Perinatal assessment of infant, parents, and parent-infant relationship: prematurity as an example.

This article reviews the stresses for parents, infants, and other caregivers during the period surrounding the birth of the premature infant. Principles of assessment of infant discomfort, parental stress, the parent-infant relationship, and the match of the medical caregiving environment to the individual infant's needs are discussed. Relevant tools to aide in these aspects of assessment are reviewed. The role of early assessment as preventive intervention and the indication for subsequent intervention in complicated cases of premature infants and their parents are further discussed. The article offers detailed clinical examples to illustrate these and other points throughout.

Central Iowa Juvenile Detention Center in Eldora Iowa, June 30, 2001 & June 30, 2002

Other Audit Reports

City of Center Point, Independent Auditor's Reports, Basic Financial Statements and Supplementary Information, Schedule of Findings, June 30, 2004

City Audit Report

Central Iowa Juvenile Detention Center, June 30, 2003

Other Audit Report

City of State Center, June 30, 2003

City Audit Report

What is the relationship between fear of falling and gait in well-functioning older persons aged 65 to 70 years?

OBJECTIVE: To investigate the association between fear of falling and gait performance in well-functioning older persons. DESIGN: Survey. SETTING: Community. PARTICIPANTS: Subjects (N=860, aged 65-70y) were a subsample of participants enrolled in a cohort study who underwent gait measurements. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Fear of falling and its severity were assessed by 2 questions about fear and related activity restriction. Gait performance, including gait variability, was measured using body-fixed sensors. RESULTS: Overall, 29.6% (210/860) of the participants reported fear of falling, with 5.2% (45/860) reporting activity restriction. Fear of falling was associated with reduced gait performance, including increased gait variability. A gradient in gait performance was observed from participants without fear to those reporting fear without activity restriction and those reporting both fear and activity restriction. For instance, stride velocity decreased from 1.15+/-.15 to 1.11+/-.17 to 1.00+/-.19 m/s (P<.001) in participants without fear, with fear but no activity restriction and with fear and activity restriction, respectively. In multivariate analysis, fear of falling with activity restriction remained associated with reduced gait performance, independent of sex, comorbidity, functional status, falls history, and depressive symptoms. CONCLUSIONS: In these well-functioning older people, those reporting fear of falling with activity restriction had reduced gait performance and increased gait variability, independent of health and functional status. These relationships suggest that early interventions targeting fear of falling might potentially help to prevent its adverse consequences on mobility and function in similar populations.

Physical activity is inversely associated with high blood pressure independently of overweight in Brazilian adolescents.

The purpose of this study was to assess the relationship between blood pressure (BP) levels and physical activity (PA) domains accounting for overweight/obesity. Adolescents aged 10 to 17 years old were recruited (n = 1021). International Obesity Task Force (IOTF) criteria were used to define overweight and obesity. High BP was defined using the Center of Disease Control and Prevention criteria. Different domains of PA (school activities, sport out of school, and leisure time PA) were assessed using a validated questionnaire. The prevalence of overweight/obesity was 21.9% for boys and 14.8% for girls. Some 13.4% of boys and 10.2% of girls, respectively, had high blood pressure (HBP). A strong and positive association was found between overweight and HBP. After adjustment for body mass index (BMI), total PA was inversely associated with BP. When all PA domains were entered simultaneously in a regression model, and after adjustment for BMI, only sport out of school was significantly and inversely associated with systolic BP [β: -0.82 (-1.50; -0.13)]. These findings open avenue for the early prevention of HBP by the prevention of obesity and promotion of PA.

Report of Recommendations to the Iowa Department of Human Services - Central Distribution Center, June 30, 2003

State Agency Audit Report

Report on Special Investigation of the Glenwood Resource Center, For the period June 21, 2002 through December 24, 2003

State Agency Audit Report

Relation soignant-soigné quand les blogs s'en mêlent [Patient-caregiver relationship: when illness blogs step in].

The use of social media as a communication tool is rapidly growing in the community, and more specifically in patients, through illness blogs. This has been true for several years in North America, but is becoming a reality in Europe as well. We report here the first results of studies on the putative psychological benefits and risks of illness blogs for their authors. We also explore the possible impact of blogging on the patient-caregiver relationship. Social media are expected to have a growing influence in certain areas of health care. Physicians should therefore stay informed about them, take advantage of their benefits, and anticipate their risks.

Change in biased thinking in a 10-session treatment for borderline personality disorder: Further evidence of the motive-oriented therapeutic relationship.

Abstract Borderline Personality Disorder (BPD) is characterized by both maladaptive thinking and problematic schemas. Kramer and colleagues (2011) showed that using the motive-oriented therapeutic relationship (MOTR), based on the individualized understanding of the patient according to Plan Analysis (Caspar, 2007), can improve treatment outcomes for BPD. The present process-outcome pilot study aimed to examine the effects of the motive-oriented therapeutic relationship on the cognitive biases of patients with BPD. Change in biased cognitions in N=10 patients who were subject to MOTR was compared to that of N=10 patients who received psychiatric-psychodynamic treatment (Gunderson & Links, 2008). Results show a greater decrease in over-generalizations in patients who received MOTR, compared to the patients who received the psychiatric-psychodynamic treatment. These changes were related to outcome in various ways. These findings underline the importance of an individualized case formulation method in bringing about therapeutic change.

A chemical Hamiltonian approach study of the basis set superposition error changes on electron densities and one- and two-center energy components

A comparision of the local effects of the basis set superposition error (BSSE) on the electron densities and energy components of three representative H-bonded complexes was carried out. The electron densities were obtained with Hartee-Fock and density functional theory versions of the chemical Hamiltonian approach (CHA) methodology. It was shown that the effects of the BSSE were common for all complexes studied. The electron density difference maps and the chemical energy component analysis (CECA) analysis confirmed that the local effects of the BSSE were different when diffuse functions were present in the calculations

One- and two-center physical space partitioning of the energy in the density functional theory

A conceptually new approach is introduced for the decomposition of the molecular energy calculated at the density functional theory level of theory into sum of one- and two-atomic energy components, and is realized in the "fuzzy atoms" framework. (Fuzzy atoms mean that the three-dimensional physical space is divided into atomic regions having no sharp boundaries but exhibiting a continuous transition from one to another.) The new scheme uses the new concept of "bond order density" to calculate the diatomic exchange energy components and gives them unexpectedly close to the values calculated by the exact (Hartree-Fock) exchange for the same Kohn-Sham orbitals