Longitudinal associations between early risk and adolescent delinquency: Mediators, moderators, and main effects

Although multiple domains of risk are theorized to predict adolescent delinquency, father-specific risk in the context of other risks is under-researched. Using the low-income Future of Families and Child Wellbeing cohort (48% Black, 27% Hispanic, 21% White, 51% boy, N = 4,255), the current study addressed three research questions. (1) are father-, mother-, child-, and family-level cumulative risk during early childhood associated with adolescent delinquent behavior?, (2) does child self-control in middle childhood mediate the associations between fathers' and mothers' cumulative risk and adolescent delinquent behavior, and do quality of parent's relationships with children and parental monitoring in middle childhood mediate the association between child cumulative risk and delinquent behavior?, (3) do parenting, quality of parent-child relationships in middle childhood, and child sex at birth moderate the associations among fathers', mothers', children's, and family risk and adolescent delinquent behavior? Results indicated father, child, and mother risk at ages 3-5 were significantly and positively associated with youth-reported delinquent behavior. Higher levels of family risk were associated with less delinquency when 9-year-olds felt closer to fathers than when they felt less close. Children's self-control at age 9 mediated the associations between father and child risk and delinquent behavior.

Investigating associations between parent engagement and toddlers' mathematics performance

Early mathematics skills relate to later mathematics achievement and educational attainment, which in turn predict career choice, income, health and financial decision-making. Critically, large differences exist among children in early mathematics performance, with parental mathematics engagement being a key predictor. However, most prior work has examined mothers' mathematics engagement with their preschool- and school-aged children. In this Registered Report, we tested concurrent associations between mothers' and fathers' engagement in mathematics activities with their 2- to 3-year-old toddlers and children's mathematics performance. Mothers and fathers did not differ in their engagement in mathematics activities, and both parents' mathematics engagement related to toddlers' mathematics skills. Fathers' mathematics engagement was associated with toddlers' number and mathematics language skills, but not their spatial skills. Mothers' mathematics engagement was only associated with toddlers' mathematics language skills. Critically, associations may be domain-specific, as parents' literacy engagement did not relate to measures of mathematics performance above their mathematics engagement. Mothers' and fathers' mathematics activities uniquely relate to toddlers' developing mathematics skills, and future work on the nuances of these associations is needed.

High-risk criteria for the physiologically difficult paediatric airway: A multicenter, observational study to generate validity evidence

BACKGROUND

Single-center studies have identified risk factors for peri-intubation cardiac arrest in the emergency department (ED). The study objective was to generate validity evidence from a more diverse, multicenter cohort of patients.

METHODS

We completed a retrospective cohort study of 1200 paediatric patients who underwent tracheal intubation in eight academic paediatric EDs (150 per ED). The exposure variables were 6 previously studied high-risk criteria for peri-intubation arrest: (1) persistent hypoxemia despite supplemental oxygen, (2) persistent hypotension, (3) concern for cardiac dysfunction, (4) post-return of spontaneous circulation (ROSC), (5) severe metabolic acidosis (pH < 7.1), and (6) status asthmaticus. The primary outcome was peri-intubation cardiac arrest. Secondary outcomes included extracorporeal membrane oxygenation (ECMO) cannulation and in-hospital mortality. We compared all outcomes between patients that met one or more versus no high-risk criteria, using generalized linear mixed models.

RESULTS

Of the 1,200 paediatric patients, 332 (27.7%) met at least one of 6 high-risk criteria. Of these, 29 (8.7%) suffered peri-intubation arrest compared to zero arrests in patients meeting none of the criteria. On adjusted analysis, meeting at least one high-risk criterion was associated with all 3 outcomes - peri-intubation arrest (AOR 75.7, 95% CI 9.7-592.6), ECMO (AOR 7.1, 95% CI 2.3-22.3) and mortality (AOR 3.4, 95% 1.9-6.2). Four of 6 criteria were independently associated with peri-intubation arrest: persistent hypoxemia despite supplemental oxygen, persistent hypotension, concern for cardiac dysfunction, and post-ROSC.

CONCLUSIONS

In a multicenter study, we confirmed that meeting at least one high-risk criterion was associated with paediatric peri-intubation cardiac arrest and patient mortality.

Caregivers' Experiences During the COVID-19 Pandemic and Their Children's Behavior

The COVID-19 pandemic has financial and emotional impacts on families. We explored how caregivers' financial strain and mental health are associated with changes in their young children's behavior during the pandemic. We additionally considered whether having a sense of purpose moderated these associations. Caregivers (n = 300) in the emergency department of a children's hospital were surveyed anonymously about changes to their employment (e.g., reduced/increased hours and job loss), ability to pay for expenses and whether their child's behavior had changed. Aligned with the Family Stress Model, caregivers' financial strain was associated with poor mental health, inconsistent sleep routines, and changes in children's problematic and prosocial behaviors. A sense of purpose buffered some of these relationships. Families are differently affected by the pandemic and our findings underscore the need for supporting caregivers' mental health and connecting them with resources.

Applying a family stress model to understand U.S. families' patterns of stress, media use, and child behavior during the COVID-19 pandemic

The COVID-19 pandemic has greatly altered family life, and research among adults and families is finding increases in financial stress, mental health problems, screen time, parental conflict, and child behavior problems. Given these patterns, we sought to replicate these findings with a younger and largely non-white sample and consider how these constructs might relate to each other by using the Family Stress Model. From surveys of 247 predominately Latine mothers and fathers of children under 4 years in the U.S., we found that financial strain was related to children's media exposure and use, largely through impacts on parents' mental health and coparenting relationship. Interestingly, only use of television in the background and during mealtimes were associated with increases in children's behavior problems. Such findings better capture how stress may operate in a family system and offer a way to counsel parents about healthier media habits for children.

Mothers’ and fathers’ engagement in math activities with their toddler sons and daughters: The moderating role of parental math beliefs

Parents’ beliefs about the importance of math predicts their math engagement with their children. However, most work focuses on mothers’ math engagement with preschool- and school-aged children, leaving gaps in knowledge about fathers and the experiences of toddlers. We examined differences in mothers’ and fathers’ (N = 94) engagement in math- and non-math activities with their two-year-old girls and boys. Parents reported their beliefs about the importance of math and literacy for young children and their frequency of home learning activities. Parents of sons did not differ in their engagement in math activities from parents of daughters. Mothers reported engaging more frequently in math activities with their toddlers than fathers did, but the difference reduced when parents endorsed stronger beliefs about the importance of math for children. Even at very early ages, children experience vastly different opportunities to learn math in the home, with math-related experiences being shaped by both parent gender and parents’ beliefs.

Explaining the long reach of prenatal behaviors and attitudes in unmarried men at birth on father engagement in early and middle childhood and adolescence

The current study examined three research questions: (a) Are unmarried at birth fathers' prenatal and birth-related behavioral, attitudinal, and identity adjustments directly related to father engagement in child-related activities during early childhood and father-child closeness in middle childhood and adolescence? (b) Do father engagement in child-related activities during early childhood, coresidence, and coparenting at age 5 mediate the association between unmarried fathers' prenatal and birth-related variables and father-child relationship in middle childhood and adolescence? (c) Do father-child closeness, coresidence, and coparenting in middle childhood mediate the association between fathers' prenatal and birth-related variables and father-child relationship during adolescence? Using a subsample of Fragile Families and Child Wellbeing data (N = 2,647), we found support for our hypotheses that fathers' prenatal and birth-related variables significantly predicted father-child engagement during early childhood and father-child closeness during middle childhood and adolescence, although not all prenatal and birth-related variables are related to outcomes during each stage of childhood development. Father involvement and coparenting cooperation significantly mediated the associations among fathers' prenatal and birth-related variables and father-child closeness at ages 9 and 15. Our findings indicate that researchers, practitioners, and policymakers should take advantage of the prenatal period and direct resources to facilitate and strengthen prospective unmarried fathers' early relationships with their partners and children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Risks and Protective Factors of Hispanic Families and Their Young Children during the COVID-19 Pandemic

This study examines the risk-related factors during the pandemic and protective factors that might reduce its effects on family functioning in a sample of 161 low-income Hispanic parents in the United States, recruited from an ongoing longitudinal intervention study. They were surveyed about family functioning six months into the pandemic. We focused on the associations between social (e.g., exposure to the virus) and economic (e.g., job loss) pandemic-related risks on parental stress, parenting, and children’s socioemotional problems and skills, as well as the degree to which coparenting support, parents’ positivity, economic support, and access to services and information mitigated (protected) the negative effects of these stressors on family functioning. We found that increases in economic risk were associated with more child competence skills, whereas increases in social risk were associated with less parental engagement. Positivity and economic support moderated the effects of economic risk on parental stress and engagement. These findings show that to intervene effectively with low-income Hispanic families, we need to strengthen and support the resources for coping with adversity.

Family Functioning in the Time of COVID-19 Among Economically Vulnerable Families: Risks and Protective Factors

The ongoing COVID-19 crisis has been particularly harmful to economically vulnerable families with young children. We surveyed 247 low-income mothers and fathers from 142 families in the United States about changes in their family life following the economic and social restrictions imposed by the pandemic. We examined the associations between pandemic-related risk factors such as economic stressors (e.g., loss of job) and social stressors (e.g., exposure to the virus) on family functioning (e.g., parents' mental health, parent engagement, and children's socioemotional behaviors) and the degree to which coparenting support and parents' positivity protected families from the negative effects of these stressors on their wellbeing. We found both positive and negative associations. Mothers and fathers who reported more economic stressors since the pandemic also observed that their children behaved more prosocially and that fathers experienced more mental health difficulties during the pandemic. Mothers and fathers who reported more social stressors reported that they were less engaged with their children and their children exhibited more behavior problems compared to before the pandemic. We also found that mothers and fathers who reported feeling more positive also reported feeling less depressed and stressed during the pandemic and observed that their children had more prosocial behaviors compared to before the pandemic. Compared to before the pandemic, mothers and fathers who reported a more supportive coparenting relationship also reported more parent engagement and observed more prosocial behaviors in their children. In terms of protective factors, high levels of parent positivity during the pandemic protected mothers (less mental health difficulties) whereas high levels of coparenting support protected fathers (less mental health difficulties) from the negative effects of economic stress on their mental health during the pandemic. These findings highlight family processes that could promote resilience in mothers and fathers in the face of pandemic-related economic and social stressors.

Challenging Parenting Behaviors in Ethnically Diverse Two-Parent Families in the United States: Association with Infants' Social Competence and Behavior Problems

We used data from a sample of ethnically diverse first-time parents (N = 186) in the United States to examine differences between mothers' and fathers' challenging parenting behaviors (CPB) when infants were 9 months old as well as covariates of CPB. We also examined associations between CPB and infants' social competence and behavior problems when they were 12 months old. Results showed no differences between mothers and fathers in the level of CPB with their infants. Mothers with more depressive symptoms engaged in more CPB. Over and above the contributions of infants' gender and temperament and parents' education, mothers' and fathers' CPB was not associated with infants' social competence and behavior problems. This study expands our understanding of the universality of CPB and whether it is associated with social competence in ethnically diverse families.

Measuring Emerging Number Knowledge in Toddlers

Recent evidence suggests that infants and toddlers may recognize counting as numerically relevant long before they are able to count or understand the cardinal meaning of number words. The Give-N task, which asks children to produce sets of objects in different quantities, is commonly used to test children’s cardinal number knowledge and understanding of exact number words but does not capture children’s preliminary understanding of number words and is difficult to administer remotely. Here, we asked whether toddlers correctly map number words to the referred quantities in a two-alternative forced choice Point-to-X task (e.g., “Which has three?”). Two- to three-year-old toddlers (N = 100) completed a Give-N task and a Point-to-X task through in-person testing or online via videoconferencing software. Across number-word trials in Point-to-X, toddlers pointed to the correct image more often than predicted by chance, indicating that they had some understanding of the prompted number word that allowed them to rule out incorrect responses, despite limited understanding of exact cardinal values. No differences in Point-to-X performance were seen for children tested in-person versus remotely. Children with better understanding of exact number words as indicated on the Give-N task also answered more trials correctly in Point-to-X. Critically, in-depth analyses of Point-to-X performance for children who were identified as 1- or 2-knowers on Give-N showed that 1-knowers do not show a preliminary understanding of numbers above their knower-level, whereas 2-knowers do. As researchers move to administering assessments remotely, the Point-to-X task promises to be an easy-to-administer alternative to Give-N for measuring children’s emerging number knowledge and capturing nuances in children’s number-word knowledge that Give-N may miss.

Fathers and Families: Risk and Resilience. An Introduction

The articles in this special issue are informed by the historic changes in the twentieth century (i.e., decreasing family size, changing family roles, and youth demonstrating more independent behaviors) that propelled intensive study of fathers’ impacts on child development. The papers are conceptualized within a developmental systems framework and focused on a father’s presence rather than on his absence in the family, going beyond the study of merely father involvement. Papers reflect longitudinal and cross-sectional methods and examine issues related to paternal mental health, parenting behavior, cultural context, and children’s physical and mental health.

QSAR and molecular docking modelling of anti-leishmanial activities of organic selenium and tellurium compounds

Leishmaniasis affects mainly rural areas and the poorest people in the world. A computational study of the antileishmanial activity of organic selenium and tellurium compounds was performed. The 3D structures of the compounds were optimized at the wb97xd/lanl2dz level and used in the quantitative structure-activity relationship (QSAR) analysis. The antileishmanial activity was measured by L. donovani β carbonic anhydrase inhibition (Ki) and the half-maximal inhibitory concentration (IC₅₀) against L. infantum amastigotes. The dataset was divided into training (75%) and test sets (25%) by using a k-means clustering algorithm. For pKi prediction, model M3 with seven 3D topographic descriptors was characterized by the following statistical parameters: r ² = 0.879, Q ² _LOO = 0.822, and Q ² _ext = 0.840. For pIC₅₀ prediction, model M12 with six attributes was characterized by the following statistical parameters: r ² = 0.907, Q ² _LOO = 0.824, and Q ² _ext = 0.795. Both models met all the requirements of Tropsha´s test, which implies predictions of pIC₅₀ and pKi activities with high accuracy. Concomitantly, favourable interactions of the sulphonamide group with the Zn atom in the protein were revealed by the docking analysis.

Seventy-two-hour Return Initiative: Improving Emergency Department Discharge to Decrease Returns

Unscheduled return visits within 72 hours of discharge account for 4% of pediatric emergency department (ED) visits each year and are a quality indicator of ED care. This project aimed to reduce the unexpected 72-hour return visit rate for a network of ED and urgent cares (UC) by improving discharge processes.

Feasibility of Targeting Hispanic Fathers and Children in an Obesity Intervention: Papás Saludables Niños Saludables

Background: Hispanic children and men carry a high burden for obesity and associated medical conditions. Healthy Dads Healthy Kids was the first obesity prevention intervention targeting fathers and demonstrated weight loss among fathers and behavior change among fathers and children in Australia. The aim of this study was to assess the feasibility of a culturally adapted version of the program for Hispanic families, Papás Saludables Niños Saludables. Methods: A randomized waitlist controlled trial with a process evaluation was conducted to assess the feasibility of Papás Saludables Niños Saludables(NCT03532048). Fathers, their partner (mother), and one to three children were enrolled. A priori feasibility criteria were: (1) recruit 40 Hispanic fathers and their families in ≤4 months; (2) retain 80% of participants for pre- and postassessments; (3) maintain ≥70% attendance to the 10 sessions; (4) obtain 80% "excellent" or "good" satisfaction from participants; and (5) collect anthropometric and behavioral data on ≥75% of participants at baseline and follow-up. Results: The study enrolled 90% (n = 36) of the goal from one local pediatric clinic between May and August 2018; retained 75% of participants for postassessment; maintained 72% attendance among those who started the program; and achieved 100% "excellent/good" satisfaction ratings among the participating fathers and mothers. One hundred percent of participants had most anthropometric and behavioral data at baseline and 72% at follow-up. Conclusions: With oversampling and improvements in the recruitment strategies, Papás Saludables Niños Saludables is feasible for a randomized controlled clinical trial to address whether a father-targeted lifestyle program is efficacious among low-income Hispanic men and their children.

FRI0460 SAFETY OF BIOLOGICAL AGENTS IN JUVENILE IDIOPATHIC ARTHRITIS: A META-ANALYSIS OF OBSERVATIONAL STUDIES

Background:

Follow-up cohorts (observational studies) were initiated consecutively or simultaneously to the development of randomised controlled trials (RCTs) in JIA patients(1,2). They help to identify many complications observed only in clinical practice related to off label use, coadministration of treatments, drug misuse, and occurrence of rare or unexpected event. In addition, observational studies include a higher number of patients with a longer duration of follow-up compared to randomised trials. Hence, they have a higher power to capture the occurrence of serious adverse events (SAE) in daily clinical practice3.

Objectives:

To estimate the incidence of serious adverse events (SAEs) including serious infections, malignancies, and death in patients with juvenile idiopathic arthritis (JIA) treated with biological agents (BAs) in daily clinical practice, using meta-analysis techniques.

Methods:

We systematically searched, up to May 2019, Medline and Embase databases for observational studies performed in JIA disease under BAs treatment. Outcomes were SAEs, serious infections, malignancies and all-cause mortality. Complementary, the incidence of SAEs in randomised controlled trials (RCTs) with withdrawal and parallel designs was performed by meta-analysis.

Results:

A total of 31 observational studies were included (6811 patients totalizing 17530 patients-years [PY] of follow-up). The incidence rate of SAEs was similar in observational cohorts and withdrawal RCTs (4.46 events per 100 PY, 95% CI 2.85- 6.38, I2= 95%) and 3.71 events per 100 PY (95%CI 0.0-13.34), I2= 56%, respectively). The incidence of SAE was lower in parallel RCT. The incidence rate of serious infections, malignancies and death in observational cohorts was estimated at 0.74 events per 100 PY (95%CI 0.32-1.30, I2=83%), 0.10 events per 100 PY (95% CI 0.06-0.16, I2=0%) and 0.09 events per 100 PY (95% CI 0.05-0.14, I2=0%), respectively. Infections were the known cause of death in 8 of the 14 deaths. In meta-regression and subgroup analysis, variation of serious infections rates were partially explained by follow-up time (R2= 30.3%, p= 0.0008), JIA categories (all JIA versus polyarticular versus systemic JIA categories, p= 0.001) and cohort quality (Newcastle-Ottawa score ≥ to 6 versus ≤ to 5 stars, p= 0.0025).

Conclusion:

Our results suggest that the incidence rate of SAEs related to BAs in JIA disease is similar to those observed in randomised withdrawal trials. The overall incidence remained low. However, unsatisfactory description of SAEs prevents analysis of hospitalisation causes. Infection and, to a lesser extent, cancer and death, explain only part of burden of BAs.

References:

[1]Berard RA, Laxer RM. Learning the hard way: clinical trials in juvenile idiopathic arthritis. Ann Rheum Dis. 2018;77(1):1–2.

[2]Swart J, Giancane G, Horneff G, Magnusson B, Hofer M, Alexeeva Е, et al. Pharmacovigilance in juvenile idiopathic arthritis patients treated with biologic or synthetic drugs: combined data of more than 15,000 patients from Pharmachild and national registries. Arthritis Res Ther. 2018 27;20(1):285.

[3]Monti S, Grosso V, Todoerti M, Caporali R. Randomized controlled trials and real-world data: differences and similarities to untangle literature data. Rheumatol Oxf Engl. 2018 01;57(57 Suppl 7):vii54–

Disclosure of Interests:

None declared

Cultural adaptation of 'Healthy Dads, Healthy Kids' for Hispanic families: applying the ecological validity model

Background

Healthy Dads Healthy Kids (HDHK) is a unique lifestyle obesity intervention for fathers and children that demonstrated weight loss among the fathers and behavior change among fathers and children in Australia. The program is gender-tailored to specifically target fathers for weight loss and 5–12 year old children for obesity prevention. The aim of this formative study was to examine an Expert Panel’s and Hispanic Family Panel’s perceptions about the program and suggestions for the cultural adaptation of HDHK for Hispanic families in southwestern US.

Methods

Forty-four Hispanic participants (22 fathers, 13 mothers and 9 children) made up the Family Panel. They participated in 1–5 study contacts (focus groups, online survey, and/or interviews). The scripts and qualitative guides assessed participants’ perceptions of the HDHK content and material using the Ecological Validity Model. Studies were conducted in English or Spanish, depending on the preference of the participant. Focus groups and interviews were audio-recorded, transcribed, translated, and thematically coded. Findings were reviewed with the Expert Panel who helped inform the cultural adaptation.

Results

80% of parents were foreign-born, 57% spoke only Spanish at home, and 60% did not graduate from high school. Several themes emerged to inform the cultural adaptation of the program. Parents agreed with the HDHK goals and recommended the program place greater emphasis on parenting and limiting children’s screen time. Some mothers and fathers wanted greater mother engagement. Weekly videos and a Facebook group emerged as favorite alternative options to engage mothers. Greater promotion of familism (inclusion and impact on whole family) was recommended for the program goals and activities. Gender roles for mothers and fathers, and differences in how fathers interact with male and female children, emerged and should be considered in program activities. Several barriers to father engagement surfaced, including lack of time due to work schedules, physically demanding jobs, concerns of caring for children without mother, fathers’ current fitness/weight, and lack of knowledge of how to eat more healthfully. The reading level of the HDHK materials was too high for some parents.

Conclusion

Findings from these formative qualitative studies informed the cultural adaptation of HDHK for Hispanic families, to account for literacy level, cultural values, and barriers to participation and engagement.

Family structure change among Latinos: Variation by ecologic risk

We examined differences in family structure change in an urban sample of mothers (N= 1,314) from their child's birth to age 5 and whether ecological risk moderated this association. We found that compared to U.S.-born Latino mothers, foreign-born Latino mothers were 62% less likely to break up and 75% less likely to repartner than remain stably resident. Across nativity status, Latina mothers with fewer children, more economic stress, less income, and less frequently reported father involvement were more likely to break up and repartner than remain stably resident. We found no moderation effects of ecological risk.

Chapter VI: Longitudinal Contributions of Maternal and Paternal Intrusive Behaviors to Children's Sociability and Sustained Attention at Prekindergarten

We examined the association between U.S.-born mothers' and fathers' intrusiveness at 24 months and children's sociability and sustained attention at prekindergarten in a sample of low-income, ethnic minority children (N = 74) enrolled in Early Head Start in the U.S. Event-based coding captured the frequency and intensity of parents' intrusive episodes with their children as well as the contingent affect of parents and children during each episode. Fathers and mothers did not differ in frequency of intrusive episodes; fathers were more intensely intrusive but exhibited more positive affect during intrusive episodes than mothers. Children exhibited more positive affect during intrusive exchanges with their fathers than with their mothers. Positive mother-child dyadic affect but not intrusive behaviors at 24 months were not related to sociability and sustained attention in prekindergarten. Moreover, positive mother-child dyadic affect buffered children from the negative effects of maternal intrusive behaviors on sociability.

Self-perceived Coparenting of Nonresident Fathers: Scale Development and Validation

This study reports on the development and validation of the Fatherhood Research and Practice Network coparenting perceptions scale for nonresident fathers. Although other measures of coparenting have been developed, this is the first measure developed specifically for low-income, nonresident fathers. Focus groups were conducted to determine various aspects of coparenting. Based on this, a scale was created and administered to 542 nonresident fathers. Participants also responded to items used to examine convergent and predictive validity (i.e., parental responsibility, contact with the mother, father self-efficacy and satisfaction, child behavior problems, and contact and engagement with the child). Factor analyses and reliability tests revealed three distinct and reliable perceived coparenting factors: undermining, alliance, and gatekeeping. Validity tests suggest substantial overlap between the undermining and alliance factors, though undermining was uniquely related to child behavior problems. The alliance and gatekeeping factors showed strong convergent validity and evidence for predictive validity. Taken together, results suggest this relatively short measure (11 items) taps into three coparenting dimensions significantly predictive of aspects of individual and family life.

Fathers' repetition of words is coupled with children's vocabularies

Differences in vocabulary size among children can be explained in part by differences in parents' language input, but features of caregivers' input can be more or less beneficial depending on children's language abilities. The current study focused on a specific feature of infant-directed speech: parents' repetition of words across utterances. Although previous work with infants showed a positive relation between repetition and children's vocabulary, we predicted that this would not be the case later in development. Instead, parents may use less repetition as their children become increasingly proficient language learners. In the current study, we examined the extent to which low-income fathers of 24-month-olds (N=41) repeat words to their children using three indices: type-token ratio, automated repetition index, and partial repetition of open-class words. The same finding emerged across all measures of repetition: Fathers whose children had larger vocabularies at 24months repeated wordslessoften, suggesting a developmental coupling of fathers' input and children's language proficiency.

Parenting in a New Land

Abstract. Immigrant parents face a double challenge in rearing their children in a foreign country. In addition to the tasks that all parents face, they must also try to find a balance between the norms and expectations of their heritage culture and those of the culture they live in. How do immigrant parents support their children and contribute to their positive adaptation? The goal of this review is to highlight selected aspects of parenting and family relationships that are strongly linked to children’s development and resilience. With regards to family processes, we underscore the contribution of fathers, the role of a potential acculturation gap between parents, and the benefit of speaking the heritage language in the family. For the connection to the world outside of the family, we highlight the advantage of having proficiency in the majority language and of parental involvement in schools. Finally, we outline the specific challenges and stressors as well as the importance of family relationships for families with refugee status. We conclude by making the case that immigrant parents should be encouraged and supported in rearing their children in a way that fosters family cohesion and reflects their heritage culture as well as the culture of the host country. This requires support and intervention programs that are not only culturally sensitive but are also two-generational and focus on mothers, fathers, and children.

The Caregiver Perspective on Unscheduled 72-Hour Return Visits to Pediatric Acute Care Sites: A Focus on Discharge Processes

OBJECTIVE

To characterize pediatric caregivers' reasons for 72-hour emergency department (ED) and urgent care (UC) returns.

METHODS

A sample of caregivers returning within 72 hours of initial visit to a pediatric ED or affiliated UC site was surveyed from November 2014 to June 2015; patients evaluated at outside ED/UC, scheduled for return, or non-English/Spanish speaking were excluded. Caregiver surveys underwent item generation, validation, and pilot testing. Survey items included caregiver reasons for unscheduled returns, with a specific assessment of delivery of key components of discharge instructions (diagnosis, duration of illness, home care, return precautions). Complete delivery of instructions was defined by caregiver reported receipt of instructions on all 4 components.

RESULTS

Of the 500 caregiver surveys analyzed 495 children received a 72-hour return ED/UC visit. Mean age of caregivers was 33 years, 62% completed college. Children were 2 years of age or younger (47%), male (52%), Caucasian (55%), and publicly insured (64%). Reported reasons for ED/UC return included belief that their child's illness had not resolved (51%) or worsened (41%). Many caregivers (41%) were not instructed on all key components of discharge. Almost half of caregivers (47%) were not educated on anticipated duration of illness. Complete delivery of discharge instructions was associated with ED/UC satisfaction (odds ratio, 5.7; 95% confidence interval, 3.8-8.5).

CONCLUSIONS

Among caregivers of children returning for an unscheduled ED/UC visit, most do not receive complete discharge instructions at initial visit. Improving delivery of key components of discharge instructions has the potential to increase ED/UC satisfaction and reduce unscheduled 72-hour returns.

Family Change and Co-parenting in Resident Couples and Children's Behavioral Problems

Using data from the Fragile Families and Child Wellbeing study (n = 1,553), the present study examined whether father involvement and co-parenting quality mediated the association between union instability (number of residential romantic partner changes) over the first 5 years of life and children's externalizing problem behaviors (EPB) at 5 years. The results indicate that only co-parenting support mediated the association between union instability and children's EPB, controlling for known covariates of children's EPB. The findings suggest that the union instability associated with romantic partner transitions has a deleterious effect on children's behaviors because the change in union status decreases the quality of the co-parenting relationship.

Going Beyond Input Quantity: Wh-Questions Matter for Toddlers' Language and Cognitive Development

There are clear associations between the overall quantity of input children are exposed to and their vocabulary acquisition. However, by uncovering specific features of the input that matter, we can better understand the mechanisms involved in vocabulary learning. We examine whether exposure to wh-questions, a challenging quality of the communicative input, is associated with toddlers' vocabulary and later verbal reasoning skills in a sample of low-income, African-American fathers and their 24-month-old children (n = 41). Dyads were videotaped in free play sessions at home. Videotapes were transcribed and reliably coded for sheer quantity of fathers' input (number of utterances) as well as the number of wh-questions fathers produce. Children's productive vocabulary was measured at 24 months using the McArthur Bates Communicative Development Inventory MCDI (completed by the mothers), and children's verbal reasoning skills were measured 1 year later using the Bayley Scales of Infant Development. Results indicate that the overall quantity of father talk did not relate to children's vocabulary or reasoning skills. However, fathers' use of wh-questions (but not other questions) related to both vocabulary and reasoning outcomes. Children's responses to wh-questions were more frequent and more syntactically complex, measured using the mean length of utterance (MLU), than their responses to other questions. Thus, posing wh-questions to 2-year-olds is a challenging type of input, which elicits a verbal response from the child that likely helps build vocabulary and foster verbal reasoning abilities.

Helping Children Navigate a Diverse World: Parents' Contributions

We review the existing literature on how parents prepare their children to navigate an increasingly diverse world. In particular, we focus much of our attention on the ethnic-racial socialization practices and beliefs of ethnic minority and majority groups, as this area of the field is currently the most expounded. We begin by exploring the current and future demographic characteristics of the United States to better contextualize research on social justice by developmental scientists. We then review the theoretical frameworks typically used to guide this body of research. Next we examine ethnic minority parents' ethnic-racial socialization practices and discuss their implications. We then consider ethnic majority parents' ethnic-racial socialization practices. Finally we address gaps in the current literature and offer directions for future research. Taken together, this small body of literature is critical to understanding how children are socialized about diversity.

Family structure, maternal employment, and change in children's externalizing problem behaviour: Differences by age and self-regulation

This study used a latent difference score growth model to investigate how changes in family structure (biological father and stepfather residence) and maternal employment are associated with American children's externalizing problem behaviors (EPB) from ages 4 to 10 and whether these associations vary by children's level of self-regulation. For all 4 year old children, living with a biological father at age 4 was associated with reductions in EPB at ages 4-6 and later years, with no variation by child self-regulation. Living with a stepfather at age 4 was associated with higher levels of EPB at age 4; however, for less-regulated children, stepfather residence at ages 4 and 8 was associated with reductions in EPB between ages 4-6 and from 8-10, respectively. Greater employment hours were associated with increased EPB in the next two years for less-regulated children of all ages; however, except for the age 4-6 transition, there was a lagged association that reduced behavior problems after two years and outweighed short-term increases.

Comparison of a new chemiluminescent immunoassay for von Willebrand factor activity with the ristocetin cofactor-induced platelet agglutination method

Measuring von Willebrand factor (VWF) activity is essential for the diagnosis of von Willebrand disease (VWD). The VWF activity is usually assessed based on measurement of the ristocetin cofactor (VWF:RCo). However, that test is technically challenging and has high intra- and inter-assay variabilities. A new automated chemiluminescent immunoassay VWF activity has recently become commercially available (HemosIL AcuStar von Willebrand Factor Ristocetin Cofactor Activity). The main objective of this study was to evaluate this new method and to compare it with the VWF:RCo assay as the reference method. We studied 91 samples, 18 healthy volunteers samples and 73 samples from patients (VWF:RCo level <50 IU dL(-1) ): 29 type 1 VWD, 13 type 2A, 5 type 2B, 5 type 2M, 3 type 2N, 5 type 3, 4 type 3 under treatment, 5 type 3 carriers and 4 samples with other pathologies. The HemosIL AcuStar VWF:RCo assay was 96% sensitive and 100% specific for detecting VWF abnormalities. The good analytical performance, and the sensitivity and specificity of HemosIL AcuStar VWF:RCo to detect VWF deficiency renders it a suitable method for VWD screening.

Longitudinal and reciprocal associations between coparenting conflict and father engagement

The major goal of the present study was to examine the reciprocal and longitudinal associations between coparenting conflict and father engagement with children during the early childhood years. Using data from the Early Childhood Longitudinal Survey--Birth Cohort (N = 3600), the findings supported the hypothesis that father engagement at 9 months has a significant effect on coparenting conflict at 24 and 48 months, but there was limited support for the hypothesis that early coparenting conflict has an effect on later engagement. The direct and indirect findings also suggest that fathers' engagement with young children has different longitudinal effects on coparenting conflict depending on the type of activity in which fathers are engaged. Whereas fathers' physical care at 9 months was associated with increased levels of later coparenting conflict, fathers' cognitive stimulation at 9 months was associated with lower levels of later coparenting conflict. Implications for programs for fathers and families are discussed.

A multicommuted flow system for the determination of copper, chromium, iron and lead in lubricating oils with detection by flame AAS

In this work, a flow analysis procedure for the determination of copper, chromium, iron and lead in lubricating oils using flame AAS as detection technique is described. The flow manifold was designed to implement the multicommutation approach and it comprised three 3-way solenoid valves controlled by a personal computer. The flow system presented allowed to process the oil samples to determine wear metals without any prior preparation. Aiming to assess accuracy the results were compared with those obtained by manual procedure using flame AAS. Applying the joint-confidence ellipse test, no significant difference at the 95% confidence level was observed. Other profitable features such as a sample throughput of 50 determinations per hour; relative standard deviations (n = 5) below 2% for Cu, and below 8% for Cr, Fe and Pb; and linear responses in the range 0-40ppm (w/w) (Cu, Fe) and 0-15ppm (w/w) (Cr, Pb) were also achieved.

An Exploratory Study of Fathers' Parenting Stress and Toddlers' Social Development in Low-Income African American Families

The present study tested Abidin's (1992) parenting stress model in a sample of low-income African American fathers and their toddlers, specifically examining the mediation effect of fathers' engagement (self-report and observed) on the association between parenting stress and children's social competence and problem behavior. We found that fathers reported moderate levels of parenting stress, but we found no evidence of a direct effect of stress on children's social development. However, parenting stress predicted more engagement in management, which predicted children's increased problem behaviour. These findings highlight the effect of fathering stress on specific forms of father engagement that affect toddlers' social development.

Inhibitor development in one patient and laboratory discrepancies in several families with both mild haemophilia and Arg531Cys mutation

Certain mutations in mild haemophilia A have been associated with a greater risk of inhibitor development, especially when associated with intense treatment. We present a patient with both mild haemophilia A and Arg531Cys mutation, which developed lowtitre inhibitors and was not seen to be related to the intense substitute treatment. The inhibitor has a greater effect on the exogenous factor VIII, permiting an adequate response to treatment with desmopressin. A discrepancy exists in the factor VIII activity in this our patient and in the haemophiliacs of another two families with the same mutation when determination is performed with one-stage or chromogenic method.

Child outcome measures in the study of child care quality

This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review by Vandell and Wolfe (2000) as the starting point. Serious methodological problems were not pervasive for child outcome measures. However, methodological concerns were most prevalent among measures of socioemotional development. Furthermore, psychometric information on outcome measures was often missing from published reports, and health outcomes and approaches to learning were infrequently studied. Future research should address alignment issues between aspects of quality and the specific child outcomes chosen for study.