Issuance of patient reminders for influenza vaccination by US-based primary care physicians during the first year of universal influenza vaccination recommendations.

To estimate the number of physician-reported influenza vaccination reminders during the 2010-2011 influenza season, the first influenza season after universal vaccination recommendations for influenza were introduced, we interviewed 493 members of the Physicians Consulting Network. Patient vaccination reminders are a highly effective means of increasing influenza vaccination; nonetheless, only one quarter of the primary care physicians interviewed issued influenza vaccination reminders during the first year of universal vaccination recommendations, highlighting the need to improve office-based promotion of influenza vaccination.

Pain and beliefs after musuloskeletal trauma: Complex relationships during the first year of rehabilitation

Introduction.- Pain and beliefs have an influence on the patient's course in rehabilitation and their relationships are complex. The aim of this study was to understand the relationships between pain at admission and the evolution of beliefs during rehabilitation as well as the relationships between pain and beliefs one year after rehabilitation.Patients and methods.- Six hundred and thirty-one consecutive patients admitted in rehabilitation after musculoskeletal trauma, were included and assessed at admission, at discharge and one year after discharge. Pain was measured by VAS (Visual Analogical Scale) and beliefs by judgement on Lickert scales. Four kinds of beliefs were evaluated: fear of a severe origin of pain, fear of movement, fear of pain and feeling of distress (loss of control). The association between pain and beliefs was assessed by logistic regressions, adjusted for gender, age, native language, education and bio-psycho-social complexity.Results.- At discharge, 44% of patients felt less distressed by pain, 34% are reinsured with regard to their fear of a severe origin of pain, 38% have less fear of pain and 33% have less fear of movement. The higher the pain at admission, the higher the probability that the distress diminished, this being true up to a threshold (70 mm/100) beyond which there was a plateau. At one year, the higher the pain, the more dysfunctional the fears.Discussion.- The relationships between pain and beliefs are complex and may change all along rehabilitation. During hospitalization, one could hope that the patient would be reinsured and would gain self-control again, if pain does not exceed a certain threshold. After one year, high pain increases the risk of dysfunctional beliefs. For clinical practice, these data suggest to think in terms of the more accessible "entrance door", act against pain and/or against beliefs, adpated to each patient.

Effets du stress sur l'évolution des représentations parentales au cours des 12 premiers mois de vie d'un enfant né avec une fente faciale = Stress influence on parental representations' development during the first year of a child born with a facial cleft

La venue au monde d'un enfant avec une fente faciale constitue un événement stressant, voire traumatique, pour les parents. Que ce soit à travers le risque de symptômes associés, la logistique d'alimentation ou par simples raisons d'esthétisme, de nombreuses personnes vivent l'annonce de la présence d'une fente faciale comme une intrusion brutale dans le vécu de la grossesse et une interruption momentanée de l'investissement représentationnel du foetus. À travers notre recherche, nous montrons qu'un haut stress n'influe pas forcément négativement sur le développement de la relation entre le parent et l'enfant et que, au contraire, dans le cas des pères, il peut contribuer à l'implication émotionnelle envers le bébé. Le moment de l'annonce de la malformation a aussi une importance dans les représentations à propos de l'enfant puisque si elle est faite durant la période prénatale, elle permet aux parents un réarrangement des représentations afin de mieux accueillir le bébé le jour de sa naissance. The birth of a child with a facial cleft is often seen as a very stressing event for both parents. Risks of comorbidity, difficulty in nutrition or just aesthetical reasons are frequently invoked while describing this moment. The announcement of the deformation is felt like a brutal intrusion in representations associated to pregnancy. Then, we can observe a kind of disinvestment of the coming baby. Through our study, we find that high stress has not always a bad issue on relationship between parents and infants. In contrary, this kind of chronic stress can preserve the well-being of the relationship, especially for fatherhood. The time of facial deformation announcement also plays its part in representations about the baby. Before birth, it opens room for reordering and modifying representations, then the baby will be accepted as it should be on his birthday.

Estimation of reference curves for the urinary steroid metabolome in the first year of life in healthy children : Tracing the complexity of human postnatal steroidogenesis.

CONTEXT: Complex steroid disorders such as P450 oxidoreductase deficiency or apparent cortisone reductase deficiency may be recognized by steroid profiling using chromatographic mass spectrometric methods. These methods are highly specific and sensitive, and provide a complete spectrum of steroid metabolites in a single measurement of one sample which makes them superior to immunoassays. The steroid metabolome during the fetal-neonatal transition is characterized by (a) the metabolites of the fetal-placental unit at birth, (b) the fetal adrenal androgens until its involution 3-6 months postnatally, and (c) the steroid metabolites produced by the developing endocrine organs. All these developmental events change the steroid metabolome in an age- and sex-dependent manner during the first year of life. OBJECTIVE: The aim of this study was to provide normative values for the urinary steroid metabolome of healthy newborns at short time intervals in the first year of life. METHODS: We conducted a prospective, longitudinal study to measure 67 urinary steroid metabolites in 21 male and 22 female term healthy newborn infants at 13 time-points from week 1 to week 49 of life. Urine samples were collected from newborn infants before discharge from hospital and from healthy infants at home. Steroid metabolites were measured by gas chromatography-mass spectrometry (GC-MS) and steroid concentrations corrected for urinary creatinine excretion were calculated. RESULTS: 61 steroids showed age and 15 steroids sex specificity. Highest urinary steroid concentrations were found in both sexes for progesterone derivatives, in particular 20α-DH-5α-DH-progesterone, and for highly polar 6α-hydroxylated glucocorticoids. The steroids peaked at week 3 and decreased by ∼80% at week 25 in both sexes. The decline of progestins, androgens and estrogens was more pronounced than of glucocorticoids whereas the excretion of corticosterone and its metabolites and of mineralocorticoids remained constant during the first year of life. CONCLUSION: The urinary steroid profile changes dramatically during the first year of life and correlates with the physiologic developmental changes during the fetal-neonatal transition. Thus detailed normative data during this time period permit the use of steroid profiling as a powerful diagnostic tool.

AVOIDING FIRST-YEAR UNIVERSITY CHEMISTRY TEXTBOOKS’ MISREPRESENTATIONS IN THE TEACHING OF SPONTANEOUS REACTIONS

This paper summarizes the misrepresentations related to Gibbs energy in general chemistry textbooks. These misrepresentations arise from a problem in the terminology textbooks use. Thus, after reviewing the proper definition of each of the terms analyzed, we present two problems to exemplify the correct treatment of the quantities involved, which may help in the discussion and clarification of the misleading conventions and assumptions reported in this study.

Group mentoring for junior medical students: perceptions of mentees and mentors

Entering medical school can be associated with a number of difficulties that can hinder students' performance. Mentoring programs are designed to help students circumvent difficulties and improve their learning and personal development. The current study aimed to evaluate the perceptions of both students and mentors regarding a recently introduced, group-based mentoring program designed to support first-year students. After one year of regular meetings, students and mentors' perceptions of the program were assessed by means of structured questionnaires. Response content categories were identified through multiple readings. Both regular attendees and non-participating students had positive opinions about the program. Mentors were highly satisfied at having participated and acknowledged that the program has been useful not only for assisting students, but also for fostering their own personal and professional development. In conclusion, the group-based mentoring program is feasible and can elicit positive views from both mentors and students. In addition, faculty members' participation as mentors can also be beneficial, since the program appears to contribute to their own personal and professional development

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8%. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1%, P < 0.001; CD8+, 70.9 vs 79.6%, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7%, P < 0.001; CD8+, 8.6 vs 4.8%, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.

Towards Equitable Access to Postsecondary Education: Learning From the Voices of First Generation Students

This qualitative, phenomenological study investigated first generation students’ perceptions of the challenges they experienced in the process of accessing higher education and the type of school-based support that was received. Particular emphasis was placed on the impact of parental education level on access to postsecondary education (PSE) and how differences in support at the primary and secondary levels of schooling influenced access. Purposeful, homogenous sampling was used to select 6 first generation students attending a postsecondary institution located in Ontario. Analysis of the data revealed that several interrelated factors impact first generation students’ access to postsecondary education. These include familial experiences and expectations, school streaming practices, secondary school teachers’ and guidance counselors’ representations of postsecondary education, and the nature of school-based support that participants received. The implications for theory, research, and practice are discussed and recommendations for enhancing school-based support to ensure equitable access to postsecondary education for first generation students are provided.

Progressive French Reader First year

UANL

Development and/or change of the notion of permanent object and operative causality: empirical evidence in the first year of life

This study examines the notion of permanent object during the first year of life, taking into account the controversy of two approaches about the nature of change: developmental change and cognitive change. Using a longitudinal/cross-sectional design, tasks adapted of the subscale of permanent object and operative causality of the Uzgiris-Hunt Scale (Uzgiris and Hunt, 1975) (Uzgiris & Hunt, 1975) were presented to 110 infants of 0, 3, 6 and 9 months-old, which reside in three cities of Colombia. The results showed three types of strategies: (a) Not resolution; (b) Exploratory and (c) Resolution, which follow different trajectories in children’s performance. This allows affirming that adaptive conquests of the cognitive development stay together with the variety of strategies. Using strategies reveals adjustments and transformations of action programs that consolidate the notion of permanent object not necessarily with age, but with self-regulatory processes. Empirical evidence contributes to the understanding of the relations between the emergence of novelty in the development and performance variability

A model of the three-dimensional evolution of Arctic melt ponds on first-year and multiyear sea ice

During winter the ocean surface in polar regions freezes over to form sea ice. In the summer the upper layers of sea ice and snow melts producing meltwater that accumulates in Arctic melt ponds on the surface of sea ice. An accurate estimate of the fraction of the sea ice surface covered in melt ponds is essential for a realistic estimate of the albedo for global climate models. We present a melt-pond–sea-ice model that simulates the three-dimensional evolution of melt ponds on an Arctic sea ice surface. The advancements of this model compared to previous models are the inclusion of snow topography; meltwater transport rates are calculated from hydraulic gradients and ice permeability; and the incorporation of a detailed one-dimensional, thermodynamic radiative balance. Results of model runs simulating first-year and multiyear sea ice are presented. Model results show good agreement with observations, with duration of pond coverage, pond area, and ice ablation comparing well for both the first-year ice and multiyear ice cases. We investigate the sensitivity of the melt pond cover to changes in ice topography, snow topography, and vertical ice permeability. Snow was found to have an important impact mainly at the start of the melt season, whereas initial ice topography strongly controlled pond size and pond fraction throughout the melt season. A reduction in ice permeability allowed surface flooding of relatively flat, first-year ice but had little impact on the pond coverage of rougher, multiyear ice. We discuss our results, including model shortcomings and areas of experimental uncertainty.

Evidence for interplay between genes and parenting on infant temperament in the first year of life: monoamine oxidase A polymorphism moderates effects of maternal sensitivity on infant anger proneness

Background The low expression polymorphism of the MAOA gene in interaction with adverse environments (G × E) is associated with antisocial behaviour disorders. These have their origins in early life, but it is not known whether MAOA G × E occurs in infants. We therefore examined whether MAOA G × E predicts infant anger proneness, a temperamental dimension associated with later antisocial behaviour disorders. In contrast to previous studies, we examined MAOA G × E prospectively using an observational measure of a key aspect of the infant environment, maternal sensitivity, at a specified developmental time point. Methods In a stratified epidemiological cohort recruited during pregnancy, we ascertained MAOA status (low vs. high expression alleles) from the saliva of 193 infants, and examined specific predictions to maternal report of infant temperament at 14 months from maternal sensitivity assessed at 29 weeks of age. Results Analyses, weighted to provide general population estimates, indicated a robust interaction between MAOA status and maternal sensitivity in the prediction of infant anger proneness (p = .003) which became stronger once possible confounders for maternal sensitivity were included in the model (p = .0001). The interaction terms were similar in males (p = .010) and females (p = .016), but the effects were different as a consequence of an additional sex of infant by maternal sensitivity interaction. Conclusions This prospective study provides the first evidence of moderation by the MAOA gene of effects of parenting on infant anger proneness, an important early risk for the development of disruptive and aggressive behaviour disorders.