Impact of peanut allergy on quality of life, stress and anxiety in the family

Background: Peanut allergy (PA) is known to impact on quality of life (QoL) of the sufferer, but little research has focused on all family members. We therefore sought to establish the impact of PA on QoL and reported anxiety of children with clinically confirmed PA, their parents and older siblings. Methods: Forty-six families, who had a child with PA, completed QoL (PedsQLTM or WHOQOL-BREF), anxiety (SCAS or STAI) and perceived stress (PSS) scales. PA children completed a PA specific QoL questionnaire (Pediatr Allergy Immunol 2003;14:378). Parents and sibling also completed QoL proxy questionnaires for the PA child (PedsQLTM, Pediatr Allergy Immunol 2003;14:378). Results: Mothers rated their own psychological (P < 0.01) and physical (P < 0.05) QoL significantly worse than fathers rated theirs, and had higher scores than fathers for anxiety (P < 0.05) and stress (P < 0.001). Children with PA had significantly poorer physical health-related QoL (P < 0.05), QoL within school (P < 0.01) and general QoL (P < 0.05) than their siblings did, and greater separation anxiety (P < 0.05). The majority of differences were between girls with PA and female siblings. Mothers felt that there was a greater impact on QoL for their PA child, compared with that reported by siblings, fathers or the PA children themselves (P < 0.01). Conclusions: Mothers report that they have significantly poorer QoL and suffer more anxiety and stress than fathers do; this inter-parental difference may be an important feature of family stress caused by PA. Siblings have a similar view of how QoL affects the PA child as the PA child does, while mothers may possibly overestimate this impact.

A survey on the adoption and usage of broadband internet

In spite of the increasing significance of broadband Internet, there are not many research papers explicitly addressing issues pertaining to its adoption and postadoption. Previous research on broadband has mainly focused on the supply side aspect at the national level, ignoring the importance of the demand side which may involve looking more deeply into the use, as well as factors impacting organizational and individual uptake. In an attempt to fill this gap, the current study empirically verifies an integrated theoretical model comprising the theory of planned behavior and the IS continuance model to examine factors influencing broadband Internet adoption and postadoption behavior of some 1,500 organizations in Singapore. Overall, strong support for the integrated model has been manifested by our results, providing insight into influential factors. At the adoption stage, perceived behavioral control has the greatest impact on behavioral intention. Our findings also suggest that, as compared to attitude, subjective norms and perceived behavioral control more significantly affect the broadband Internet adoption decision. At the postadoption stage, intention is no longer the only determinant of broadband Internet continuance; rather, initial usage was found to significantly affect broadband Internet continuance.

The impact of coordination on the effectiveness of last mile relief distribution

Last mile relief distribution is the final stage of humanitarian logistics. It refers to the supply of relief items from local distribution centers to the disaster affected people (Balcik et al., 2008). In the last mile relief distribution literature, researchers have focused on the use of optimisation techniques for determining the exact optimal solution (Liberatore et al., 2014), but there is a need to include behavioural factors with those optimisation techniques in order to obtain better predictive results. This paper will explain how improving the coordination factor increases the effectiveness of the last mile relief distribution process. There are two stages of methodology used to achieve the goal: Interviews: The authors conducted interviews with the Indian Government and with South Asian NGOs to identify the critical factors for final relief distribution. After thematic and content analysis of the interviews and the reports, the authors found some behavioural factors which affect the final relief distribution. Model building: Last mile relief distribution in India follows a specific framework described in the Indian Government disaster management handbook. We modelled this framework using agent based simulation and investigated the impact of coordination on effectiveness. We define effectiveness as the speed and accuracy with which aid is delivered to affected people. We tested through simulation modelling whether coordination improves effectiveness.

Influence of light exposure during early life on the age of onset of bipolar disorder

Background: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. Methods: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4N and 70.7N, and 1.2S and 41.3S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. Results: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. Conclusions: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.

Effect of support and cultural intelligence on the adjustment and performance of expatriates and their family members in Malaysia

Theory suggests that people fear the unknown and no matter how experienced one is, the feelings of anxiety and uncertainty, if not managed well would affect how we view ourselves and how others view us. Hence, it is in human nature to engage in activities to help decipher behaviours that seem contrary to their beliefs and hinder the smooth-flowing of their work and daily activities. Building on these arguments, this research investigates the two types of support that are provided by multinational corporations (MNCs) and host country nationals (HCNs) to the expatriates and their family members whilst on international assignments in Malaysia as antecedents to their adjustment and performance in the host country. To complement the support provided, cultural intelligence (CQ) is investigated to explain the influence of cultural elements in facilitating adjustment and performance of the relocating families, especially to socially integrate into the host country. This research aims to investigate the influence of support and CQ on the adjustment and performance of expatriates in Malaysia. Path analyses are used to test the hypothesised relationships. The findings substantiate the pivotal roles that MNCs and HCNs play in helping the expatriates and their families acclimatise to the host country. This corroborates the norm of reciprocity where assistance or support rendered especially at the times when they were crucially needed would be reciprocated with positive behaviour deemed of equal value. Additionally, CQ is significantly positive in enhancing adjustment to the host country, which highlights the vital role that cultural awareness and knowledge play in enhancing effective intercultural communication and better execution of contextual performance. The research highlights the interdependence of the expatriates? multiple stakeholders (i.e. MNCs, HCNs, family members) in supporting the expatriates whilst on assignments. Finally, the findings reveal that the expatriate families do influence how the locals view the families and would be a great asset in initiating future communication between the expatriates and HCNs. The research contributes to the fields of intercultural adjustment and communication and also has key messages for policy makers.

Families 'at risk' and the family nurse partnership:the intrusion of risk into social exclusion policy

This article considers why the family nurse partnership (FNP) has been promoted as a means of tackling social exclusion in the UK. The FNP consists in a programme of visits by nurses to low-income first-time mothers, both while the mothers are pregnant and for the first two years following birth. The FNP is focused on both teaching parenthood and encouraging mothers back into education and/or into employment. Although the FNP marks a considerable discontinuity with previous approaches to family health, it is congruent with an emerging new approach to social exclusion. This new approach maintains that the most important task of social policy is to identify quickly the most 'at-risk' households, individuals and children so that interventions can be targeted more effectively at those 'at risk', either to themselves or to others. The article illustrates this new approach by analysing a succession of reports by the Social Exclusion Unit. It indicates that there is a considerable amount of ambiguity about the relationship between specific risk-factors and being 'at risk of social exclusion'. Nonetheless, this new approach helps to explain why British policy-makers may have chosen to promote the new FNP now. © 2009 Cambridge University Press.

Functional neuroimaging studies of bipolar disorder:examining the wide clinical spectrum in the search for disease endophenotypes

Bipolar disorder (BP) is among the top ten most disabling illnesses worldwide. This review includes findings from recent studies employing functional neuroimaging to examine functional abnormalities in neural systems underlying core domains of the psychopathology in BP: emotion processing, emotion regulation and executive control, and common comorbid features of BP, that are relevant to the wide spectrum of BP rather than focused on the more traditional BPI subtype, and that may facilitate future identification of diagnostically-relevant biomarkers of the disorder. In addition, an emerging number of studies are reviewed that demonstrate the use of neuroimaging to elucidate biomarkers whose identification may help to (1) identify at-risk individuals who will subsequently develop the illness to facilitate early intervention, (2) identify targets for treatment and markers of treatment response. The use of newer neuroimaging techniques and potential confounds of psychotropic medication upon neuroimaging findings in BP are also examined. These approaches will help to improve diagnosis and the mental well-being of all individuals with BP.

The Maudsley Early Onset Schizophrenia Study:The effect of age of onset and illness duration on fronto-parietal gray matter

Objective: In Early Onset Schizophrenia (EOS; onset before the 18th birthday) late brain maturational changes may interact with disease mechanisms leading to a wave of back to front structural changes during adolescence. To further explore this effect we examined the relationship between age of onset and duration of illness on brain morphology in adolescents with EOS. Subjects and methods: Structural brain magnetic resonance imaging scans were obtained from 40 adolescents with EOS. We used Voxel Based Morphometry and multiple regressions analyses, implemented in SPM, to examine the relationship between gray matter volume with age of onset and illness duration. Results: Age of onset showed a positive correlation with regional gray matter volume in the right superior parietal lobule (Brodmann Area 7). Duration of illness was inversely related to regional gray matter volume in the left inferior frontal gyrus (BA 11/47). Conclusions: Parietal gray matter loss may contribute to the onset of schizophrenia while orbitofrontal gray matter loss is associated with illness duration. © 2008 Elsevier Masson SAS. All rights reserved.

Neuronal network dynamics during epileptogenesis in the medial temporal lobe

Epilepsy is one of the most common neurological disorders, a large fraction of which is resistant to pharmacotherapy. In this light, understanding the mechanisms of epilepsy and its intractable forms in particular could create new targets for pharmacotherapeutic intervention. The current project explores the dynamic changes in neuronal network function in the chronic temporal lobe epilepsy (TLE) in rat and human brain in vitro. I focused on the process of establishment of epilepsy (epileptogenesis) in the temporal lobe. Rhythmic behaviour of the hippocampal neuronal networks in healthy animals was explored using spontaneous oscillations in the gamma frequency band (SγO). The use of an improved brain slice preparation technique resulted in the natural occurence (in the absence of pharmacological stimulation) of rhythmic activity, which was then pharmacologically characterised and compared to other models of gamma oscillations (KA- and CCh-induced oscillations) using local field potential recording technique. The results showed that SγO differed from pharmacologically driven models, suggesting higher physiological relevance of SγO. Network activity was also explored in the medial entorhinal cortex (mEC), where spontaneous slow wave oscillations (SWO) were detected. To investigate the course of chronic TLE establishment, a refined Li-pilocarpine-based model of epilepsy (RISE) was developed. The model significantly reduced animal mortality and demonstrated reduced intensity, yet high morbidy with almost 70% mean success rate of developing spontaneous recurrent seizures. We used SγO to characterize changes in the hippocampal neuronal networks throughout the epileptogenesis. The results showed that the network remained largely intact, demonstrating the subtle nature of the RISE model. Despite this, a reduction in network activity was detected during the so-called latent (no seizure) period, which was hypothesized to occur due to network fragmentation and an abnormal function of kainate receptors (KAr). We therefore explored the function of KAr by challenging SγO with kainic acid (KA). The results demonstrated a remarkable decrease in KAr response during the latent period, suggesting KAr dysfunction or altered expression, which will be further investigated using a variety of electrophysiological and immunocytochemical methods. The entorhinal cortex, together with the hippocampus, is known to play an important role in the TLE. Considering this, we investigated neuronal network function of the mEC during epileptogenesis using SWO. The results demonstrated a striking difference in AMPAr function, with possible receptor upregulation or abnormal composition in the early development of epilepsy. Alterations in receptor function inevitably lead to changes in the network function, which may play an important role in the development of epilepsy. Preliminary investigations were made using slices of human brain tissue taken following surgery for intratctable epilepsy. Initial results showed that oscillogenesis could be induced in human brain slices and that such network activity was pharmacologically similar to that observed in rodent brain. Overall, our findings suggest that excitatory glutamatergic transmission is heavily involved in the process of epileptogenesis. Together with other types of receptors, KAr and AMPAr contribute to epilepsy establishment and may be the key to uncovering its mechanism.