectively. No significant association has been found between the type of product consumed (cannabis, alcohol, cannabis and alcohol) and anxiety, depression, insomnia and self-esteem. Conclusions These findings highlight prevalent mental health disorders in cannabis and alcohol addiction, underscoring the need for comprehensive, multidisciplinary treatments, including regular mental health screenings, quarterly follow-ups, and family involvement in group therapies at Moroccan addiction centers.

Adapting to the 21st Century Learning: Teaching Strategies of Filipino Sped Teachers in the United States

This study employs a narrative research methodology to explore the instructional modifications and teaching practices utilized by Filipino Special Education (SPED) teachers in the United States to meet the demands of 21st-century learning. Through in-depth, semi-structured interviews with ten purposely selected SPED educators, key themes emerged, including technology integration, differentiated instruction, cultural sensitivity, individualized education plans (IEPs), family and community involvement, and the creation of sensory-friendly environments. Participants highlighted the importance of leveraging technology for personalized learning, implementing varied instructional strategies to accommodate diverse learning styles, and incorporating culturally relevant materials to foster inclusivity. Regular IEP reviews and active family engagement were identified as critical for enhancing student motivation and success. Additionally, creating sensory-friendly classroom environments was emphasized as essential for supporting students' sensory processing needs. The findings indicate that these multifaceted strategies not only promote academic achievement but also enhance social-emotional development and inclusivity among students with special needs. Recommendations include ongoing professional development for educators, increased parental involvement in the IEP process, and systematic reviews of instructional strategies. This research contributes to a deeper understanding of how Filipino SPED teachers adapt their practices in diverse contexts, ultimately informing educational policies and teacher preparation programs aimed at fostering equitable learning environments.

Family meals on prescription as treatment for childhood obesity-a randomized controlled trial.

The aim with the present study was to evaluate the effects and tolerability of Family Meals on Prescription, a 3-month intensive dietary intervention with a participatory approach on body mass index (BMI) and metabolic health in children living with obesity. In this prospective randomized controlled trial, children aged 5-15years were included from the Pediatric Obesity outpatient Clinics in Halland, Sweden. Participants were randomly assigned to receive lifestyle treatment with or without Family Meals on Prescription (FMP) consisting of a subsidized prepacked grocery bag including recipes and provisions for five Family Meals per week for 3months. The primary endpoint was changed in BMIz after 3, 12 and 18-24months and secondary endpoints included to assess tolerability of FMP and effects on metabolic biomarker and frequency of shared meals. Eighty-nine children (51.7% female) entered the study, 54 patients in the intervention group and 35 in the control group. There were no significant differences between the groups concerning gender, age or level of obesity at baseline. The Family Meal on Prescription intervention combined with lifestyle treatment led to a significantly greater reduction in BMIz than lifestyle treatment alone after the 3-month long intervention (- 0.17 vs + 0.01, p < 0.01); however, this difference was not sustained throughout the study period, and in fact, the control group had a greater reduction in BMIz after 18-24months.A subsidized prepacked grocery bag may be a novel, well-tolerated and effective tool in the treatment of childhood obesity. The fact that the BMIz reduction shown at the end of the intervention did not persist over time emphasized the need of long-term treatment. Registered at clinicaltrals.gov 27 Nov 2020, retrospectively registered: clinicaltrials.gov number 19002468. https://clinicaltrials.gov/study/NCT05225350 What is Known: • Swedish data shows that lifestyle treatment alone is not sufficient for many families undergoing treatment for childhood obesity. • Regular family meals and mealtime routines have been shown to be important for nutritional health and dietary patterns in children and adolescents. What is New: • This intervention with a participatory approach involving prepacked family meals was well tolerated and led to a significant reduction in BMIz during the intervention. • That fact that these results were not sustained over time indicates a need to evaluate longer interventions, and that childhood obesity is a chronic and complex disease which requires long-time treatments.

Family Social Work Interventions Model To Promote Family Cohesion Among The Users Of Social Media In Uasin-Gishu County, Kenya

In the rapidly evolving digital age, social media has become an integral part of daily life, significantly influencing family dynamics and cohesion. This study explored the impact of social media on family cohesion and examined possible family social work intervention models to promote family unity among users in Uasin Gishu County, Kenya. Utilizing a convergent parallel mixed-methods design, the research gathered quantitative data through surveys of 400 respondents and qualitative insights from focus group discussions and key informant interviews. The findings revealed that 72.1% of participants supported the establishment of clear boundaries and rules around social media use to enhance family cohesion, with a mean score of 3.84. Additionally, 70.3% agreed that regular family activities strengthened family bonds, while 68.8% acknowledged the positive impact of family therapy on communication within social media-using families. The study also found strong support for educational initiatives on healthy social media use, with 71.3% of respondents endorsing their effectiveness. Hypothesis testing confirmed a significant relationship between family social work interventions and improved family cohesion, evidenced by a Pearson correlation coefficient of .648 and a significant chi-square result (p &lt; .001). The study concludes that structured social work interventions, such as setting boundaries, promoting family activities, and providing education, are crucial in maintaining family cohesion in the context of increasing social media usage. These findings offer valuable insights for social work practitioners, policymakers, and families seeking to balance digital engagement with family unity

Cut‐Cell Microstructures for Two‐scale Structural Optimization

AbstractTwo‐scale topology optimization, combined with the design of microstructure families with a broad range of effective material parameters, is widely used in many fabrication applications to achieve a target deformation behavior for a variety of objects. The main idea of this approach is to optimize the distribution of material properties in the object partitioned into relatively coarse cells, and then replace each cell with microstructure geometry that mimics these material properties. In this paper, we focus on adapting this approach to complex shapes in situations when preserving the shape's surface is essential.Our approach extends any regular (i.e. defined on a regular lattice grid) microstructure family to complex shapes, by enriching it with tiles adapted to the geometry of the cut‐cell. We propose a fully automated and robust pipeline based on this approach, and we show that the performance of the regular microstructure family is only minimally affected by our extension while allowing its use on 2D and 3D shapes of high complexity.

Factors associated with patients' experience of access to their multidisciplinary primary health care clinic: A multilevel analysis.

Understanding patients' experiences accessing primary health care (PHC) is necessary to improve service organisation. This study aims to examine individual, organisational, and contextual factors associated with patients' experience of accessing the multidisciplinary PHC clinic to which they are attached. This cross-sectional study builds on survey data collected in multidisciplinary PHC clinics located in 14 regions in the province of Quebec (Canada). Between September 2022 and June 2023, an online questionnaire was sent to patients with an email contact and attached to a family physician. Two patient-reported experience measures were assessed: (1) difficulty obtaining an appointment with their regular family physician or nurse practitioner and (2) perceived unmet healthcare needs. A self-reported online questionnaire based on the advanced access model was also sent to PHC professionals and administrative staff to assess the use of advanced access strategies in their practice. Multilevel logistic regression models were fit. Stratified analyses were conducted according to the number of consultations received. In total, 122,397 patients and 847 family physicians, 97 nurse practitioners and 347 administrative staff nested into 104 clinics answered the survey. In the overall sample, having a chronic disorder was the only individual factor associated with the patient experience of access. Organizational factors including estimation of demand and supply, use of a referral algorithm, and strategies to optimise consultations were associated with a better access experience. Patients from medium size clinics compared to small clinics had better experiences of care for both outcomes. Stratified analysis indicated similar results for patients who consulted at the clinic 1-5 times in the last 12months as observed in the overall sample. This study indicates that enhancing organizational processes can improve patients' access experiences.

GP’s GP, general practitioner’s health and willingness to contract family doctors in China: a national cross-sectional study

ObjectivesGeneral practitioners are trained to care for patients with a high level of responsibility and professional competency. However, there are few reports on the physical and mental health status of general practitioners (GPs) in China, particularly regarding help seeking and self-treatment. The primary aims of this study were to explore GPs’ expectations of their own family doctors and their reflection on role positioning, and to explore the objective factors that hinder the system of family doctors.Study designCross-sectional study.MethodsWe conducted an online survey of Chinese GPs. Descriptive statistics were used to summarize the findings.ResultsMore than half of the participants (57.20%) reported that their health was normal over the past year. A total of 420 participants (23.35%) reported having chronic diseases. For sleep duration, 1205 participants (66.98%) reported sleeping 6–8 h per day; 473 participants (26.29%) reported chronic insomnia. Two hundred thirty-one participants (12.84%) had possible depression. A total of 595 (33.07%) participants reported that they had contracted a fixed family doctor. In terms of preventing themselves from contracting for a family doctor, the following factors were identified: lack of sufficient time (54.81%), could solve obstacles themselves (50.97%), and embarrassment (24.24%). The proportion of the contract group (12.44%) taking personal relationship as a consideration was higher than that of the non-contract group (7.64%) (χ2 = 10.934 P = 0.01). Most participants (79.90%) in the non-signed group reported never having seen a family doctor. In terms of obstacles, more than half of the signed group thought that they could solve obstacles themselves, while the non-signed group (39.20%) was less confident in the ability of family doctors than the signed group (29.75%) (χ2 = 15.436, P < 0.01).ConclusionsGPs work under great pressure and lack of self-care awareness, resulting in an increased prevalence of health conditions. Most GPs did not have a regular family doctor. Having a family doctor with a fixed contract is more conducive to the scientific management of their health and provides a reasonable solution to health problems. The main factors hindering GPs from choosing a family doctor were time consumption, abilities to solve obstacles themselves, and trust in the abilities of GPs. Therefore, simplifying the process of family doctor visits, Changing the GPs' medical cognition, and strengthening the policy of GP training would be conducive to promoting a family doctor system that enhances hierarchical diagnosis and treatment. International collaboration could integrate GP health support into global healthcare system.

Association Between Health Literacy and Understanding of Doctors' Explanations: The Yamagata Study.

In Japan, the doctor-patient relationship has traditionally been characterized by a power imbalance that may contribute to communication gaps. To date, however, the link between patients' health literacy levels and their understanding of doctors' explanations of medical conditions and treatment has yet to be fully examined in Japan. The purpose of this study was to investigate the association between patients' health literacy level and their understanding of doctors' explanations. This was a cross-sectional study analyzing data derived from 11,217 questionnaires collected in July 2021 from participants of the Yamagata Study, a community-based cohort study implemented by Yamagata University since 2009. The results showed lower health literacy was associated with poorer understanding of physicians' explanations, adjusting for potential confounding factors. In addition to low health literacy, factors associated with lower comprehension were being male, not having a regular family doctor, and having lower self-perceived levels of health and happiness. The results suggest that health care professionals need to communicate with patients according to their health literacy level and ensure they fully understand their medical condition and treatment. Medical providers need to create a better health-literate environment to enable patients and families to make decisions by themselves. [HLRP: Health Literacy Research and Practice. 2024;8(3):e175-e183.].

The Relationship Between Continuity of Care and Enhancement of Clinical Outcomes Among Patients with Chronic Conditions.

Continuity of care is one of the main principles of family medicine, described as a relationship with a single provider that extends beyond a single illness episode. This retrospective study, conducted at King Saud University Family Medicine Center in Riyadh, Saudi Arabia, aimed to investigate the impact of having a regular primary care provider on clinical outcomes and preventive service delivery for patients with diabetes and/or hypertension. The study, spanning 2017 to 2019, included 400 patients diagnosed with diabetes and/or hypertension for at least six months before the 6-month pre-attachment period to regular family medicine physicians in 2018. Data before and after attachment for at least six months were compared using electronic health records. The mean age of the patients was 60.9, with a predominant female representation (66.8%) and 90.7% Saudis. Results indicated a significant improvement in glycated hemoglobin (HbA1c) levels (p = 0.005) and systolic blood pressure (p = 0.014) post-attachment. Preventive service delivery saw notable enhancements, with increased colon cancer screening (p = 0.03), breast cancer screening (p < 0.001), and retinal screening (p < 0.001) post-attachment. This study's findings underscore the importance of continuity of care in chronic disease management and provide valuable and promising insights into the Saudi healthcare context, aligning with the Saudi Ministry of Health's vision for universal access to regular primary care providers.

Inclusive Education and Rehabilitation of Students with Neurological and Developmental Disabilities: A Case of Pakistani Schools- Community Collaboration

The study was carried out to explore the nature of collaboration between the schools of students with neurological and developmental disabilities(SWNDDs)and the community institutions including family, health, general education, and social welfare. The study is carried out through a quantitative survey. The population of the study was teachers, and the parents of students with neurological and developmental disabilities studying in different schools in Punjab. A total number of 100 teachers (both male and female) and 31 parents(Mothers &amp; fathers ) were selected through a simple random sampling technique. Two structured questionnaires, one for teachers and one for parents, were used to collect the data. Each questionnaire consisted of two sections; demographic information and close-ended statements. The validity of the questionnaires was estimated from experts in special education. The reliability of the questionnaires was .83 and .80(Cronbach’s Alpha). The data analysis shows that schools had a low level of collaboration with health and social welfare departments but a moderate level of collaboration with regular education and families of students with NDDs.The need for strong and effective school-community collaboration for the welfare and uplift of students with neurological and developmental disabilities and their parents is recommended.

Raised in conditions of psychosocial deprivation: Effects of infant institutionalization on early development

BackgroundInstitutionalization is associated with a substantial developmental risk. Ethical constraints make it challenging to obtain robust empirical data on the effects of deprivation. Furthermore, because institutionalized children often face global deprivation, assessing the specific effects of psychosocial deprivation becomes difficult. Moreover, limited research exists on factors explaining interindividual differences. ObjectiveTo investigate developmental outcomes of children raised in institutions in conditions of psychosocial deprivation and to identify possible risk and protective factors at institutional and child levels. Participants and SettingSecondary analyses of data collected 1958–1961 in Switzerland in a population-based survey of institutionalized infants and toddlers. Participants (n = 332, Mage = 11.1 months, SD = 6.4, 48.2 % female, 45.3 % Swiss) were matched with a comparison group of 332 children raised in families (Mage = 10.9 months, SD = 6.2, 50.0 % female, 100 % Swiss). MethodsDevelopmental status was assessed using the standardized Brunet-Lézine Developmental Test. Additional data were obtained from administrative records and through observations. ResultsInstitutionalized children had significantly lower developmental quotients than the comparison group (d = −1.60, p < 0.001), with most prominent differences for language and social skills (d = −1.21/−1.20, p < 0.001). Within the institutionalized group, higher interaction time, higher birth weight, more regular family contact, and a shorter duration of institutionalization were associated with better developmental outcomes. ConclusionsThis study emphasizes the impact of isolated psychosocial deprivation on early development and identifies several risk and protective factors. To reduce developmental risk of institutionalization, the results are globally relevant for infants placed in institutions with comparable conditions today.

Impact of Family Counseling on Development of Special Children

Children with special needs are often at a risk in society. They encounter barriers in school and social situations, such as being bullied and not being taken seriously. While the world is changing, these children are not always welcome in society. Parents and caregivers play an important role in helping children with special needs to grow and develop to their potential. Studies have found that children raised in families with high levels of cohesion, harmony and child support succeed in more adaptive ways than those raised in families with less cohesion. This suggests that parents of children with disabilities need more assistance. This study uses a constructive theoretical framework to explore the notion of disability as experienced by parents of children with disabilities. The purpose of this study was to examine the effectiveness of a therapy intervention in a specific group of people who underwent family counselling sessions. The past researches of different authors were evaluated. Surveys were conducted using self-structured questionnaire, the results of which have been interpreted using statistical analysis. 68% respondents were male, and the rest were females. The respondents were divided into different age classes where the modal class was 20-25 years having a frequency of 45. It was observed that the family counselling had a positive impact on 80% of the children. This improvement was found in their social, physical, emotional, and cognitive abilities. It was concluded that regular family counselling sessions are recommended for the students having special needs for better results.

The impact of hypertension follow-up management on the choices of signing up family doctor contract services: does socioeconomic status matter?

BackgroundThis study aimed to explore the association between hypertension follow-up management and family doctor contract services, as well as to examine whether socioeconomic status (SES) had an interaction effect on this relationship among older adults in China.MethodsWe used data from the sixth National Health Service Survey of Shandong Province, China, including 3,112 older adults (age ≥ 60 years) with hypertension in 2018. Logistic regression models and a margins plot were used to analyze the role of SES in the relationship between hypertension follow-up management and family doctor contract services.ResultsThe regular hypertension follow-up management rate and family doctor contracting rate were 81.8% and 70.9%, respectively, among older adults with hypertension. We found that participants with regular hypertension follow-up management were more likely to sign family doctor contract services (OR=1.28, 95%CI: 1.04, 1.58, P=0.018). The interaction effect occurred in the groups who lived in rural areas (OR=1.55, 95%CI: 1.02, 2.35), with high education level (OR=0.53, 95%CI: 0.32, 0.88) and had high incomes (OR=0.53, 95%CI: 0.35, 0.81).ConclusionsOur findings suggested that regular hypertension follow-up management was associated with family doctor contract services and SES influenced this relationship. Primary health care should improve the contracting rate of family doctors by strengthening follow-up management of chronic diseases. Family doctors should focus on improving services quality and enriching the content of service packages especially for older adults with higher income and education level.

Social Workers’ Perspectives on Socially Isolated Older Adults Living with a Robot Companion

ABSTRACT Addressing depression and social isolation among solo-living older adults in South Korea requires a multi-faceted approach. This study aims to explore the advantages and obstacles of a robotic elder care program by analyzing social workers’ viewpoints regarding interactions between older adults and a companion robot named Hyodol. Through the purposive sampling method, we conducted comprehensive interviews with 10 social workers who are pioneering the integration of robots in elder care. The study participants observed and compared the demographic characteristics of users and non-users, elucidated usage patterns, described the roles of robot companions, and shared remarkable instances. Overall, the experiences of these social workers underscored the positive influence of Hyodol in offering companionship, care, and emotional support, especially in circumstances where clients experienced isolation or lacked regular family interactions. In addition, social workers’ perspectives hold significant value in comprehending the genuine effects of anthropomorphism – the inclination to attribute human-like qualities and emotions to robots. Our investigation revealed the existence of two distinct modes of personification among older adults, which we have labeled as “imagination” and “projection.”

The true complexities of "standard" family practice visits unmasked: an observational cross-sectional study in Regina.

Many patients present to their family medicine clinic with more than one health concern, placing an increased demand on family physicians. Research into the average number of concerns per regular family medicine visit is limited. Recognition of the frequency that family physicians address more than one concern per visit and adapting practices accordingly is important for improving patient care. To examine whether family physicians routinely address multiple different patient concerns during a single visit and if this is influenced by patient demographics. This study was conducted at a multi-physician family medicine clinic in Regina, Saskatchewan, Canada. Five physicians contributed their 500 most recent charts, extending retrospectively from 1 June 2023, from in-person visits by patients over 18 years of age and billed as regular appointments without billed procedures. Each chart was reviewed for the number of concerns addressed in the visit. Fifty percent of visits addressed more than 1 concern (range = 1-8). A generalized linear mixed model using Poisson distribution showed certain physicians (incident rate ratio [IRR]: 1.192, 95% CI: 1.087-1.307, P < 0.001) and adults older than 65 years compared to adults less than 40 years (IRR 1.151, 95% CI: 1.069-1.239, P < 0.001) were more likely to present with multiple concerns, but patient sex was not a significant predictor. Family physicians routinely address more than one concern per visit. Standard visit length and billing practices should be adapted to reflect this complexity.

Structural violence and everyday survival during COVID-19 lockdown: The experiences of street children in Uyo, Nigeria

BackgroundMost studies on the effect of covid-19 lockdowns on children have focused on those in regular family settings and in-school children. Research on the experiences of street children during lockdown are scarce. Our study seeks to fill this gap by exploring the negative effects of lockdowns on street children in a commercial city in South-South Nigeria, and how they coped with these effects. MethodUsing purposive sampling technique, we recruited twenty-four street children for the semi-structured interviews. Thematic analysis was used in identifying specific themes on the effect of COVID-19 lockdown on street children. ResultsAll children interviewed reported direct adverse socioeconomic effects of COVID-19 lockdown. Also, they reported being victimised by law enforcement agents and adult street actors. Their public perception as a ‘diseased category’ capable of COVID-19 transmission contributed to stigma and eviction from places of abode, a situation that exposed some female street children to sexual violence. Street children coped with economic effects of lockdown through exploring further opportunities for income generation. ConclusionStreet children bear a disproportionate effect of COVID-19 lockdown. There exists a need to prioritize their needs as well as include them in social protection measures for COVID-19.

Exposure to Second-hand Smoke and Having Regular Family Physicians Are Associated With Cessation of Smoking During Pregnancy: A Population-based Study

Background: The association of second-hand smoke with prenatal smoking cessation is less studied, and so is the family physician’s role in prenatal smoking cessation. We examined the association between second-hand smoke during pregnancy and having a regular family physician with prenatal smoking cessation in a representative sample of Canadian households. Method: We used the data from Canadian Community Health Surveys (CCHS), 2017–2018, with a sample of 838 women who reported regular (every day) smoking within the 3 months before knowing their last pregnancy. The outcome variable was dichotomized as cessation or continuation of smoking during pregnancy. We used multivariable logistic regression, adjusted for socio-demographic variables, to examine the association of smoking cessation during pregnancy with second-hand smoke and having a regular family physician. Results: Overall, 33.9% (95% confidence interval, 30.0%, 39.2%) of women who were regular smokers before pregnancy reported quitting smoking during pregnancy. The smoking cessation rate was 17.6% (95% CI 11.8, 25.4) among women who had exposure to second-hand smoke and 38.1% (95% CI 32.1, 44.5) women who had a regular family physician. When adjusted for maternal age, maternal education, total household income, and indigenous status, exposure to second-hand smoke was associated with lower odds of smoking cessation during pregnancy, adjusted odds ratios (aOR) of 0.22 (95% CI: 0.12, 0.41) and having a regular family physician was associated with higher odds of quitting smoking [aOR 2.67 (95% CI: 1.23, 5.79)]. Conclusion: Smoking cessation during pregnancy was negatively associated with ongoing exposure to second-hand smoke and was positively associated with having a regular family physician. Contexte: L’association entre l’exposition à la fumée secondaire et le renoncement au tabac pendant la grossesse est moins étudiée, tout comme le rôle du médecin de famille dans le renoncement au tabac pendant la grossesse. Nous avons examiné l’association entre la fumée secondaire pendant la grossesse et le fait d’avoir un médecin de famille régulier et l’abandon du tabagisme prénatal dans un échantillon représentatif de ménages canadiens. Méthode: Nous avons utilisé les données des enquêtes sur la santé dans les collectivités canadiennes (ESCC), 2017–2018, avec un échantillon de 838 femmes qui ont déclaré avoir fumé régulièrement (tous les jours) au cours des trois mois avant de connaitre leur dernière grossesse. La variable de résultat a été divisée en cessation ou poursuite du tabagisme pendant la grossesse. Nous avons utilisé une régression logistique multivariable, ajustée sur les variables sociodémographiques, pour examiner l’association de l’arrêt du tabac pendant la grossesse avec l’exposition à la fumée secondaire et le fait d’avoir un médecin de famille régulier. Résultats: Dans l’ensemble, 33.9% (intervalle de confiance à 95%, 30.0%, 39.2%) des femmes qui fumaient régulièrement avant la grossesse ont déclaré avoir cessé de fumer pendant la grossesse. Le taux d’abandon du tabac était de 17.6% (IC 95% 11.8, 25.4) chez les femmes exposées à la fumée secondaire et de 38.1% (IC 95% 32.1, 44.5) chez les femmes qui avaient un médecin de famille régulier. Après ajustement en fonction de l'âge maternel, du niveau d'éducation de la mère, du revenu total du ménage et du statut d’autochtone, l’exposition à la fumée secondaire était associée à une probabilité plus faible d’arrêt du tabac pendant la grossesse, rapport de cotes ajusté (RCA) de 0.22 (IC à 95%: 0.12, 0.41), et le fait d’avoir un médecin de famille régulier était associé à une probabilité plus élevée d’arrêt du tabac [RCA de 2.67 (IC à 95% : 1.23, 5.79)]. Conclusion: L’arrêt du tabac pendant la grossesse est négativement associé à l’exposition continue à la fumée secondaire et positivement associé au fait d’avoir un médecin de famille régulier.

Strong posterior contraction rates via Wasserstein dynamics

In Bayesian statistics, posterior contraction rates (PCRs) quantify the speed at which the posterior distribution concentrates on arbitrarily small neighborhoods of a true model, in a suitable way, as the sample size goes to infinity. In this paper, we develop a new approach to PCRs, with respect to strong norm distances on parameter spaces of functions. Critical to our approach is the combination of a local Lipschitz-continuity for the posterior distribution with a dynamic formulation of the Wasserstein distance, which allows to set forth an interesting connection between PCRs and some classical problems arising in mathematical analysis, probability and statistics, e.g., Laplace methods for approximating integrals, Sanov’s large deviation principles in the Wasserstein distance, rates of convergence of mean Glivenko–Cantelli theorems, and estimates of weighted Poincaré–Wirtinger constants. We first present a theorem on PCRs for a model in the regular infinite-dimensional exponential family, which exploits sufficient statistics of the model, and then extend such a theorem to a general dominated model. These results rely on the development of novel techniques to evaluate Laplace integrals and weighted Poincaré–Wirtinger constants in infinite-dimension, which are of independent interest. The proposed approach is applied to the regular parametric model, the multinomial model, the finite-dimensional and the infinite-dimensional logistic-Gaussian model and the infinite-dimensional linear regression. In general, our approach leads to optimal PCRs in finite-dimensional models, whereas for infinite-dimensional models it is shown explicitly how the prior distribution affect PCRs.

Influence of Bamboo Fiber Content on the Properties of Asphalt Mixtures

Inspecting what how much bamboo fiber means for the attributes of asphalt mixtures and searching for ways of further developing maintainability and execution. To assess the impacts of bamboo fibers on significant qualities including soundness, rutting opposition, weakness conduct, and dampness helplessness, asphalt details coordinate these sustainable and ecologically harmless fibers. This review evaluated the presentation improving use of bamboo fiber, a new expansion to the regular fiber family, in stone matrix asphalt (SMA) and dense-grade (DG) mixes. As well as having a harsh surface like that of a typical lignin fiber, bamboo fiber has a high rigidity in the fiber course. Furthermore, bamboo fiber has satisfactory warm dependability, an issue with plant-based materials that is normally raised. The ideal asphalt cover contents for DG and SMA mixtures with differing measures of bamboo fiber were picked utilizing the Marshall blend plan procedure. Utilizing the wheel following test, inundation Marshall test, freeze-defrost cycle test, and three-point twisting bar test, separately, the impacts of bamboo fiber on blend dampness helplessness, rutting, and low-temperature breaking execution were surveyed. The presentation of the previously mentioned blend was fundamentally worked on by the expansion of bamboo fiber, as indicated by test results. All in all, blends including bamboo fiber exhibited execution that was either tantamount to or better than those containing polyester and lignin fiber, proposing that bamboo fiber can be utilized in asphalt mixtures.