Illumination Characteristics of Mobility Lights

The authors measured the light-distribution patterns and the decay in light output of three mobility lights that visually impaired persons can use for night travel: the Wide-Angle Mobility Light (WAML), the Streamlight, and the Mag-Lite. The WAML had a wide beam with a medium-bright central region. The beam of the Streamlight had the brightest central region and a moderately wide surround of lower illumination. The Mag-Lite had the narrowest light distribution about a bright central spot. Both the Streamlight and the Mag-Lite maintained near-maximum brightness before undergoing rapid decay, while the WAML showed a gradual decay changing from near-maximum brightness to near extinction in almost a linear fashion 40 to 80 minutes after being turned on.

Engaging From Both Sides: Facilitating a Canadian Two-Generation Prenatal-to-Three Program for Families Experiencing Vulnerability

BACKGROUND

Young children living in families experiencing social vulnerability, including low income, mental illness, addictions, social isolation, and/or homelessness, are at risk of developmental delay. Two-generation programs can improve outcomes for preschool children, but underlying mechanisms and outcomes for younger children remain unclear.

PURPOSE

We explored program facilitation and identified developmental benefits of a two-generation program beginning prenatally.

METHODS

In our convergent, concurrent mixed methods study, we interviewed agency staff (n = 10) and held focus groups with parents (n = 14). We compared child (N = 100) development between program intake and exit as measured by the Ages and Stages Questionnaires 3rd edition.

RESULTS

Our core category, Engaging From Both Sides, included (a) Mitigating Adversity (focused codes Developing Trust, Letting Go of Fear, and Putting in the Effort); (b) Continual Learning (focused codes Staying Connected, and Taking it to the Community); (c) Fostering Families (focused codes Cultivating Optimism, and Happiness and Love); (d) Unravelling Cycles of Crisis (focused codes Advocating, and Helping Parents' Parent); and (e) Becoming Mainstream (focused codes Knowing Someone Has Your Back, and Managing Stress, Anxiety, and Anger). We found significant improvements in child Fine Motor, Problem-Solving, and Personal-Social domains between program intake and exit.

CONCLUSIONS

Our study adds to existing literature regarding mechanisms of two-generation programs beginning prenatally. Mitigating effects of intergenerational adversity was the primary motivation for interaction and engagement of staff and parents in two-generation programming, which improved child development.

Fathers' and mothers' attachment styles, couple conflict, parenting quality, and children's behavior problems: an intervention test of mediation

A diverse sample of 239 primarily low-income couples participated in a random controlled trial of the Supporting Father Involvement couples group intervention. In this report, we examined the value of adding measures of fathers' attachment style and parenting to mothers' measures in order to explain variations in children's behavior problems. We also tested the hypothesis that the link between intervention-induced reductions in couple conflict and reductions in anxious/harsh parenting can be explained by intervention effects on parents' attachment insecurity or on anxiety and depression. Fathers' attachment security and parenting behavior added significantly to mothers' in accounting for children's internalizing and externalizing problem behaviors. Fathers' anxious attachment style and anxiety/depression mediated the link between post-intervention reductions in parental conflict and anxious/harsh parenting. For mothers, only improvements in attachment security accounted for those links. The findings support the need for attachment researchers to consider the contributions of both parents to their children's development.

More than One Way to Get There: Pathways of Change in Coparenting Conflict after a Preventive Intervention

This study explored pathways of change in the levels of conflict couples experienced after Supporting Father Involvement, an evidence-based, prevention-oriented couples and parenting intervention that included a diverse low-income and working class group of participants. Pathways of change were examined for couples with baseline conflict scores that were initially low, medium, and high. The growth mixture model analysis found that the best-fitting model for change in couples' conflict was represented by three distinctly different change patterns. The intervention was most successful for High-Conflict couples. This finding contributes to a growing literature examining variations in how relationships change over time and the process of change, especially for couples in distress. This study supports further investigation into the impact and costs associated with universal interventions versus those that target specific groups of higher risk families.

Practitioner review: Engaging fathers--recommendations for a game change in parenting interventions based on a systematic review of the global evidence

BACKGROUND

Despite robust evidence of fathers' impact on children and mothers, engaging with fathers is one of the least well-explored and articulated aspects of parenting interventions. It is therefore critical to evaluate implicit and explicit biases manifested in current approaches to research, intervention, and policy.

METHODS

We conducted a systematic database and a thematic hand search of the global literature on parenting interventions. Studies were selected from Medline, Psychinfo, SSCI, and Cochrane databases, and from gray literature on parenting programs, using multiple search terms for parent, father, intervention, and evaluation. We tabulated single programs and undertook systematic quality coding to review the evidence base in terms of the scope and nature of data reporting.

RESULTS

After screening 786 nonduplicate records, we identified 199 publications that presented evidence on father participation and impact in parenting interventions. With some notable exceptions, few interventions disaggregate 'father' or 'couple' effects in their evaluation, being mostly driven by a focus on the mother-child dyad. We identified seven key barriers to engaging fathers in parenting programs, pertaining to cultural, institutional, professional, operational, content, resource, and policy considerations in their design and delivery.

CONCLUSIONS

Barriers to engaging men as parents work against father inclusion as well as father retention, and undervalue coparenting as contrasted with mothering. Robust evaluations of father participation and father impact on child or family outcomes are stymied by the ways in which parenting interventions are currently designed, delivered, and evaluated. Three key priorities are to engage fathers and coparenting couples successfully, to disaggregate process and impact data by fathers, mothers, and coparents, and to pay greater attention to issues of reach, sustainability, cost, equity, and scale-up. Clarity of purpose with respect to gender-differentiated and coparenting issues in the design, delivery, and evaluation of parenting programs will constitute a game change in this field.

An approach to preventing coparenting conflict and divorce in low-income families: strengthening couple relationships and fostering fathers' involvement

In the context of current concern about levels of marital distress, family violence, and divorce, the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children, in part by strengthening the men's relationships with their children's mothers. The study design involves a randomized clinical trial that includes assignment to a 16-week couples group, a 16-week fathers group, or a single-session control group. Couples in both group interventions and the control condition include partners who are married, cohabiting, and living separately but raising a young child together. This article presents the rationale, design, and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives, many of whom are manifesting some degree of individual or relationship distress. We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest, and the first 160 who completed one postintervention assessment 9 months after entering the study. Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families.

An approach to preventing coparenting conflict and divorce in low-income families: strengthening couple relationships and fostering fathers' involvement

In the context of current concern about levels of marital distress, family violence, and divorce, the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children, in part by strengthening the men's relationships with their children's mothers. The study design involves a randomized clinical trial that includes assignment to a 16-week couples group, a 16-week fathers group, or a single-session control group. Couples in both group interventions and the control condition include partners who are married, cohabiting, and living separately but raising a young child together. This article presents the rationale, design, and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives, many of whom are manifesting some degree of individual or relationship distress. We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest, and the first 160 who completed one postintervention assessment 9 months after entering the study. Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families.

From too little too late to early and often: child psychiatry education during medical school (and before and after)

In this article we propose developmentally informed remedies to the challenges that face research training. The initiatives described in it have been implemented to various degrees at our institution, and several are already being replicated or expanded through strategic partnerships across the country. We are fortunate to work in an environment in which child and adolescent psychiatry is visible and well represented, but we are aware than many of the settings in which education and recruitment needs are most pressing may not have the range of our resources. We view our different programs as seamlessly interconnected with one another but present them as separate entities to facilitate the incorporation of different components into local realities.

Correlation of ultrasonography and bacteriology of the endocervix and posterior cul-de-sac of patients with severe pelvic inflammatory disease

We evaluated 30 patients admitted with a diagnosis of pelvic inflammatory disease (PID) by culdocentesis and ultrasonography to determine the severity of disease in relation to endocervical and culdocentesis bacteriology. Specimens from the endocervix were cultured for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum. In addition, culdocentesis fluid was cultured for aerobes and anaerobes. Patients with N. gonorrhoeae or C. trachomatis had significantly milder disease (P less than 0.05) compared with patients whose specimens were negative for those organisms. Furthermore, those patients with ultrasound confirmation of a tubo-ovarian complex had significantly (P less than 0.0001) greater recovery of aerobes and anaerobes from culdocentesis fluid than did patients with milder disease.

Pyelonephritis associated with respiratory distress

We present a case of pyelonephritis associated with respiratory distress and elevated liver enzymes in a pregnant patient.