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The successful provision of middle-ear surgery requires appropriate anaesthesia. This may take the form of local or general anaesthesia; both methods have their advantages and disadvantages. Local anaesthesia is simple to administer and does not require the additional personnel required for general anaesthesia. In the low-resource setting, it can provide a very safe and effective means of allowing middle-ear surgery to be successfully completed. However, some middle-ear surgery is too complex to consider performing under local anaesthesia and here general anaesthesia will be required.
This article highlights considerations for performing middle-ear surgery in a safe manner when the available resources may be more limited than those expected in high-income settings. There are situations where local anaesthesia with sedation may prove a useful compromise of the two techniques.
Piroplasms are intraerythrocytic parasites that are often transmitted by ixodid ticks, but vertical transmission is an alternative route for some species. In the USA, raccoons (Procyon lotor) are hosts for two known species, a Babesia microti-like sp. and Babesia lotori (in Babesia sensu stricto group). To better understand the natural history of Babesia in raccoons, we tested young raccoons from Minnesota and Colorado for Babesia spp., examined them for ticks, and assessing for splenomegaly as a sign of clinical disease. Raccoons from both states were infected with B. microti-like sp. and Babesia sensu stricto spp. Infections of B. microti-like were common, even in 1-week-old raccoons, suggesting vertical transmission. Babesia sensu stricto infections were more common in older raccoons. Raccoons infected with Babesia sensu stricto had significantly higher spleen:body weight ratios compared with uninfected or B. microti-like sp.-infected raccoons. Ticks were only found on raccoons from Minnesota. The most common and abundant tick was Ixodes texanus but Ixodes scapularis and Dermacentor variabilis were also found on raccoons. We report piroplasm infections and infestations with several tick species in very young raccoons. Young raccoons infected with Babesia sensu stricto spp. had higher spleen:body weight ratios, suggesting a disease risk.
Many preschool-age children meet criteria for psychiatric disorders, and rates approach those observed in later childhood and adolescence. However, there is a paucity of longitudinal research examining the outcomes of preschool diagnoses.
Families with a 3-year-old child (N = 559) were recruited from the community. Primary caregivers were interviewed using the Preschool Age Psychiatric Assessment when children were 3 years old (n = 541), and, along with children, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version when children were 9 and 12 years old.
Rates of disruptive behavior disorders (DBD) decreased from preschool to middle childhood and early adolescence, whereas rates of attention-deficit/hyperactivity disorder (ADHD) increased. Rates of any psychiatric disorder and depression increased from preschool to early adolescence only. Preschoolers with a diagnosis were over twice as likely to have a diagnosis during later periods. Homotypic continuity was present for anxiety disorders from preschool to middle childhood, for ADHD from preschool to early adolescence, and for DBD through both later time points. There was heterotypic continuity between preschool anxiety and early adolescent depression, and between preschool ADHD and early adolescent DBD. Dimensional symptom scores showed homotypic continuity for all diagnostic categories and showed a number of heterotypic associations as well.
Results provide moderate support for the predictive validity of psychiatric disorders in preschoolers. Psychopathology in preschool is a significant risk factor for future psychiatric disorders during middle childhood and early adolescence.
Tidewater glaciers in Greenland experienced widespread retreat during the last century. Information on their behaviour prior to this is often poorly constrained due to lack of observations, while determining the drivers prior to instrumental records is also problematic. Here we present a record of the dynamics of Kangiata Nunaata Sermia (KNS), southwest Greenland, from its Little Ice Age maximum (LIAmax) to 1859 – the period before continuous air temperature observations began at Nuuk in 1866. Using glacial geomorphology, historical accounts, photographs and GIS analyses, we provide evidence KNS was at its LIAmax by 1761, had retreated by ~5 km by 1808 and a further 7 km by 1859. This predates retreat at Jakobshavn Isbræ by 43–113 years, demonstrating the asynchroneity of tidewater glacier terminus response following the LIA. We use a one-dimensional flowband model to determine the relative sensitivity of KNS to atmospheric and oceanic climate forcing. Results demonstrate that terminus forcing rather than surface mass balance drove the retreat. Modelled glacier sensitivity to submarine melt rates is also insufficient to explain the retreat observed. However, moderate increases in crevasse water depth, driving an increase in calving, are capable of causing terminus retreat of the observed magnitude and timing.
Early maturation, indexed by pubertal development (PD), has been associated with earlier initiation and greater frequency of adolescent substance use, but this relationship may be biased by confounding factors and effects that change across development. Using a population-based Finnish twin sample (N = 3,632 individuals), we conducted twin modeling and multilevel structural equation modeling of the relationship between PD and substance use at ages 12–22. Shared environmental factors contributed to early PD and heavier substance use for females. Biological father absence was associated with early PD for boys but not girls, and did not account for the relationship between PD and substance use. The association between early PD and heavier substance use was partially due to between-family confounds, although early PD appeared to qualitatively alter long-term trajectories for some substances (nicotine), but not others (alcohol). Mediation by peer and parental factors did not explain this relationship within families. However, higher peer substance use and lower parental monitoring were themselves associated with heavier substance use, strengthening the existing evidence for these factors as targets for prevention/intervention efforts. Early maturation was not supported as a robust determinant of alcohol use trajectories in adolescence and young adulthood, but may require longer term follow-up. Subtle effects of early PD on nicotine and illicit drug use trajectories throughout adolescence and adulthood merit further investigation.
Little is known about the role of stress reactivity in the emergence of psychopathology across early childhood. In this longitudinal study, we tested the hypothesis that child cortisol reactivity at age 3 moderates associations between early parenting and children's internalizing and externalizing symptoms from age 3 to age 6. One hundred and sixty children were assessed at age 3, and 135 children were reassessed at age 6. At age 3, we exposed children to stress-inducing laboratory tasks, during which we obtained four salivary cortisol samples, and parental hostility was assessed using an observational parent–child interaction task. At ages 3 and 6, child psychiatric symptoms were assessed using a clinical interview with parents. The results indicated that the combination of high child cortisol reactivity and high observed parental hostility at age 3 was associated with greater concurrent externalizing symptoms at age 3 and predicted increases in internalizing and externalizing symptoms from age 3 to age 6. Findings highlight that increased stress reactivity, within the context of hostile parenting, plays a role in the emergence of psychopathology from preschool to school entry.
In 133 BC, when Scipio Aemilianus heard of the violent death of his cousin and brother-in-law, Ti. Gracchus, he uttered a line from Homer: ‘Thus perish all who attempt such.’ In effect, this endorsed the lynching of Gracchus. At a deeper level, it cast Gracchus (in the Homeric context of that quotation) as the tyrant Aegisthus. It may also have suggested an image of moral turpitude, Aegisthus having debauched his cousin Agamemnon’s wife. By analogy (if intended), that would have suggested an adulterous union between Gracchus and his sister Sempronia. It is further suggested that gossip arising from this extraordinary insinuation might have prompted a special reading of the claims circa 102 BC of L. Equitius to be the bastard son of Gracchus.
Young children's disregard for conduct rules (failing to experience discomfort following transgressions and violating adults' prohibitions) often foreshadows future antisocial trajectories, perhaps in part because it elicits more power-assertive parental discipline, which in turn promotes children's antisocial behavior. This process may be particularly likely for children with low skin conductance level (SCL). In 102 two-parent community families, we tested a model in which children's SCL, assessed at 8 years, was posed as a moderator of the cascade from children's disregard for conduct rules at 4.5 years to parents' power assertion at 5.5 and 6.5 years to antisocial behavior at 10 and 12 years. Children's disregard for conduct rules was observed in scripted laboratory paradigms, parents' power assertion was observed in discipline contexts, and children's antisocial behavior was rated by parents. Conditional process analyses revealed that the developmental cascade from early disregard for rules to future parental power assertion to antisocial outcomes occurred only for the children with low SCL (below median), but not their high-SCL (above median) peers. By elucidating the specific interplay among children's disregard for rules, the parenting they receive, and their psychophysiology, this study represents a developmentally informed, multilevel approach to early etiology of antisocial behavior.
We offer a brief sketch of an overlooked early twin researcher, Arvo Johannes Lehtovaara (1905–1985), Professor of Psychology at the University of Jyväskylä, 1939–1952, and the University of Helsinki, 1952–1970, with background notes on his mentor, Eino Kaila.
In a change from the once-dominant view of children as passive in the parent-led process of socialization, children are now seen as active agents who can considerably influence that process. However, these newer perspectives typically focus on the child's antagonistic influence, due either to a difficult temperament or aversive, resistant, negative behaviors that elicit adversarial responses from the parent and lead to future coercive cascades in the relationship. Children's capacity to act as receptive, willing, even enthusiastic, active socialization agents is largely overlooked. Informed by attachment theory and other relational perspectives, we depict children as able to adopt an active willing stance and to exert robust positive influence in the mutually cooperative socialization enterprise. A longitudinal study of 100 community families (mothers, fathers, and children) demonstrates that willing stance (a) is a latent construct, observable in diverse parent–child contexts, parallel at 38, 52, and 67 months and longitudinally stable; (b) originates within an early secure parent–child relationship at 25 months; and (c) promotes a positive future cascade toward adaptive outcomes at age 10. The outcomes include the parent's observed and child-reported positive, responsive behavior, as well as child-reported internal obligation to obey the parent and parent-reported low level of child behavior problems. The construct of willing stance has implications for basic research in typical socialization and in developmental psychopathology as well as for prevention and intervention.
The Fezzan Project is investigating the last 10,000 years of human settlement, landscape evolution and climatic change in the Germa region in southern Libya. The second season in February–March 1998 comprised interdisciplinary research in archaeology and geography, centred around excavation and survey work carried out at the site of Old Germa. To date, three phases of mud brick buildings have been partially explored. In addition, wider geomorphological study and archaeological survey and fieldwalking were carried out elsewhere in the Germa/Twesh oasis and around el-Hatiya. Numerous sites were discovered, including a new hillfort of Zinchecra type and several valley centre ‘villages’ of Garamantian/Roman date. Artefactual studies were carried out on pottery and lithics, animal bones and seeds. Further work on the subterranean irrigation features, the foggaras, have confirmed their pre-Islamic origins.
Plutarch records calumny directed at Cornelia, mother of the Gracchi, though he offers no detail as to its content. This article speculates that Cicero's reference to rhetorical misgivings concerning her marriage offers a clue. References by Pliny and Solinus to the ominous nature of Cornelia's postnatal condition prompt the further speculation that enemies of the Gracchi were able to claim that both her marriage and the birth of her children had run counter to divine injunction.
We followed 100 community families from toddler age to preadolescence. Each mother– and father–child dyad was observed at 25, 38, 52, 67, and 80 months (10 hr/child) to assess positive and power-assertive parenting. At age 10 (N = 82), we obtained parent- and child-reported outcome measures of children's acceptance of parental socialization: cooperation with parental monitoring, negative attitude toward substance use, internalization of adult values, and callous–unemotional tendencies. Children who carried a short serotonin transporter linked polymorphic region gene (5-HTTLPR) allele and were highly anger prone, based on anger observed in laboratory from 25 to 80 months, were classified as high in biobehavioral risk. The remaining children were classified as low in biobehavioral risk. Biobehavioral risk moderated links between parenting history and outcomes. For low-risk children, parenting measures were unrelated to outcomes. For children high in biobehavioral risk, variations in positive parenting predicted cooperation with monitoring and negative attitude toward substance use, and variations in power-assertive parenting predicted internalization of adult values and callous–unemotional tendencies. Suboptimal parenting combined with high biobehavioral risk resulted in the poorest outcomes. The effect for attitude toward substance use supported differential susceptibility: children high in biobehavioral risk who received optimal parenting had a more adaptive outcome than their low-risk peers. The remaining effects were consistent with diathesis–stress.
Parent–child relationships are critical in development, but much remains to be learned about the mechanisms of their impact. We examined the early parent–child relationship as a moderator of the developmental trajectory from children's affective and behavioral responses to transgressions to future antisocial, externalizing behavior problems in the Family Study (102 community mothers, fathers, and infants, followed through age 8) and the Play Study (186 low-income, diverse mothers and toddlers, followed for 10 months). The relationship quality was indexed by attachment security in the Family Study and maternal responsiveness in the Play Study. Responses to transgressions (tense discomfort and reparation) were observed in laboratory mishaps wherein children believed they had damaged a valued object. Antisocial outcomes were rated by parents. In both studies, early relationships moderated the future developmental trajectory: diminished tense discomfort predicted more antisocial outcomes, but only in insecure or unresponsive relationships. That risk was defused in secure or responsive relationships. Moderated mediation analyses in the Family Study indicated that the links between diminished tense discomfort and future antisocial behavior in insecure parent–child dyads were mediated by stronger discipline pressure from parents. By indirectly influencing future developmental sequelae, early relationships may increase or decrease the probability that the parent–child dyad will embark on a path toward antisocial outcomes.
Although children's active role in socialization has been long acknowledged, relevant research has typically focused on children's difficult temperament or negative behaviors that elicit coercive and adversarial processes, largely overlooking their capacity to act as positive, willing, even enthusiastic, active socialization agents. We studied the willing, receptive stance toward their mothers in a low-income sample of 186 children who were 24 to 44 months old. Confirmatory factor analysis supported a latent construct of willing stance, manifested as children's responsiveness to mothers in naturalistic interactions, responsive imitation in teaching contexts, and committed compliance with maternal prohibitions, all observed in the laboratory. Structural equation modeling analyses confirmed that ecological adversity undermined maternal responsiveness, and responsiveness, in turn, was linked to children's willing stance. A compromised willing stance predicted externalizing behavior problems, assessed 10 months later, and fully mediated the links between maternal responsiveness and those outcomes. Ecological adversity had a direct, unmediated effect on internalizing behavior problems. Considering children's active role as willing, receptive agents capable of embracing parental influence can lead to a more complete understanding of detrimental mechanisms that link ecological adversity with antisocial developmental pathways. It can also inform research on the normative socialization process, consistent with the objectives of developmental psychopathology.
A study was conducted to evaluate a natural carbohydrate fraction Actigen™ (NCF), derived from mannanoligosaccharide, in feed on growth performance, intestinal morphology and goblet cell number and area of male broilers'. Dietary treatments included: 1) control diet (antibiotic and NCF free), 2) NCF at 200 g/t, 3) NCF at 400 g/t, and 4) NCF 800 g/t. Two hundred and forty birds were placed into 12 replicate pens per treatment (5 birds/pen), sixty birds per treatment. Body weight and feed intake were recorded weekly up to day 42. At this time a 2.5cm section of jejunum and duodenum were excised post mortem for morphological analysis. Birds fed 200 g/t and 800 g/t NCF were significantly (P < 0.01) heavier from day 14 onwards than the control birds. Feed intake was significantly higher in birds fed 200 g/t NCF compared to those fed the control at 21 and 35 days (P < 0.05). Diets containing 200 g/t and 800 g/t of NCF significantly decreased broiler feed conversion ratio (FCR) compared to the control in the first phase (1–14 days) (P < 0.01) and levels of NCF decreased FCR (P < 0.05) in the second phase (15–28 days). NCF had no significant effect on villus height, villus width, crypt depth or villus to crypt ratio in either duodenum or jejunum. NCF did not significantly affect goblet cell area or goblet cell number in the duodenum, however, in the jejunum, 800 g/t NCF significantly (P < 0.05) increased goblet cell area over the control. In conclusion, NCF showed a positive effect on broiler performance in the starter and grower phases, and increased goblet cell area in the jejunum, suggesting higher levels of mucin production. This indicated that the performance benefit of NCF could be age-dependent, with younger birds responding more than the older ones. There were no additional benefits to performance when feeding NCF for a longer period (after 28 d of age), however it is postulated that birds fed NCF would have greater defence to pathogenic challenge through increased storage capacity of mucin.
Preliminary work indicates that cognitive vulnerability to depression may be associated with variants of the serotonin transporter promoter polymorphism (5-HTTLPR) and the valine to methionine at position 66 (val66met) polymorphism of the brain-derived neurotrophic factor (BDNF) gene; however, existing reports come from small samples. The present study sought to replicate and extend this research in a sample of 375 community-dwelling children and their parents. Following a negative mood induction, children completed a self-referent encoding task tapping memory for positive and negative self-descriptive traits. Consistent with previous work, we found that children with at least one short variant of the 5-HTTLPR had enhanced memory for negative self-descriptive traits. The BDNF val66met polymorphism had no main effect but was moderated by maternal depression, such that children with a BDNF methionine allele had a heightened memory for negative self-descriptive traits when mothers had experienced depression during children's lifetimes; in contrast, children with a methionine allele had low recall of negative traits when mothers had no depression history. The findings provide further support for the notion that the 5-HTTLPR is associated with cognitive markers of depression vulnerability and that the BDNF methionine allele moderates children's sensitivity to contextual factors.