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Barnicot K, Welsh M, Kalwarowsky S, Stevens E, Iles J, Parker J, Miele M, Lawn T, O'Hanlon L, Sundaresh S, Ajala O, Bassett P, Jones C, Ramchandani P, Crawford M. Video feedback parent-infant intervention for mothers experiencing enduring difficulties in managing emotions and relationships: A randomised controlled feasibility trial. Br J Clin Psychol 2022; 61:1188-1210. [PMID: 36018275 DOI: 10.1111/bjc.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/26/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Parents experiencing mental health difficulties consistent with "personality disorder", often related to a history of complex trauma, may face increased challenges in parent-child relationships and child socioemotional development. There are no published randomised controlled trials (RCTs) evaluating perinatal parent-child interventions for this population. We evaluated the feasibility and acceptability of undertaking an RCT of the video feedback intervention for positive parenting adapted for perinatal mental health (VIPP-PMH). DESIGN Feasibility study incorporating a pilot RCT. METHODS Mothers with enduring difficulties in managing emotions and relationships, consistent with a "personality disorder", and their 6- to 36-month old infants were randomly allocated to receive six sessions of VIPP-PMH (n = 20) or usual care alone (n = 14). RESULTS 76% of eligible mothers consented to participate. Intervention uptake and completion rates were 95% (≥1 VIPP-PMH session) and 70% (6 sessions), respectively. Follow-up rates were 85% at month 5 and 65% at month 8 post-baseline. Blinded observer-ratings of maternal sensitivity in parent-child interaction favoured the intervention group at month 5 (RR = 1.94, 95% CI 0.67-5.63) and month 8 (RR = 1.91, 95% CI 0.68-5.33). Small changes over time in self-rated parenting confidence and stress favoured the intervention group. There were no clear intervention effects on maternal non-intrusiveness or mental health, or on child behaviour problems, emotional functioning, or self-regulation. CONCLUSIONS An RCT of VIPP-PMH is feasible and acceptable to implement with mothers experiencing difficulties consistent with perinatal "personality disorder". A fully powered definitive RCT should be undertaken.
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Affiliation(s)
- Kirsten Barnicot
- Research and Development/Perinatal Mental Health Service, Central & North West London NHS Foundation Trust, London, UK.,Division of Psychiatry, Imperial College London, London, UK.,Centre for Mental Health Research, City University of London, London, UK
| | - Morgan Welsh
- Department of Psychology, University of Surrey, Guildford, UK
| | - Sarah Kalwarowsky
- Research and Development/Perinatal Mental Health Service, Central & North West London NHS Foundation Trust, London, UK
| | - Eloise Stevens
- Research and Development/Perinatal Mental Health Service, Central & North West London NHS Foundation Trust, London, UK.,Division of Psychiatry, Imperial College London, London, UK
| | - Jane Iles
- Department of Psychology, University of Surrey, Guildford, UK
| | - Jennie Parker
- Research and Development/Perinatal Mental Health Service, Central & North West London NHS Foundation Trust, London, UK
| | - Maddalena Miele
- Research and Development/Perinatal Mental Health Service, Central & North West London NHS Foundation Trust, London, UK
| | - Tara Lawn
- Perinatal Mental Health Service, East London NHS Foundation Trust, London, UK
| | - Laura O'Hanlon
- Perinatal Mental Health Service, East London NHS Foundation Trust, London, UK
| | - Sushma Sundaresh
- Perinatal Mental Health Service, Oxleas NHS Foundation Trust, London, UK
| | - Ola Ajala
- Perinatal Mental Health Service, Camden & Islington NHS Foundation Trust, London, UK
| | | | - Christina Jones
- Department of Psychology, University of Surrey, Guildford, UK
| | | | - Mike Crawford
- Division of Psychiatry, Imperial College London, London, UK
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Ajala O, Mold F, Boughton C, Cooke D, Whyte M. Childhood predictors of cardiovascular disease in adulthood. A systematic review and meta-analysis. Obes Rev 2017; 18:1061-1070. [PMID: 28545166 DOI: 10.1111/obr.12561] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 04/01/2017] [Accepted: 04/04/2017] [Indexed: 11/27/2022]
Abstract
Childhood obesity predicts the risk of adult adiposity, which is associated with the earlier onset of cardiovascular disease [adult atherosclerotic cardiovascular disease, ACVD: hypertension, increased carotid intima media thickness (CIMT) stroke, ischemic heart disease (IHD)] and dysglycaemia. Because it is not known whether childhood obesity contributes to these diseases, we conducted a systematic review of studies that examine the ability of measures of obesity in childhood to predict dysglycaemia and ACVD. Data sources were Web of Science, MEDLINE, PubMed, CINAHL, Cochrane, SCOPUS, ProQuest and reference lists. Studies measuring body mass index (BMI), skin fold thickness and waist circumference were selected; of 1,954 studies, 18 met study criteria. Childhood BMI predicted CIMT: odds ratio (OR), 3.39 (95% confidence interval (CI), 2.02 to 5.67, P < 0.001) and risk of impaired glucose tolerance in adulthood, but its ability to predict ACVD events (stroke, IHD; OR, 1.04; 95% CI, 1.02 to 1.07; P < 0.001) and hypertension (OR, 1.17, 95% CI 1.06 to 1.27, P = 0.003) was weak-moderate. Body mass index was not predictive of systolic BP (r -0.57, P = 0.08) and weakly predicted diastolic BP (r 0.21, P = 0.002). Skin fold thickness in childhood weakly predicted CIMT in female adults only (rs 0.09, P < 0.05). Childhood BMI predicts the risk of dysglycaemia and abnormal CIMT in adulthood, but its ability to predict hypertension and ACVD events was weak and moderate, respectively. Skin fold thickness was a weak predictor of CIMT in female adults.
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Affiliation(s)
- O Ajala
- Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - F Mold
- Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - C Boughton
- Department Diabetes, King's College Hospital NHS Foundation Trust, London, UK
| | - D Cooke
- Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - M Whyte
- Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK.,Department Diabetes, King's College Hospital NHS Foundation Trust, London, UK
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Ajala O, Owoyemi A. Effect of dietary vernonia amygdalina del. supplementation on some biological parameters of milt of male African catfish (Clarias gariepinus). BJVM 2016. [DOI: 10.15547/bjvm.876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Brognaro E, Ghods A, Feinstein D, Glick R, Connolly KJ, Meetze K, Boudrow A, Gyuris J, Han M, Hingtgen S, Figueiredo JL, Farrar C, Farrar C, Deubgen M, Martinez-Quintanilla J, Bhere D, Shah K, Marino AM, Lang SS, Boucher K, Sievert AJ, Madsen PJ, Slaunwhite E, Brewington D, Storm PB, Resnick AC, Poon C, Wu W, Pontifex C, Al-Najjar M, Artee Luchman H, Chesnelong C, Chan J, Weiss S, Gregory Cairncross J, Blough M, Brennan PM, Baily J, Diaz M, Ironside JW, Sansom O, Brunton V, Frame M, Tome CML, Miller LD, Debinski W, Borges AR, Larrubia PL, Marques JMB, Cerdan SG, Ozawa T, Huse JT, Squatrito M, Holland EC, Lee MH, Amlin-Van Schaick J, Broman K, Reilly K, Miller CR, Vitucci M, Bash R, White KK, Schmid RS, Pham CD, Flores C, Snyder D, Bigner DD, Sampson JH, Mitchell DA, Lal B, Rath P, Ajala O, Goodwin RC, Mughal S, Laterra JJ, Corwin D, Holdsworth C, Stewart R, Baldock A, Rockne R, Swanson K, Corwin D, Holdsworth C, Stewart R, Baldock A, Rockne R, Swanson K, Mikheev AM, Ramakrishna R, Stoll EA, Mikheeva SA, Beyer RP, Born D, Rockhill JK, Silber JR, Horner PJ, Rostomily R, Higgins DM, Wang R, Schroeder M, Carlson B, Yamada R, Meyer FB, Sarkaria JN, Henley JR, Parney IF, Chae M, Zhang L, Peterson TE, Schroeder MA, Sarkaria JN. LAB-TUMOR MODELS (IN VIVO/IN VITRO). Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
CONTEXT The insulin tolerance test (ITT) is the gold standard for assessment of the pituitary adrenal axis but its use is limited because of concerns relating to the risk of hypoglycaemia. OBJECTIVE This study examined the depth and duration of hypoglycaemia achieved during the test in a large cohort of patients. DESIGN Two hundred and twenty ITTs were performed from 2005 to 2010. SETTING A 1200-bed University Teaching Hospital. PATIENTS Two hundred and twenty ITTs were carried out in patients with suspected or known pituitary disorders. INTERVENTIONS Intravenous insulin was administered to achieve nadir plasma glucose (NPG) of 2.2 mmol/l (39.6 mg/dl). Blood chemistry to show the cortisol and GH response to hypoglycaemic stress was measured. MAIN OUTCOME MEASURES Predictors of depth and duration of hypoglycaemia, adverse events and within-subject variability of nadir glucose, peak cortisol and peak GH were studied. RESULTS Thirty percent of the cohort achieved a nadir glucose of <2.0 mmol/l (36 mg/dl) that lasted for 60 min or more. The NPG correlated positively with fasting plasma glucose (FPG; r=0:56; P<0.0005), insulin dose (r=0.27; P<0.0005) and weight (r=0.21; P<0.004). The within subject variability of nadir glucose was 15.2%, peak cortisol was 11.7% and peak GH was 6.4%. The factors determining nadir blood glucose were FPG (b=0.56, P<0.0005, 20% contribution) and weight (b=0.14, P<0.05, 2% contribution). The five patients with adverse events had NPG and insulin dose comparable with the rest of the population. CONCLUSIONS The hypoglycaemia achieved during the ITT is much lower than the target required. However, adverse events are few and do not relate to the depth of hypoglycaemia.
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Affiliation(s)
- O Ajala
- Department of Endocrinology, Derriford Hospital, Level 9, Plymouth PL6 8DH, UK.
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Ajala O, Hosking J, Metcalf BS, Jeffery AN, Voss LD, Wilkin TJ. The contribution of parental BMI to the metabolic health of their offspring: a longitudinal cohort study (EarlyBird 55). Pediatr Obes 2012; 7:143-50. [PMID: 22434754 DOI: 10.1111/j.2047-6310.2011.00013.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 10/12/2011] [Accepted: 10/18/2011] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The objective of this study was to establish the extent to which parental factors influence the metabolic health of their offspring. DESIGN The study was designed as a prospective longitudinal cohort study SUBJECTS The study's subjects were 226 healthy trios from a 1995 to 1996 birth cohort randomly recruited in the city of Plymouth, UK MEASUREMENTS: Body mass index (BMI) and metabolic z-score (derived from natural log HOMA-IR, triglycerides, total/high-density lipoprotein cholesterol ratio), measured at nine annual time points, from 5 to 13 years. RESULTS As expected, the metabolic z score was closely related to BMI in both genders and at all ages (r = 0.40-0.57, P < 0.001). Accordingly, there were large and significant differences in the metabolic z-score between children categorized as normal weight or overweight/obese. At 13 years, for example, the metabolic z score of the overweight/obese girls was 14-fold greater than that of the normal-weight girls (P < 0.001). However, parental BMI and metabolic status had little effect on these differences. Indeed, mixed effects modelling showed that, as the child's BMI increased, so the influence of parental factors became less relevant. Time-lag analyses confirmed that weight gain preceded metabolic disturbances in the children. CONCLUSION The impact of obesity on the metabolic health of contemporary children is a function of their own weight gain, rather than that of their parents, and is therefore potentially preventable.
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Affiliation(s)
- O Ajala
- Department of Endocrinology and Metabolism, Peninsula College of Medicine and Dentistry (Plymouth Campus), Plymouth, UK
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Hebert D, Cantu P, Washington C, Ajala O, Feldman M. Note: high capacity digital laser beam steering system. Rev Sci Instrum 2011; 82:116101. [PMID: 22129017 DOI: 10.1063/1.3659949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The combination of liquid crystal cells with polarizing cube beam splitters has been used to direct a beam of light to multiple directions. The polarization at each beam splitter is controlled by applying a signal to a corresponding liquid crystal cell. Ten cascaded stages have deflected a HeNe laser beam to 1024 digitally selectable angles.
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Affiliation(s)
- D Hebert
- Department of Electrical and Computer Engineering, Louisiana State University, Baton Rouge, Louisiana 70803, USA
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