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Causal Pathways (causal + pathway)
Selected AbstractsModeling the genetic and environmental association between peer group deviance and cannabis use in male twinsADDICTION, Issue 3 2009Nathan A. Gillespie ABSTRACT Background Peer group deviance (PGD) is linked strongly to liability to drug use, including cannabis. Our aim was to model the genetic and environmental association, including direction of causation, between PGD and cannabis use (CU). Method Results were based on 1736 to 1765 adult males from the Mid-Atlantic Twin Registry with complete CU and PGD data measured retrospectively at three time-intervals between 15 and 25 years using a life-history calendar. Results At all ages, multivariate modeling showed that familial aggregation in PGD was explained by a combination of additive genetic and shared environmental effects. Moreover, the significant PGD,CU association was best explained by a CU,PGD causal model in which large portions of the additive genetic (50,78%) and shared environmental variance (25,73%) in PGD were explained by CU. Conclusions Until recently PGD was assumed to be an environmental, upstream risk factor for CU. Our data are not consistent with this hypothesis. Rather, they suggest that the liability to affiliate with deviant peers is explained more clearly by a combination of genetic and environmental factors that are indexed by CU which sits as a ,risk indicator' in the causal pathway between genetic and environmental risks and the expression of PGD. This is consistent with a process of social selection by which the genetic and environmental risks in CU largely drive the propensity to affiliate with deviant peers. [source] Effects of maternal smoking in pregnancy on prenatal brain development.EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2007The Generation R Study Abstract Nicotine, as has been shown in animal studies, is a neuroteratogen, even in concentrations that do not cause growth retardation. In humans, there is only indirect evidence for negative influences of nicotine on brain development from studies on the association between maternal smoking in pregnancy and behavioural and cognitive development in the offspring. We investigated the associations of maternal smoking in pregnancy with foetal head growth characteristics in 7042 pregnant women. This study was embedded in the Generation R Study, a population-based prospective cohort study from foetal life until adulthood. Maternal smoking was assessed by questionnaires in early, mid- and late pregnancy. Head circumference, biparietal diameter, transcerebellar diameter and atrial width of lateral ventricles were repeatedly measured by ultrasound. When mothers continued to smoke during pregnancy, foetal head circumference showed a growth reduction of 0.13 mm [95% confidence interval (CI): ,0.18, ,0.09] per week compared to foetuses of mothers who never smoked during pregnancy. Biparietal diameter of foetuses with smoking mothers grew 0.04 mm (95% CI: ,0.05, ,0.02) less per week than that of foetuses of nonsmoking mothers. Atrial width of lateral ventricle was 0.12 mm (95% CI: ,0.22, ,0.02) smaller and transcerebellar diameter was 0.08 mm (95% CI: ,0.15, ,0.00) smaller if mothers smoked, but growth per week of these characteristics was not affected by maternal smoking in pregnancy. In conclusion, continuing to smoke during pregnancy leads to reduced growth of the foetal head. Further research should focus on the causal pathway from prenatal cigarette exposure via brain development to behavioural and cognitive functions. [source] Near miss and minor occupational injury: Does it share a common causal pathway with major injury?AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Hasanat Alamgir MBA Abstract Background An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. Methods The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. Results For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. Conclusions Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs. Am. J. Ind. Med. 52:69,75, 2009. © 2008 Wiley-Liss, Inc. [source] Lifetime comorbidities between phobic disorders and major depression in Japan: results from the World Mental Health Japan 2002,2004 Survey,DEPRESSION AND ANXIETY, Issue 10 2009Masao Tsuchiya M.A. Abstract Background: Although often considered of minor significance in themselves, evidence exists that early-onset phobic disorders might be predictors of later more serious disorders, such as major depressive disorder (MDD). The purpose of this study is to investigate the association of phobic disorders with the onset of MDD in the community in Japan. Methods: Data from the World Mental Health Japan 2002,2004 Survey were analyzed. A total of 2,436 community residents aged 20 and older were interviewed using the WHO Composite International Diagnostic Interview 3.0 (response rate, 58.4%). A Cox proportional hazard model was used to predict the onset of MDD as a function of prior history of DSM-IV specific phobia, agoraphobia, or social phobia, adjusting for gender, birth-cohort, other anxiety disorders, education, and marital status at survey. Results: Social phobia was strongly associated with the subsequent onset of MDD (hazard ratio [HR]=4.1 [95% CI: 2.0,8.7]) after adjusting for sex, birth cohort, and the number of other anxiety disorders. The association between agoraphobia or specific phobia and MDD was not statistically significant after adjusting for these variables. Conclusions: Social phobia is a powerful predictor of the subsequent first onset of MDD in Japan. Although this finding argues against a simple neurobiological model and in favor of a model in which the cultural meanings of phobia play a part in promoting MDD, an elucidation of causal pathways will require more fine-grained comparative research. Depression and Anxiety, 2009. Published 2009 Wiley-liss, Inc. [source] Do mood disorders alter crying? a pilot investigationDEPRESSION AND ANXIETY, Issue 5 2008Jonathan Rottenberg Ph.D. Abstract Clinical commentators widely interpret crying as a sign of depressed mood. However, there is virtually no empirical data on this topic, and the evidence that mood disorders alter crying is surprisingly weak. This study compared mood disordered patients to a nonpsychiatric reference group on the frequency, antecedents, and consequences of crying behavior using a well-validated questionnaire measure of crying. Forty-four outpatients diagnosed with three forms of mood pathology were age and gender matched to a reference group of 132 participants sampled to be representative of the Dutch population. Both groups completed the Adult Crying Inventory, which provides estimates of the self-reported frequency, antecedents, and consequences of crying behavior. Depression severity and psychiatric symptom severity data were also collected from patients. Compared with the reference group, patients with mood pathology reported increased cry proneness to negative antecedents. By contrast, patients and controls did not differ in reported cry proneness to positive antecedents. Patients reported less mood improvement after crying than did controls. Among male patients, but not female patients, depression severity was associated with increased crying proneness and increased crying frequency. This pilot investigation suggests that mood disorders increase the frequency of negative emotional crying, and may also alter the functions of this behavior. Mood disorders may influence male crying to a greater extent than female crying. Future directions designed to clarify the causal pathways between mood disorders and alterations in crying behavior are discussed. Depression and Anxiety 0:1,7, 2007. © 2007 Wiley-Liss, Inc. [source] Private-Sector Investment in Infrastructure: Rationale and Causality for Pro-poor ImpactsDEVELOPMENT POLICY REVIEW, Issue 4 2009Rebecca Shah This article reviews the arguments for promoting private investment in infrastructure as a basis for poverty reduction in developing countries. It describes the experience leading to the development of international ,facilities' intended to address impediments to private investment. It then explores three ,levels' of literature: that of the facilities themselves, of donor organisations, and of academic authors. At each, it investigates the rationale and causal pathways leading from support for private investment to pro-poor outcomes. It finds there is a possible but not necessary association between private investment, economic growth and poverty reduction, but the causal chain is poorly understood. It proposes the development of such a causal framework. [source] The diabetic foot: grand overview, epidemiology and pathogenesisDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S1 2008Andrew J. M. Boulton Abstract This review assesses the progress that has been made over the last quarter century in our understanding of the pathogenesis of diabetic foot problems as well as in their management. Some recent exciting developments are highlighted. This is followed by a brief discussion on the epidemiology and causal pathways to diabetic foot disease. Copyright © 2008 John Wiley & Sons, Ltd. [source] Mental health and alcohol, drugs and tobacco: a review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugsDRUG AND ALCOHOL REVIEW, Issue 6 2006EVA JANE-LLOPIS Abstract This paper reviews some major epidemiological studies undertaken in high-income countries during the last 15 years which have reported the prevalence of mental disorders and substance use disorders and their relationship. Comorbidity between mental and substance use disorders is highly prevalent across countries. In general, people with a substance use disorder had higher comorbid rates of mental disorders than vice versa, and people with illicit drug disorders had the highest rates of comorbid mental disorders. There is a strong direct association between the magnitude of comorbidity and the severity of substance use disorders. While causal pathways differ across substances and disorders, there is evidence that alcohol is a casual factor for depression, in some European countries up to 10% of male depression. Policies that reduce the use of substances are likely to reduce the prevalence of mental disorders. Treatment should be available in an integrated fashion for both mental and substance use disorders. There is a need to expand the evidence base on comorbidity, particularly in low-income countries. [source] Ecohydrological feedbacks and linkages associated with land degradation: a case study from MexicoHYDROLOGICAL PROCESSES, Issue 15 2006Elisabeth Huber-Sannwald Abstract Land degradation and desertification are major environmental problems of human societies in drylands of North and South America. Mexico is one of the most severely affected countries. An assessment of how both biophysical and socio-economic processes simultaneously affect, and are affected by, land degradation is recognized as one of the most important and challenging topics in the research on global change. Towards meeting this challenge, in June 2004 an interdisciplinary mix of scientists assembled in Mexico to participate in a workshop convened by the ARIDnet network. The focus of the workshop was to apply a new conceptual framework,the Dahlem Desertification Paradigm (DDP),to La Amapola, a small rural community located in the Central Plateau of Mexico. The DDP aims to advance understanding of global desertification issues by focusing on the interrelationships within coupled human-environment systems that cause desertification. In this paper we summarize the conclusions of the La Amapola workshop. First, we present a brief review of some of the broader issues and concerns of global desertification, which led to the formation of ARIDnet and to the DDP. Second, we provide an overview of land degradation issues in La Amapola, highlighting examples of hydrological linkages between biophysical and socio-economic factors. Third, we summarize our findings in a conceptual model, which highlights linkages between biophysical and socio-economic factors in La Amapola, and the role of hydrology in desertification. Lastly, we discuss the results derived from the application of the major assertions of the DDP to La Amapola. The numerous feedbacks, linkages, and causal pathways between the biophysical and human dimensions suggest that hydrology is the fundamental component of the livelihoods of rural communities in this region of Mexico, and thus it is of central importance when evaluating desertification. Copyright © 2006 John Wiley & Sons, Ltd. [source] Cross-sectional survey of risk factors for asthma in 6,7-year-old children in New Zealand: International Study of Asthma and Allergy in Childhood Phase ThreeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2009Edwin A Mitchell Aim: To identify risk factors for asthma in primary school-aged children in New Zealand. Methods: A cross-sectional survey of 10 873 6,7-year-old children in Auckland, Bay of Plenty, Nelson and Christchurch (a response rate of 85.2%). A questionnaire was completed by the parent or care giver. Results: 22.2% of children wheezed in the last 12 months (current wheeze). Maori children were at greater risk of current wheeze compared with European children (adjusted odds ratio (adjOR) = 1.37; 95% confidence interval = 1.18,1.59). Antibiotics and paracetamol used in the first year of life were associated with an increased risk of current wheeze (adjOR = 1.78 (1.56,2.04) and adjOR = 1.31 (1.06,1.61), respectively). Watching television for 5 or more hours per day was associated with an increased risk of current wheeze (adjOR = 1.44 (1.13,1.83)). Milk and egg consumption in the last 12 months was associated with a reduced risk of current wheeze. Conclusions: This study has identified risk factors for asthma in children aged 6,7 years, although causal pathways cannot be established. These associations have important public health implications if causal. [source] Even Lawyers Get the Blues: Gender, Depression, and Job Satisfaction in Legal PracticeLAW & SOCIETY REVIEW, Issue 1 2007John Hagan It is an intriguing puzzle that women lawyers, despite less desirable working conditions and blocked career advancement, report similar satisfaction as men lawyers with their legal careers. The paradoxical work satisfaction reported by women and men lawyers obscures a more notable difference in their depressed or despondent feelings. Using a panel study of women and men lawyers practicing in Toronto since the mid-1980s, we find at least three causal pathways through which gender indirectly is connected to job dissatisfaction and feelings of despondency. The first path is through gender differences in occupational power, which lead to differential despondency. The second path is through differences in perceived powerlessness, which directly influence job dissatisfaction. The third path is through feelings of despondency that result from concerns about the career consequences of having children. The combined picture that results illustrates the necessity to include measures of depressed affect in studies of dissatisfaction with legal practice. Explicit measurement and modeling of concerns about the consequences of having children and depressed feelings reveal a highly gendered response of women to legal practice that is otherwise much less apparent. Women are more likely to respond to their professional grievances with internalized feelings of despondency than with externalized expressions of job dissatisfaction. That is, they are more likely to privatize than publicize their professional troubles. [source] Silent mysteries: epigenetic paradigms could hold the key to conquering the epidemic of allergy and immune diseaseALLERGY, Issue 1 2010D. J. Martino Abstract Epigenetic mechanisms provide new insights into how environmental changes may mediate the increasing propensity for complex immune diseases such as allergic disease. There is now strong evidence that early environmental exposures play a key role in activating or silencing genes by altering DNA and histone methylation, histone acetylation and chromatin structure. These modifications determine the degree of DNA compaction and accessibility for gene transcription, altering gene expression, phenotype and disease susceptibility. While there is already evidence that a number of early environmental exposures are associated with an increased risk of allergic disease, several new studies indicate in utero microbial and dietary exposures can modify gene expression and allergic disease propensity through epigenetic modification. This review explores the evidence that immune development is under clear epigenetic regulation, including the pattern of T helper (Th)1 and Th2 cell differentiation, regulatory T cell differentiation, and more recently, Th17 development. It also considers the mechanisms of epigenetic regulation and early immune defects in allergy prone neonates. The inherent plasticity conferred by epigenetic mechanisms clearly also provides opportunities for environmental strategies that can re-programme gene expression for disease prevention. Identifying genes that are differentially silenced or activated in relation to subsequent disease will not only assist in identifying causal pathways, but may also help identify the contributing environmental factors. [source] Determinants of termination of breastfeeding within the first 2 years of life in India: evidence from the National Family Health Survey-2MATERNAL & CHILD NUTRITION, Issue 3 2008Rahul Malhotra Abstract The present study assesses socio-demographic and health service determinants of termination of breastfeeding within the first 2 years of life in India by analysing data from the nationally representative National Family Health Survey-2 using Cox regression modelling techniques. While the likelihood of stopping breastfeeding increased with increasing household wealth status, it declined with increasing maternal age at childbirth. The likelihood of stopping breastfeeding was significantly higher among female children compared with male children, and the gender differential was attenuated by increasing maternal educational status. Overall, findings of the present study suggest that breastfeeding promotion programmes in India should focus on certain high-risk mother,child pairs such as female infants, first-born babies, babies born in the private sector and in urban areas, as well as mothers who are literate, have a higher wealth status, are aged less than 20 years and belong to Sikh or Christian communities. Qualitative studies to understand cultural factors or norms and causal pathways responsible for the association of identified factors and early termination of breastfeeding, especially household wealth status and maternal education, are also called for. [source] Bronchopulmonary dysplasia and brain white matter damage in the preterm infant: a complex relationshipPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2009Luigi Gagliardi Summary We analysed the relationship between bronchopulmonary dysplasia (BPD) and brain white matter damage (WMD) in very preterm infants, adjusting for common risk factors and confounders. We studied a cohort of infants <32 weeks gestational age (GA) and <1500 g, admitted to 12 hospitals in Northern Italy in 1999,2002. The association between BPD and WMD was estimated by generalised estimating equations and conditional logistic models, adjusting for centre, GA, propensity score for prolonged ventilation and other potential confounders. Directed acyclic graphs (DAG) were used to depict the underlying causal structure and guide analysis. Of the 1209 infants reaching 36 weeks, 192 (15.8%) developed BPD (supplemental oxygen at 36 weeks) and 88 (7.3%) ultrasound-defined WMD (cystic periventricular leukomalacia). In crude analysis, BPD was a strong risk factor for WMD [odds ratio (OR) = 5.9]. With successive adjustments, the OR progressively decreased to 3.88 when adjusting for GA, to 2.72 adding perinatal risk factors, and further down to 2.16 [95% confidence interval 1.1, 3.9] when ventilation was also adjusted for. Postnatal factors did not change the OR. Significant risk factors for WMD, in addition to BPD, were a low GA, a lower Apgar score, a higher illness severity score, ventilation and early-onset sepsis, while antenatal steroids, being small for GA, and surfactant were associated with a reduced risk. In conclusion, our data suggest that BPD is associated with an increased risk of WMD; most of the effect is due to shared risk factors and causal pathways. DAGs helped clarify the complex confounding of this scenario. [source] The importance of a genetic component in longitudinal birth cohortsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2009Jean Golding The risks of most common health and developmental outcomes are contributed to by a combination of genetic and environmental factors. Understanding of ways in which genes influence such outcomes, and especially of how their interaction with environmental factors affects health and development should lead to the identification of causal pathways and thence appropriate intervention strategies. [source] The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerationsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2008Deborah Lehmann Summary Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research. [source] Studies of twins: what can they tell us about the fetal origins of adult disease?PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2005Ruth Morley Summary There has been much interest in evidence that people with lower birthweight have higher risk of adult cardiovascular disease, but the causal pathways underlying such observations are uncertain. Study of twins offers an opportunity to shed light on the underlying causal pathways, in particular by investigating the role of ,shared' factors vs. factors affecting each individual fetus. This involves comparing results of within-cohort vs. within-pair analyses. Twins share many factors during gestation but birthweight discordance (difference in birthweight within a twin pair) cannot be determined by these shared factors and must relate to factors affecting growth of each individual fetus. If associations seen in a cohort of twins remain in within-pair analyses, then factors specific to each individual must be involved in the underlying causal pathways. Conversely, if the relationships disappear or substantially diminish in within-pair analyses, then factors common to the pair must be involved. Comparison of findings in monozygotic vs. dizygotic twins may provide insights into the role of genetic factors, although issues related to chorionicity need to be taken into account. We tabulate published data and conclude that differences in methodology and analyses preclude informative meta-analysis, and that analysis of pooled data would provide more useful information. [source] Assessing the contribution of working conditions to socioeconomic disparities in health: A commentaryAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Paul A. Landsbergis PhD Abstract Introduction Occupational health researchers can play a pivotal role in increasing our understanding of the role of physical and psychosocial working conditions in producing socioeconomic health disparities and trends of increasing socioeconomic health disparities, contributing to interventions to reduce such disparities, and helping to improve public education materials on this subject. However, a number of methodological challenges in this field need to be considered. Methods Commentary, including a review of selected studies. Results/Conclusion Research needs to be guided by models of the associations between social (socioeconomic position (SEP), race/ethnicity, immigration status, and gender) and occupational variables and health, to avoid inappropriate control for confounding, and to specify causal pathways (mediation) and interaction effects. Different approaches to the theory and measurement of SEP also need to be tested. Am. J. Ind. Med. 53:95,103 2010. © 2009 Wiley-Liss, Inc. [source] Near miss and minor occupational injury: Does it share a common causal pathway with major injury?AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Hasanat Alamgir MBA Abstract Background An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. Methods The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. Results For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. Conclusions Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs. Am. J. Ind. Med. 52:69,75, 2009. © 2008 Wiley-Liss, Inc. [source] Do paternal arrest and imprisonment lead to child behaviour problems and substance use?THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2007A longitudinal analysis Background:, Children of prisoners are at increased risk of impaired health, behavioural problems and substance misuse; however, the causal pathways to these problems are unclear. Under some circumstances, parental imprisonment may result in improved outcomes for the child. This study investigates the impact of paternal arrest and imprisonment on child behaviour and substance use, as a function of child gender, and in the context of known social and familial risk factors. Methods:, Longitudinal analysis of an Australian birth cohort (N = 2,399) recruited 1981,83, with child outcomes measured at age 14. Participants were recruited prenatally from a large, public hospital in Brisbane, Australia and followed up in the community. History of paternal arrest and imprisonment were based on maternal self-report, at age 14. Outcome measures included mother- and child-reported internalising and externalising behaviour (CBCL and YSR), and child self-reported alcohol and tobacco use. Results:, In univariate analyses, paternal imprisonment was associated with maternal reports of increased child internalising (OR = 1.82, 95%CI 1.08,3.06) and externalising (OR = 2.24, 95%CI 1.41,3.57), and alcohol use (OR = 1.68, 95%CI 1.11,2.53) at age 14. However, controlling for socio-economic status, maternal mental health and substance use, parenting style and family adjustment, these associations became non-significant. For boys only, in the multivariate model paternal arrest but not imprisonment predicted alcohol (OR = 1.79, 95%CI 1.09,2.95) and tobacco (OR = 1.83, 95%CI 1.03,3.25) use at age 14. Conclusions:, The association between paternal arrest and imprisonment and adverse outcomes in adolescence is accounted for by well-established social and familial risk factors. Paternal imprisonment may not, in itself, increase the risk for child behaviour and substance use problems. [source] Mother,child joint activity and behaviour problems of pre-school childrenTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 7 2003Kumari Chandani Galboda-Liyanage Background: Behaviour problems are common among pre-school children, and a substantial proportion persist, causing significant burden to the family, schools and health services. Relatively little research has addressed the effects of positive parenting on behaviour disorder in pre-school children, particularly in larger population-based studies. Method: A cross-sectional postal survey of a representative, population-based sample of 800 mothers of 3½-year-old children living in an outer London Borough was carried out to assess the association between mother,child joint activity and behaviour problems of pre-school children. The response rate was 70%. Results: Lower levels of mother,child joint activity remained independently associated with behaviour problems of pre-school children both on a binary and a continuous scale after adjusting for a wide range of household, maternal and child circumstances. The association between low levels of mother,child joint activities and behaviour problems of the children was stronger in the presence of social problems in the family. Conclusion: Possible causal pathways and directions for future research and intervention are discussed. [source] Framing Disparities Along the Continuum of Care from Chronic Kidney Disease to Transplantation: Barriers and InterventionsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2009K. Ladin Research in renal transplantation continues to document scores of disparities affecting vulnerable populations at various stages along the transplantation process. Given that both biological and environmental determinants contribute significantly to variation, identifying factors underlying an unfairly biased distribution of the disease burden is crucial. Confounded definitions and gaps in understanding causal pathways impede effectiveness of interventions aimed at alleviating disparities. This article offers an operational definition of disparities in the context of a framework aimed at facilitating interventional research. Utilizing an original framework describing the entire continuum of the transplant process from diagnosis of chronic kidney disease through successful transplant, this article explores the case of racial disparities, illustrating key factors predicting and perpetuating disparities. Though gaps in current research leave us unable to identify which stages of the transplant pathway adversely affect most people, by identifying key risk factors across the continuum of care, this article highlights areas suited for targeted interventions and presents recommendations for improvement and future research. [source] The comparison of health status and health services utilisation between Indigenous and non-Indigenous infants in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010Lixin Ou Abstract Objective: To examine the differences in health services utilisation and the associated risk factors between Indigenous and non-Indigenous infants at a national level in Australia. Methods: We analysed data from a national representative longitudinal study, the Longitudinal Study for Australian Children (LSAC) starting in 2004. We used survey logistic regression and survey multiple linear regression to examine the factors associated with health services utilisation. Results: Health status of Indigenous infants was poorer than that of non-Indigenous. In comparison to non-Indigenous infants, in the previous 12-month period, the Indigenous infants were significantly less likely to use the following health services: maternal and child health centre or help lines (OR=0.35, 95%CI: 0.24-0.49); maternal and child health nurse visits (OR=0.45, 95%CI: 0.32-0.63); general practitioners (GPs) (OR=0.45, 95%CI: 0.31-0.64); and paediatrician (OR=0.52, 95%CI: 0.35-0.77). In contrast, they were more likely to visit a hospital outpatient clinic (OR=1.82, 95%CI: 1.16-2.85). Mothers' age, education and marital status were associated with certain health services use. Financial status and residential location were the important predictors of the use of health services. Conclusion: The rates of health services utilisation by Indigenous infants were lower and were associated with mothers' characteristics and socio-economic status. Implications: The gaps in health services utilisation between Indigenous and non-Indigenous infant requires immediate policy initiatives. Further research is needed to explore the causal pathways between health status, health services utilisation and multiple risk factors at different levels. [source] Thermal effects on reptile reproduction: adaptation and phenotypic plasticity in a montane lizardBIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 3 2010RORY S. TELEMECO Interspecific comparisons suggest a strong association between cool climates and viviparity in reptiles. However, intraspecific comparisons, which provide an opportunity to identify causal pathways and to distinguish facultative (phenotypically plastic) effects from canalized (genetically fixed) responses, are lacking. We documented the reproductive traits in an alpine oviparous lizard, and manipulated thermal regimes of gravid females and their eggs to identify proximate causes of life-history variation. Embryonic development at oviposition was more advanced in eggs laid by females from high-elevation populations than in eggs produced by females from lower elevations. In the laboratory, experimentally imposed low maternal body temperatures delayed oviposition and resulted in more advanced embryonic development at oviposition. Warm conditions both in utero and in the nest increased hatching success and offspring body size. Our intraspecific comparisons support the hypothesis that viviparity has evolved in cold-climate squamates because of the direct fitness advantages that warm temperatures provide developing offspring. © 2010 The Linnean Society of London, Biological Journal of the Linnean Society, 2010, 100, 642,655. [source] Psychological Treatment and Medication for the Mood and Anxiety Disorders: Moderators, Mediators, and Domains of OutcomeCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2005David J. MiklowitzArticle first published online: 11 MAY 200 Studies that combine pharmacotherapy with psychological treatment for the mood and anxiety disorders must consider the role of moderators (pretreatment variables that specify the conditions under which treatments are effective) and mediators (change mechanisms in the causal pathways between treatments and outcomes) in explaining the impact of experimental treatments. This article gives examples of the kinds of moderators and mediators,both psychosocial and biological,that are important to examine in combination treatment studies. It conceptualizes outcome as involving multiple domains, including mood and anxiety symptoms, life functioning, and illness costs. Research should also examine the appropriate sequencing of pharmacological and psycho-social interventions and how this sequencing may vary from disorder to disorder. [source] | |||||||||||||||||||