Attachment representations, sleep quality and adaptive functioning in preschool age children.

Both the attachment system and sleep are considered to be important biopsychosocial regulators of development and of adaptive functioning in children, and there is a substantial literature suggesting that the two systems may be mutually influencing. To date, however, the bulk of research attempting to link these systems has focused on infancy and the results of empirical studies are mixed. Thirty-nine preschool children participated in this study (valid sleep data for 34 cases).

Screening for tuberculosis and hepatitis B prior to the initiation of anti-tumor necrosis therapy.

Background: Since the introduction of infliximab, anti-tumor necrosis factor alpha (anti-TNF-α) agents have been used with increasing frequency for the treatment of inflammatory bowel disease (IBD). Reactivation of latent Mycobacterium tuberculosis (TB) soon became recognized as a complication of therapy. More recently, reactivation of hepatitis B while on anti-TNF therapy has been documented.

Patient outcomes associated with 2-octyl cyanoacrylate topical skin adhesive in coronary artery bypass graft surgery.

Background: Surgical site infection (SSI) is an important cause of morbidity and occasionally death after coronary artery bypass graft (CABG) surgery. These infections also are associated with higher costs and poorer surgical outcomes. We used a retrospective observational database to examine and quantify the effects of the topical skin adhesive 2-octyl cyanoacrylate, used as the final layer of site closure in patients undergoing CABG surgery, on the incidence of post-operative SSI.

Preschool children's mental representations of attachment: antecedents in their secure base behaviors and maternal attachment scripts.

This study examined the antecedents of preschool age children's mental representations of attachment, assessed using the Attachment Story Completion Task (ASCT). Antecedent predictors were maternal attachment scripts, assessed using the Attachment Script Assessment (ASA), and the child's secure base behaviors, assessed using the Attachment Q-Set (AQS). Participants were 121 mothers and their preschool children assessed in three samples (Portuguese sample, n = 31; US Midwestern sample, n = 38; US Southeastern sample, n = 52).

Abdominal phlegmons in Crohn's disease: outcomes following antitumor necrosis factor therapy.

Background: An abdominal phlegmon is an inflammatory mass that can develop in the setting of penetrating Crohn's disease (CD). Anti-tumor necrosis factor (TNF) antibody therapy is typically avoided in CD complicated by phlegmon because of concern for peritoneal infection but may offer an effective alternative to surgical resection after infection has been controlled with antibiotics. The aim of this study was to examine outcomes for patients with CD who developed an abdominal phlegmon that was subsequently treated with an anti-TNF antibody.

Acid-suppressive medication use and the risk for nosocomial gastrointestinal tract bleeding.

Background: Acid-suppressive medications are increasingly prescribed for noncritically ill hospitalized patients, although the incidence of nosocomial gastrointestinal (GI) tract bleeding (GI bleeding) and magnitude of potential benefit from this practice are unknown. We aimed to define the incidence of nosocomial GI bleeding outside of the intensive care unit and examine the association between acid-suppressive medication use and this complication.

Methods: We conducted a pharmacoepidemiologic cohort study of patients admitted to an academic medical center from 2004 through 2007, at least 18 years of age, and hospitalized for 3 or more days.

Relations between mucosal immunity and children's mental health: the role of child sex.

This study examines relations between children's salivary interleukin-6 (IL-6) and secretory immunoglobulin A (SIgA) and mental health. Child sex was considered as a moderator of relations. Data were from 329 normally developing children (M age=9.

Topiramate responsive exploding head syndrome.

Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep.

Clinical discourse and engagement during shared storybook reading in preschool groups.

This study investigated the impact of discourse on engagement in shared storybook reading in children who are language impaired and hard to engage. Although active participation in shared storybook reading in children who are typically developing is well defined, research has shown that the engagement of children with language disorders differ as a result of adult reading styles. To investigate the influence of reading style on children who were hard to engage, four shared storybook-reading sessions were analyzed.

Can we close the income and wealth gap between specialists and primary care physicians?

Over their lifetimes, primary care physicians earn lower incomes--and accumulate considerably less wealth--than their specialist counterparts. This gap influences medical students, who are choosing careers in primary care in declining numbers. We estimated career wealth accumulation across specialists, primary care physicians, physician assistants, business school graduates, and college graduates.

Heart period sensitivity to forced oscillations in ventilatory pressure.

Heart rate variability analysis is a dynamic method to estimate the autonomic control over the cardiac cycle. Although dysfunction in this control system may appear spontaneously, other deficits may require provocation of the system. In this article we describe a non-invasive method to perturb the autonomic influences on the cardiac cycle.

Differential effects of outdoor versus indoor fungal spores on asthma morbidity in inner-city children.

Background: Although sensitization to fungal allergens is prevalent in inner-city children with asthma, the relationship between fungal exposure and morbidity is poorly understood.

Objective: We examined relationships between fungal sensitization, exposure, and asthma morbidity in inner-city children.

Methods: Participants were 5 to 11 years old and enrolled in the Inner-City Asthma Study.

Hierarchical models of social competence in preschool children: a multisite, multinational study.

The generality of a multilevel factorial model of social competence (SC) for preschool children was tested in a 5-group, multinational sample (N = 1,540) using confirmatory factor analysis. The model fits the observed data well, and tests constraining paths for measured variables to their respective first-order factors across samples also fit well. Equivalence of measurement models was found at sample and sex within-sample levels but not for age within sample.

Gastrointestinal physiology and digestive disorders in sleep.

Purpose Of Review: The dynamic interplay of the digestive system and sleep is an excellent example of brain-body interaction. New advances in measuring techniques provide an opportunity to evaluate physiology that is dependent upon the sleep/wake state or circadian rhythm and potentially differentiate between normal and pathological conditions.

Recent Findings: Sleep-related changes in gastrointestinal physiology create vulnerabilities to digestive issues such as reflux, whereas disorders such as duodenal ulcers raise the importance of circadian variations in digestive system function.

Demonstration of high-precision continuous measurements of water vapor isotopologues in laboratory and remote field deployments using wavelength-scanned cavity ring-down spectroscopy (WS-CRDS) technology.

This study demonstrates the application of Wavelength-Scanned Cavity Ring-Down Spectroscopy (WS-CRDS) technology which is used to measure the stable isotopic composition of water. This isotopic water analyzer incorporates an evaporator system that allows liquid water as well as water vapor to be measured with high precision. The analyzer can measure H2(18)O, H2(16)O and HD(16)O content of the water sample simultaneously.

Surgical site infection: incidence and impact on hospital utilization and treatment costs.

Background: Surgical site infections (SSIs) are serious operative complications that occur in approximately 2% of surgical procedures and account for some 20% of health care-associated infections.

Methods: SSI was identified based on the presence of ICD-9-CM diagnosis code 998.59 in hospital discharge records for 7 categories of surgical procedures: neurological; cardiovascular; colorectal; skin, subcutaneous tissue, and breast; gastrointestinal; orthopedic; and obstetric and gynecologic.

High-precision CO2 isotopologue spectrometer with a difference-frequency-generation laser source.

A precision laser spectrometer for the detection of CO(2) isotopes is reported. The spectrometer measures the fundamental absorption signatures of (13)C and (12)C isotopes in CO(2) at 4.32 microm using a tunable mid-IR laser source based on difference-frequency generation.

Technical review of polysomnography.

Polysomnography has developed from our understanding of sleep and its associated physiologic processes. This important tool extends the clinical examination into dynamic states that typically do not permit intrusive inspection. The two critical components of polysomnography are the determination of sleep-wake stage and identification of related bodily processes.

The impact of familial environment on depression scores after genetic testing for cancer susceptibility.

The associations between characteristics of family relationships and family trends in cancer worry and the psychological adjustment of recipients of genetic testing for cancer susceptibility were investigated. Data provided by 178 individuals from 24 families with Lynch syndrome who participated in a cohort study investigating psychological and behavioral outcomes of genetic testing were used. Responses from multiple family members were aggregated to construct family trends representing norms and departure from norms in cancer worry.

Secure base representations for both fathers and mothers predict children's secure base behavior in a sample of Portuguese families.

Relations between fathers' and mothers' representations of attachment (independently assessed using an attachment script representation task) and children's secure base behavior (assessed using the Attachment Q-sort; AQS) were studied in 56 Portuguese families (mean age of child = 31.9 months). Each parent's secure base script representation score predicted AQS security scores for the child with that parent at approximately equivalent degrees of association.

Treating obstructive sleep apnea in adults with epilepsy: a randomized pilot trial.

Objective: Small uncontrolled series suggest that treatment of obstructive sleep apnea (OSA) in patients with epilepsy may improve seizure control. Prior to conducting a definitive randomized controlled trial, we addressed critical design issues in a pilot study.

Methods: We identified a cohort of adult patients with medically refractory epilepsy and coexisting OSA, documented by polysomnography (PSG).

Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect?

Purpose: We performed this analysis of possible first night effects (FNEs) on sleep and respiratory parameters in order to evaluate the need for two serial night polysomnograms (PSGs) to diagnose obstructive sleep apnea (OSA) in epilepsy patients.

Methods: As part of a pilot multicenter clinical trial investigating the effects of treating sleep apnea in epilepsy, two nights of PSG recording were performed for 40 patients with refractory epilepsy and OSA symptoms. Sleep architecture was examined in detail, along with respiratory parameters including apnea/hypopnea index (AHI) and minimum oxygen saturation.

Acute respiratory health effects of air pollution on children with asthma in US inner cities.

Background: Children with asthma in inner-city communities may be particularly vulnerable to adverse effects of air pollution because of their airways disease and exposure to relatively high levels of motor vehicle emissions.

Objective: To investigate the association between fluctuations in outdoor air pollution and asthma morbidity among inner-city children with asthma.

Methods: We analyzed data from 861 children with persistent asthma in 7 US urban communities who performed 2-week periods of twice-daily pulmonary function testing every 6 months for 2 years.