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The relationship between sexual abuse during childhood and parenting outcomes: modeling direct and indirect pathways.

OBJECTIVE: This study examined the association between childhood sexual abuse (CSA) and parenting outcomes including parenting stress, feelings of competence and discipline strategies. Maternal depression and current partner violence were hypothesized to be mediators of the association between CSA and parenting. METHOD: This study is based on secondary data analysis of archived data. The participants were 263 primiparous mothers (107 with a history of CSA and 156 comparison mothers recruited from a prenatal clinic prior to the birth of their first child. Mothers were interviewed twice: once when they were between 28 and 32 weeks gestation and again when their child was between 2 and 4 years of age. During the first interview, women were asked about childhood experiences of sexual abuse. During their second interview, they were asked about current symptoms of pathology and experiences with partner violence and parenting beliefs and practices. RESULTS: Structural Equation Modeling indicated that the relationship between CSA and punitive discipline was mediated by maternal depression and current partner violence. CSA was associated with higher maternal depression and higher partner violence. CSA, maternal depression, and current partner violence were associated with more negative parental perceptions and higher punitive discipline. Once maternal depression and current partner violence were in the model, the relationship between CSA and parenting outcomes was no different from zero. CONCLUSION: These results highlight the risks associated with CSA for parenting outcomes and suggest two potential pathways for this increased risk.

Adult↗

Simulation analysis of the consequences of shifting the balance of health care: a system dynamics approach.

OBJECTIVES: The shift in the balance of health care, bringing services 'closer to home', is a well-established trend. This study sought to provide insight into the consequences of this trend, in particular the stimulation of demand, by exploring the underlying feedback structure. METHODS: We constructed a simulation model using the system dynamics method, which is specifically designed for the analysis of feedback structure. The model was calibrated to two cases of the shift in cardiac catheterization services in the UK. Data sources included archival data, observations and interviews with senior health care professionals. Key model outputs were the basic trends displayed by waiting lists, average waiting times, cumulative patient referrals, cumulative patient activity and cumulative overall costs. RESULTS: Demand was stimulated in both cases via several different mechanisms. We revealed the roles for clinical guidelines and capacity changes, and the typical responses to imbalances between supply and demand. Our analysis also demonstrated the potential benefits of changing the goals that drive activity by seeking a waiting list goal rather than a waiting time goal. CONCLUSIONS: Appreciating the wider consequences of shifting the balance of care is essential if services are to be improved overall. The underlying feedback mechanisms of both intended and unintended effects need to be understood. Using a systemic approach, more effective policies may be designed through coordinated programmes rather than isolated initiatives, which may have only a limited impact.

Cardiac Catheterization↗

Antiepileptic TDM pattern at a tertiary care hospital in India.

Therapeutic drug monitoring, a comparatively new investigational procedure in clinical pharmacology, is considered very beneficial to epilepsy patients though it increase the health care cost. Aim of this study was to determine the pattern of use of antiepileptic drug level monitoring over the last 7 years in our tertiary care centre and to critically comment on its utility. Retrospective data audit of archived data from 1998 to 2004 and age, sex, estimated levels of phenytoin, carbamazepine and phenobarbitone by HPLC were noted down, tabulated and compared. Chi square test was used for analysis. Three thousand five jundred thirty four blood samples of patients requesting for 4213 estimations of phenytoin, phenobarbitone or carbamazepine were received. Among the obtained samples, 44.0% (1058) were of children, 68.0% (2402) were of males, 0.6% (22) patients were getting 3 and 18.0% (635) getting 2, antiepileptic medications. 13.0% (546) samples showed level in the toxic range and 39.0% (1653) in lower range. There was increasing demand observed for estimation of antiepileptic drugs, over the 7 years. The number of abnormal values of phenytoin, phenobarbitone and carbamazepine did not show any significant difference over the years. The pattern was similar to that observed in other countries.

Anticonvulsants↗

Data Grids: a new computational infrastructure for data-intensive science.

Twenty-first-century scientific and engineering enterprises are increasingly characterized by their geographic dispersion and their reliance on large data archives. These characteristics bring with them unique challenges. First, the increasing size and complexity of modern data collections require significant investments in information technologies to store, retrieve and analyse them. Second, the increased distribution of people and resources in these projects has made resource sharing and collaboration across significant geographic and organizational boundaries critical to their success. In this paper I explore how computing infrastructures based on Data Grids offer data-intensive enterprises a comprehensive, scalable framework for collaboration and resource sharing. A detailed example of a Data Grid framework is presented for a Large Hadron Collider experiment, where a hierarchical set of laboratory and university resources comprising petaflops of processing power and a multi-petabyte data archive must be efficiently used by a global collaboration. The experience gained with these new information systems, providing transparent managed access to massive distributed data collections, will be applicable to large-scale, data-intensive problems in a wide spectrum of scientific and engineering disciplines, and eventually in industry and commerce. Such systems will be needed in the coming decades as a central element of our information-based society.

Computer Communication Networks↗

Patterns of maternal behavior among neglectful families: implications for research and intervention.

OBJECTIVE: The heterogeneity within neglecting caregivers has not been explored in an empirical fashion. The current study sought to address this limitation by utilizing archival data in order to explore variability of maternal behavior among neglectful families. METHOD: The current study utilized archival data containing caseworker and self-report information on 100 mothers for whom neglect had been substantiated and was the primary referral concern. Cluster analysis was used to describe patterns of maternal behavior. Subsequent analysis was used to determine differences between the clusters on degree of neglect, maternal depression, perceived social support, and other demographic characteristics (income, education). RESULTS: Five distinct patterns of maternal behavior emerged, each with different ratings of maternal confidence, relatedness, impulse control, and willingness to engage in verbal interactions. The clusters differed on ratings of neglect, life stressors, resource problems and adult problems. The clusters were similar in terms of maternal education, number of children in the home, and monthly income. Additionally, women in all clusters reported similar levels of depression, similar number of children, and a comparable amount of social support. CONCLUSIONS: The five clusters are described and implications for intervention approaches are discussed.

Adolescent↗

Operating system components--Part II.

To summarize this discussion, let us look at a prototype, a capsule scenario in an OS. You make a process creation request on your local timeshare system. The long-term scheduler queues up this request, and eventually creates the corresponding process. Your process takes its turns executing, scheduled by the short-term scheduler. You request a tape drive to retrieve some archived data you need, and thus invoke the resource manager. You use the file manager to access the archived data. You use the I/O system to interact with the application program and to print the reports. The memory manager is swapping pages of your data and program between main memory and secondary memory. The dispatcher in the kernel is loading your process context into the CPU when your process is next on the execute list. The interrupt handler in the kernel is servicing interrupt requests, such as those made when you do I/O to the tape. The concurrency control in the kernel is coordinating your updating and spooled printing activities. So, your process is invoking activities throughout the various layers of the OS. Most of the time, you are unaware of these many varied activities.

Computer Systems↗

The California Child Health and Development Studies of the School of Public Health, University of California at Berkeley.

The Child Health and Development Studies are prospective longitudinal studies on medical and social aspects of pregnancies and on the health and development of children. Data have been assembled on about 20,000 pregnancies occurring in one hospital between 1959 and 1967, and on follow-up of the children through adolescence. A currently ongoing project updates certain vital statistics of the entire study population. The data assembled in this longitudinal study supported a wide range of research projects, several of which proved to be important for the health of mothers and children. Notwithstanding, subsets of the assembled data, with potential value for public health, have not yet been explored. The data archive has been made accessible to the research community at large so that other significant research topics can be investigated. In the following article, brief descriptions are given of the history and design of the Child Health and Development Studies, of the contents of the data archive, and of the major areas of research that have been explored. Procedures to obtain access to the data and to the user's manual are explained, and a bibliography is included.

Adolescent↗

The Karyote physico-chemical genomic, proteomic, metabolic cell modeling system.

Modeling approaches to the dynamics of a living cell are presented that are strongly based on its underlying physical and chemical processes and its hierarchical spatio-temporal organization. Through the inclusion of a broad spectrum of processes and a rigorous analysis of the multiple scale nature of cellular dynamics, we are attempting to advance cell modeling and its applications. The presentation focuses on our cell modeling system, which integrates data archiving and quantitative physico-chemical modeling and information theory to provide a seamless approach to the modeling/data analysis endeavor. Thereby the rapidly growing mess of genomic, proteomic, metabolic, and cell physiological data can be automatically used to develop and calibrate a predictive cell model. The discussion focuses on the Karyote cell modeling system and an introduction to the CellX and VirusX models. The Karyote software system integrates three elements: (1) a model-building and data archiving module that allows one to define a cell type to be modeled through its reaction network, structure, and transport processes as well as to choose the surrounding medium and other parameters of the phenomenon to be modeled; (2) a genomic, proteomic, metabolic cell simulator that solves the equations of metabolic reaction, transcription/translation polymerization and the exchange of molecules between parts of the cell and with the surrounding medium; and (3) an information theory module (ITM) that automates model calibration and development, and integrates a variety of data types with the cell dynamic computations. In Karyote, reactions may be fast (equilibrated) or slow (finite rate), and the special effects of enzymes and other minority species yielding steady-state cycles of arbitrary complexities are accounted for. These features of the dynamics are handled via rigorous multiple scale analysis. A user interface allows for an automated generation and solution of the equations of multiple timescale, compartmented dynamics. Karyote is based on a fixed intracellular structure. However, cell response to changes in the host medium, damage, development or transformation to abnormality can involve dramatic changes in intracellular structure. As this changes the nature of the cellular dynamics, a new model, CellX, is being developed based on the spatial distribution of concentration and other variables. This allows CellX to capture the self-organizing character of cellular behavior. The self-assembly of organelles, viruses, and other subcellular bodies is being addressed in a second new model, VirusX, that integrates molecular mechanics and continuum theory. VirusX is designed to study the influence of a host medium on viral self-assembly, structural stability, infection of a single cell, and transmission of disease.

Animals↗

A new perspective in learning pattern generation for teaching neural networks.

This article deals with the Learning Patterns (LPs)' generation, a major aspect of Feed-Forward Artificial Neural Networks (FANNs)' learning process. Currently, more work is done to understand the mechanisms and improve the speed, learning accuracy, and implementation features of FANNs' teaching algorithms, though little is done towards the development of enhanced techniques that would extract experts' knowledge (from examples, rules, etc.) and obtain standardised LPs that would improve this learning process. A new approach in generating LPs is thereby introduced, that is used to train a new Medical Decision Support System (MDSS) based on FANNs, and its performance is analysed and compared with previous methods. It can handle incomplete data archives, individually boost any particular dataum special characteristics, and its application induces the FANNs to show better convergent facets. The efficiency of the resulting MDSS was thoroughly tested by pulmonologists and haematologists using medical data archives of a regional hospital.

Journal Article↗

[Completed suicide in outline--on basis of Cracow's Institute of Forensic Medicine data in 1991-2000 years].

The study presents the results of research into completed suicide. The authors have analyzed cases of completed suicide committed in Cracow and it's environs in the years 1991-2000. The aim of the research is to describe some features of this phenomenon with it's transformations in the last periods. The presented material bases on archival data of postmortem examinations made in Cracow's Institute of Forensic Medicine. Analyses' were executed in reference of victims' sex, age and place of residence, number and frequency of suicides in Cracow population, methods, predictors and possible motives. The authors also present a sketch of the bibliography regarding the topic, and the comparison between the results of the present study and the results of earlier studies from Cracow environs of the phenomenon of suicide. 1933 cases of completed suicides were analysed, from what over a half concerned occupants of our city. The average coefficient for 100 000 occupants carried out 13.2. There were 1485 men and 448 women among victims, in age from 13 to 95 years. Male to female avarage ratio carried out 3.3:1 in the described period.. Average age carried out 45.5 years, for men 44.5, and for women 48.8 years. The superiority of men is strongly visible in groups of young persons and in "middle age". Results from archival data show that, hanging was the the most frequent way of suicide. In studied material there were more then 63% cases of suicidal hanging. Falls from height, poisonings and drownings were next in line. In very considerable number of cases (almost 60%) the presence of mental disorder in anamnesis was affirmed. This concerned particularly women where the most frequent were depression disorders. For men, first of all factors was dependence from acohol. Over one third of the victims were pensioners and unemployeds. The level of ethanol in blood in 718 cases was crossed 0.5 promille.

Adolescent↗

The nature and evolution of phenomenological empathy in nursing: an historical treatment.

This study is an historical analysis of the nature and evolution of phenomenological empathy in nursing covering the period from 1861 through 1981. Nursing archival data were analyzed beginning with the inception of modern American nursing during the Civil War. The categories patient cues, empathy, nursing interventions, and patient responses were applied to the qualitative data. Analysis generated 119 instances of phenomenological empathy. The findings showed that patient cues were not a factor in precipitating nurse empathy, whereas patient responses to nursing interventions showed positive outcomes. A conceptual model of phenomenological empathy comprised of four major constructs and 18 concepts was derived from the archival data.

Empathy↗

The worldwide Protein Data Bank (wwPDB): ensuring a single, uniform archive of PDB data.

The worldwide Protein Data Bank (wwPDB) is the international collaboration that manages the deposition, processing and distribution of the PDB archive. The online PDB archive is a repository for the coordinates and related information for more than 38 000 structures, including proteins, nucleic acids and large macromolecular complexes that have been determined using X-ray crystallography, NMR and electron microscopy techniques. The founding members of the wwPDB are RCSB PDB (USA), MSD-EBI (Europe) and PDBj (Japan) [H.M. Berman, K. Henrick and H. Nakamura (2003) Nature Struct. Biol., 10, 980]. The BMRB group (USA) joined the wwPDB in 2006. The mission of the wwPDB is to maintain a single archive of macromolecular structural data that are freely and publicly available to the global community. Additionally, the wwPDB provides a variety of services to a broad community of users. The wwPDB website at http://www.wwpdb.org/ provides information about services provided by the individual member organizations and about projects undertaken by the wwPDB.

Databases, Protein↗

School and neighborhood characteristics associated with school rates of alcohol, cigarette, and marijuana use.

Previous research has noted that schools vary in substance use prevalence rates, but explanations for school differences have received little empirical attention. We assess variability across elementary schools (N = 36) in rates of early adolescent alcohol, cigarette, and marijuana use. Characteristics of neighborhoods and schools potentially related to school prevalence rates are examined, as well as whether these characteristics have independent effects or whether neighborhood characteristics are mediated by school characteristics. Neighborhood and school characteristics were measured using student, parent, and archival data. The findings show substantial variation across schools in substance use. Attributes of neighborhoods and schools are statistically significantly related to school rates of lifetime alcohol use, lifetime cigarette use, and current cigarette use. Contrary to expectations, lifetime alcohol and cigarette use rates are higher in schools located in neighborhoods having greater social advantages as indicated by the perceptions of residents and archival data. Neighborhood effects are expressed both directly and indirectly through school characteristics. The findings are discussed in light of contagion and social disorganization theories.

Adolescent↗

The Protein Data Bank: unifying the archive.

The Protein Data Bank (PDB; http://www.pdb.org/) is the single worldwide archive of structural data of biological macromolecules. This paper describes the progress that has been made in validating all data in the PDB archive and in releasing a uniform archive for the community. We have now produced a collection of mmCIF data files for the PDB archive (ftp://beta.rcsb.org/pub/pdb/uniformity/data/mmCIF/). A utility application that converts the mmCIF data files to the PDB format (called CIFTr) has also been released to provide support for existing software.

Amino Acid Sequence↗

[The completed and attempted suicide in Krakow: similarities and differences].

The study presents the results of the interdisciplinary research conducted on the basis of cooperation between the Institute of Forensic Medicine, the Department of Clinical Toxicology, and the Clinic of Psychiatry in Kraków. The aim of the research was to determine similarities and differences between attempted and completed suicide from the point of view of socio-demographic and clinical traits. The authors analysed 220 cases of completed suicide committed in Kraków and its environs in the year 2000. The material presented in the study was based on the archive data from post mortem examinations conducted in the Institute of Forensic Medicine in Kraków. The sample consisted of 177 males and 43 females ranging in age from 13 to 89 years. The mean age was 43.6 years for the entire group, 42 years for males and 50 years for females. The majority of subjects were males, either unemployed, or pensioners. A similar tendency was observed in the group of female subjects. Mental disorders and alcoholic addiction in anamnesis were discovered in a significant number of cases, both in the group of males and in the group of females. Subjects, in whom serious somatic diseases had been detected, constituted a separate group of cases. According to the archive data, in the last century, suicide was most frequently committed by hanging. Similarly, in the sample examined, in 133 cases, suicide was committed by hanging. In 37% of cases, the level of alcohol in the suicides' blood was between 0.5 and 3 or more g/L. In 2000/2001, within the analogical period of 12 months, the group of 200 patients after a suicide attempt by drug intoxication was examined in the Department of Clinical of Toxicology Jagiellonian University College of Medicine. This group included 49 males and 150 females, ranging in age from 18 to 79 years (mean age 35). The examination was conducted by means of structured investigation and medical documentation. Contrary to completed suicide, in the group of suicide attempters, females outnumbered males. Young people under thirty, living in a large city, possessing elementary or secondary education, and either unemployed, or pensioners, constituted the majority of the examined group. A significant percentage of females was divorced and lived with their children only. The majority of the examined population of suicide attempters had used alcohol during the attempt, had suffered from depression, personality or behavioural disorders, had undergone psychiatric treatment, or had had cases of suicide among their friends or relatives.

Adolescent↗

Patterns of child abuse and neglect associated with chronological age of children living in a midwestern county.

OBJECTIVE: The main objective of the study was to investigate the relationship between age of the very young victim and the type of abuse perpetrated against that victim. A secondary objective was to examine gender and racial differences in child abuse and neglect in children between the ages of birth and 7 years. METHOD: Archived data for all cases of substantiated abuse of children for the years of 1990-1996 inclusive were retrieved from a data bank at a county children services department (N = 876). Chi-square analyses were used to determine age, gender, and racial differences in child abuse and neglect in children 0 to 7 years of age. RESULTS: Neglect was the most common form of primary substantiated abuse recorded for this population of children under the age of 7 years, although the incidence of neglect decreased as chronological age of the child increased. Sexual abuse increased in occurrence as the children got older. Girls were more likely to be victims of sexual abuse than boys. No significant age differences were observed for physical abuse or for emotional abuse, and no racial differences were detected for any of the four types of abuse examined. CONCLUSIONS: Although the findings of this study are in agreement with those of previously published reports, there is some question as to whether archived data are an accurate reflection of actual patterns of maltreatment occurring in very young children or whether they represent the types of abuse that are subjectively identified and reported by authorities.

Age Factors↗