Two -way direction of influence in mother-infant interaction as denoted by concurrent reciprocal learning processes

This series of 5 single-subject studies used the operant conditioning paradigm to investigate, within the two-way influence process, how (a) contingent infant attention can reinforce maternal verbal behaviors during a period of mother-infant interaction and under subsequent experimental manipulation. Differential reinforcement was used to determine if it is possible that an infant attending to the mother (denoted by head-turns towards the image of the mother plus eye contact) increases (reinforces) the mother's verbal response (to a cue from the infant) upon which the infant behavior is contingent. There was also (b) an evaluation during the contrived parent-infant interaction for concurrent operant learning of infant vocal behavior via contingent verbal responding (reinforcement) implemented by the mother. Further, it was noted (c) whether or not the mother reported being aware that her responses were influenced by the infant's behavior. Findings showed: the operant conditioning of the maternal verbal behaviors were reinforced by contingent infant attention; and the operant conditioning of infant vocalizations was reinforced by contingent maternal verbal behaviors. No parent reported (1) being aware of the increase in their verbal response reinforced during operant conditioning of parental behavior nor a decrease in those responses during the DRA reversal phase, or (2) noticing a contingency between infant's and mother's response. By binomial 1-tail tests, the verbal-behavior patterns of the 5 mothers were conditioned by infant reinforcement (p < 0.02) and, concurrently, the vocal-response patterns of the 5 infants were conditioned by maternal reinforcement (p < 0.02). A program of systematic empirical research on the determinants of concurrent conditioning within mother-child interaction may provide a way to evaluate the differential effectiveness of interventions aimed at improving parent-child interactions. The work conducted in the present study is one step in this direction. ^

*Adoption status: A risk factor or protective factor for children of divorced families

This study examined two competitive hypotheses: the double jeopardy hypothesis and the buffering effect hypothesis on whether parental divorce affects adopted children and non-adopted children similarly or differently. The double jeopardy hypothesis suggests that when adopted children experience their parents' divorce, they perform worse because they carry two risk factors, adoption status and parental divorce, while their non-adopted counterparts carry only the risk factor of their parents' divorce. The buffering effect hypothesis suggests that, being adopted children, their previous experiences of parental loss help them better deal with the later loss of their parents' divorce so their adoption status is a protective factor rather than a risk factor. ^ Secondary analyses of a nation-wide data set were executed using different statistical methods such as ANOVA and Chi-square on different outcome variables. The results indicated that there was no evidence supporting the double-jeopardy hypothesis. That is, adopted children from divorced families did not perform significantly worse than the non-adopted children from divorced families on any outcome variable. The results also indicated that there was only weak evidence supporting the buffering effect hypothesis. The general conclusion based on the results from most of the outcome variables suggest that adopted children from divorced families do not perform differently than the biological children from divorced families. ^

Factors surgical team members perceive influence choices of wearing or not wearing personal protective equipment during operative /invasive procedures

Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.

Acculturation and Diabetes Self-management of Cuban Americans: Is Age a Protective Factor?

Migration to the United States has been linked to obesity and poor diet quality. We investigated the relationship among diabetes self-management, diet, age and acculturation factors for 182 Cuban-Americans (Females = 110, Males = 72) with type 2 diabetes recruited from a randomized mailing list in South Florida. Inadequate glycemic control (β = 0.257), BMI (β = 0.251), total fat intake (β = 0.251), and smoking (β = 0.200), were positively associated, while understanding of overall diabetes care (β = -0.165), was negatively associated with migration (N = 162, adj.R2 = 0.286, F = 14.65, p < 0.001). These associations suggest that effective diabetes education targeting acculturation issues is lacking.

Factors Surgical Team Members Perceive Influence Choices of Wearing or not Wearing Personal Protective Equipment During Operative/Invasive Procedures

Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.

The Effects of Peer Teaching of Infant Massage on General Self-Efficacy and Mother Infant Attachment Among Mothers in a Residential Rehabilitation Facility for Drug Addiction and Substance Abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

Mother-Infant Reciprocity and the Development of Joint Attention in 12 Month Old Infants

Social contingency is the ability to connect social stimuli, such as those behaviors performed by oneself and those performed by others. Detecting social contingencies occurs by means of reciprocity through shared experiences with others. Reciprocity denotes a circumstance in which two individuals participate in a collaborative exchange, and is distinguished from an event in which two individuals engage in separate, unrelated activities. Specifically, reciprocity incorporates joint attention (JA), which occurs when two individuals simultaneously and visually attend to the same item. JA is facilitated by gazing and pointing, whereby one individual initiates the action and the second individual follows suit by, for example, gaze-following. However, little is known about the role the mother may play in the development of JA. The purpose of our study was to investigate social contingency between mothers and infants engaging in dyadic interactions. Thirty-three 12-month-old typically developing infants (M = 12.2, SD = .19; N = 19 males) were filmed for 10 minutes during free play with their mothers and toys provided by an experimenter. Reciprocity was measured by coding mother-infant interactions when a precise chain of events occurred: (1) mother initiated a bid by introducing a toy/activity or request to the infant, (2) infant accepted the bid/request by engaging in play with the given toy/activity, and (3) mother persisted by continuing to engage in play with said toy/activity. We computed a Pearson Correlation to assess the relation between the mothers’ initiations of JA and their infants’ responses to JA. We found a moderately positive correlation between the two variables (r= 0.37, p<.05). Our findings suggest that reciprocity, an important component of social relationships, during parent-infant dyads may serve as a scaffold for joint attention abilities, which have been linked to social and language development.

Risk and protective factors in the mental health of adolescents living with HIV in Namibia

"Introducción": A pesar de que el 90% de los adolescentes con VIH en el mundo viven en África subsahariana, pocos estudios han examinado el impacto que tiene el hecho de estar infectados por VIH sobre su salud mental en este región. Además, los adolescentes con VIH en contextos de escasos recursos se enfrentan con factores de riesgo adicionales, como la pobreza, la falta de apoyo social y el estigma relacionado con el VIH. Este estudio examina la salud mental de los adolescentes que viven con el VIH en Namibia, un país con una de las prevalencias de VIH más altas del mundo. El estudio examina si estos adolescentes muestran mayores problemas de salud mental respecto a un grupo de comparación de la comunidad. Asimismo, el estudio evalúa los factores que predicen problemas de salud mental con el fin de identificar las potenciales áreas de intervención que permitan mejorar dichos problemas. Métodos: En una fase piloto, se organizan grupos de discusión con 34 adolescentes y entrevistas con ocho informantes clave para explorar las percepciones locales sobre los problemas de salud mental, así como sus factores de riesgo y factores de proteccion. Dado que las propiedades psicométricas del instrumento seleccionado para medir salud mental, el cuestionario Strengths and Difficulties Questionnaire/ Cuestionario de Capacidades y Dificultades (SDQ), nunca habían sido exploradas antes en Namibia, se decidió administrarlo a 236 participantes con edades comprendidas entre 12 y 18 años en una fase piloto cuantitativa...

Mother with child at work (day care)

General note: Title and date provided by Bettye Lane.

Mother Teresa at International Women's Year Conference in Mexico City

General note: Title and date provided by Bettye Lane.

Sarah Montgomery, mother of gay son, at demonstration

General note: Title and date provided by Bettye Lane.

Founder of Hale House and her daughter Dr. Lorraine E. Hale attend celebration for Mother Hale's work involving the housing of addicted infants, at Westbeth's Artists Gallery

General note: Title and date provided by Bettye Lane.

Women in support of surrogate mother Mary Beth Whitehead at NJ Courthouse

General note: Title and date provided by Bettye Lane.

Writer Dr. Phyllis Chelser reads a statement in support of surrogate mother Mary Beth Whitehead in front of New Jersey Court House

General note: Title and date provided by Bettye Lane.