Impact of "early intervention" parent workshops on outcomes for caregivers of children with neurodisabilities: a mixed-methods study

PURPOSE

This study explored the feasibility, impact and parent experiences of ENVISAGE (ENabling VISions And Growing Expectations)-Families, a parent-researcher co-designed and co-led program for parents/caregivers raising children with early-onset neurodisabilities.

METHODS

Parents/caregivers of a child with a neurodisability aged ≤6 years, recruited in Australia and Canada, participated in five weekly online workshops with other parents. Self-report measures were collected at baseline, immediately after, and 3 months post-ENVISAGE-Families; interviews were done following program completion. Quantitative data were analyzed with generalized estimating equations and qualitative data using interpretive description methodology.

RESULTS

Sixty-five parents (86% mothers) were recruited and 60 (92%) completed the program. Strong evidence was found of effects on family empowerment and parent confidence (all p ≤ 0.05 after the program and maintained at 3-month follow-up). The ENVISAGE-Families program was relevant to parents' needs for: information, connection, support, wellbeing, and preparing for the future. Participants experienced opportunities to reflect on and/or validate their perspectives of disability and development, and how these perspectives related to themselves, their children and family, and their service providers.

CONCLUSIONS

ENVISAGE was feasible and acceptable for parent/caregivers. The program inspired parents to think, feel and do things differently with their child, family and the people who work with them.Implications for rehabilitationENVISAGE (ENabling VISions And Growing Expectations)-Families is a co-designed, validated parent/researcher "early intervention and orientation" program for caregivers raising a child with neurodevelopmental disabilities (NDDs).ENVISAGE-Families empowered parents' strengths-based approaches to their child, family, disability, and parenting.ENVISAGE-Families increased caregivers' confidence in parenting children with NDD's and provided them tools to support connection, collaboration, and wellbeing.Raising children with NDD can have a profound impact on caregivers, who can benefit from strengths-based, future focused supports early in their parenting experience.

Targeted delivery of regulatory macrophages to lymph nodes interferes with T cell priming by preventing the formation of stable immune synapses

Immunosuppressive myeloid cells are frequently induced in tumors and attenuate anti-tumor effector functions. In this study, we differentiate immunosuppressive regulatory macrophages (Mregs) from hematopoietic progenitors and test their potential to suppress adaptive immune responses in lymph nodes. Targeted delivery of Mregs to lymph nodes is facilitated by retroviral overexpression of the chemokine receptor CCR7 and intra-lymphatic cell application. Delivery of Mregs completely abolishes the priming of cognate CD8 cells and strongly reduces delayed-type hypersensitivity reactions. Mreg-mediated T cell suppression requires cell-cell contact-regulated nitric oxide production. Two-photon microscopy reveals that nitric oxide produced by Mregs reduces the interaction duration between dendritic cells and T cells. Exposure of activated T cells to nitric oxide strongly reduces their binding to ICAM-1, indicating that nitrosylation of proteins involved in cell adhesion affects synapse formation. Thus, this study identifies a mechanism of myeloid cell-mediated immune suppression and provides an approach for its therapeutic use.

Efficient homing of T cells via afferent lymphatics requires mechanical arrest and integrin-supported chemokine guidance

Little is known regarding lymph node (LN)-homing of immune cells via afferent lymphatics. Here, we show, using a photo-convertible Dendra-2 reporter, that recently activated CD4 T cells enter downstream LNs via afferent lymphatics at high frequencies. Intra-lymphatic immune cell transfer and live imaging data further show that activated T cells come to an instantaneous arrest mediated passively by the mechanical 3D-sieve barrier of the LN subcapsular sinus (SCS). Arrested T cells subsequently migrate randomly on the sinus floor independent of both chemokines and integrins. However, chemokine receptors are imperative for guiding cells out of the SCS, and for their subsequent directional translocation towards the T cell zone. By contrast, integrins are dispensable for LN homing, yet still contribute by increasing the dwell time within the SCS and by potentially enhancing T cell sensing of chemokine gradients. Together, these findings provide fundamental insights into mechanisms that control homing of lymph-derived immune cells.

Immune cells mostly enter lymph nodes (LN) from blood circulation, but whether afferent lymphatics contributes to LN entry is unclear. Here, the authors show, using a photo-convertible reporter, that T cells in afferent lymphatics frequently enter LN and become arrested in the subcapsular sinus, with chemokines and integrins further guiding their migration in the LN.

In Vivo Killing Capacity of Cytotoxic T Cells Is Limited and Involves Dynamic Interactions and T Cell Cooperativity

According to in vitro assays, T cells are thought to kill rapidly and efficiently, but the efficacy and dynamics of cytotoxic T lymphocyte (CTL)-mediated killing of virus-infected cells in vivo remains elusive. We used two-photon microscopy to quantify CTL-mediated killing in mice infected with herpesviruses or poxviruses. On average, one CTL killed 2–16 virus-infected cells per day as determined by real-time imaging and by mathematical modeling. In contrast, upon virus-induced MHC class I downmodulation, CTLs failed to destroy their targets. During killing, CTLs remained migratory and formed motile kinapses rather than static synapses with targets. Viruses encoding the calcium sensor GCaMP6s revealed strong heterogeneity in individual CTL functional capacity. Furthermore, the probability of death of infected cells increased for those contacted by more than two CTLs, indicative of CTL cooperation. Thus, direct visualization of CTLs during killing of virus-infected cells reveals crucial parameters of CD8⁺ T cell immunity.

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Two-photon imaging indicates that CTLs kill 2–16 virus-infected cells per day

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CTLs form kinapses rather than stable synapses when killing virus-infected cells

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Some CTL contacts trigger long-lasting calcium fluxes in virus-infected cells

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CTLs can cooperate during killing of virus-infected cells

Atmospheric dispersion modelling applying advanced model approaches

Incidents and accidents occurring in nuclear facilities, transport accidents or malevolent actions associated with radioactive material may involve a release of airborne radionuclides. For these situations, a realistic assessment of the radiological consequences for the public is of great importance with respect to adequate emergency measures. Within this context, the determination of the spatial distribution of the resulting airborne concentration as well as of the deposition of radionuclides on the ground, vegetation and building surfaces are necessary prerequisites. For such calculations, advanced atmospheric dispersion models are increasingly used. Their characteristics and fields of application are presented.

Screening of white-rot fungi for their ability to mineralize polycyclic aromatic hydrocarbons in soil

Soil samples from an agricultural field contaminated with 10 ppm 14C-benz(a)anthracene in glass tubes were brought into contact with cultures of wood-rotting fungi, precultivated on wheat straw substrate. Forty-five strains of white-rot fungi and four brown-rot fungi were tested for their ability to colonize the soil and to mineralize 14C-benz(a)anthracene to 14CO2 within a 20-week incubation time. Twenty-two white-rot fungi and all brown-rot fungi were unable to colonize the soil. Twenty-three strains of white-rot fungi, all belonging to the genus Pleurotus, colonized the soil. During the experiment the non-colonizing fungi and their substrate disintegrated more and more to a nonstructured pulp from which water diffused into the soil. The same phenomenon was observed in the control which contained only straw without fungus and contaminated soil. In samples with colonizing fungi the substrate as well as the mycelia in the soil remained visibly unchanged during the entire experiment. Surprisingly, most samples with fungi not colonizing the soil and the control without fungus liberated between 40 and 58% of the applied radioactivity as 14CO2 whereas the samples with the colonizing fungi respired only 15-25% as 14CO2. This was 3-5 times more 14CO2 than that liberated from the control (4.9%) which contained only contaminated soil without straw and fungus. A similar result was obtained with selected colonizing and noncolonizing fungi and soil contaminated with 10 ppm 14C-pyrene. However, in pure culture studies in which 14C-pyrene was added to the straw substrate, Pleurotus sp. (P2), as a representative of the colonizing fungi, mineralized 40.3% of the added radioactivity to 14CO2. The noncolonizing fungi Dichomitus squalens and Flammulina velutipes liberated only 17.2 or 1.7%, respectively, as 14CO2. These results lead to the hypothesis that the native soil microflora stimulated by the formed products of straw lysis is responsible for high degradation rates found with noncolonizing fungi.

Comparison of phenanthrene and pyrene degradation by different wood-decaying fungi

The degradation of phenanthrene and pyrene was investigated by using five different wood-decaying fungi. After 63 days of incubation in liquid culture, 13.8 and 4.3% of the [ring U-14C]phenantherene and 2.4 and 1.4% of the [4,5,9,10-14C]pyrene were mineralized by Trametes versicolor and Kuehneromyces mutabilis, respectively. No 14CO2 evolution was detected in either [14C]phenanthrene or [14C]pyrene liquid cultures of Flammulina velutipes, Laetiporus sulphureus, and Agrocybe aegerita. Cultivation in straw cultures demonstrated that, in addition to T. versicolor (15.5%) and K. mutabilis (5.0%), L. sulphureus (10.7%) and A. aegerita (3.7%) were also capable of mineralizing phenanthrene in a period of 63 days. Additionally, K. mutabilis (6.7%), L. sulphureus (4.3%), and A. aegerita (3.3%) mineralized [14C]pyrene in straw cultures. The highest mineralization of [14C] pyrene was detected in straw cultures of T. versicolor (34.1%), which suggested that mineralization of both compounds by fungi may be independent of the number of aromatic rings. Phenanthrene and pyrene metabolites were purified by high-performance liquid chromatography and identified by UV absorption, mass, and 1H nuclear magnetic resonance spectrometry. Fungi capable of mineralizing phenanthrene and pyrene in liquid culture produced enriched metabolites substituted in the K region (C-9,10 position of phenanthrene and C-4,5 position of pyrene), whereas all other fungi investigated produced metabolites substituted in the C-1,2, C-3,4, and C-9,10 positions of phenanthrene and the C-1 position of pyrene.

Two-step degradation of pyrene by white-rot fungi and soil microorganisms

The effect of soil microorganisms on mineralization of 14C-labelled pyrene by white-rot fungi in solid-state fermentation was investigated. Two strains of white-rot fungi, Dichomitus squalens and a Pleurotus sp., were tested. The fungi were incubated on milled wheat straw contaminated with [14C]pyrene for 15 weeks. CO2 and 14CO2 liberated from the cultures were determined weekly. To study the effect of soil microorganisms on respiration and [14C]pyrene mineralization in different periods of fungal development, the fungal substrate was covered with soil at different times of incubation (after 0, 1, 3, 5, 7, 9 or 11 weeks). The two fungi showed contrasting ecological behaviour in competition with the soil microflora. Pleurotus sp. was highly resistant to microbial attack and had the ability to penetrate the soil. D. squalens was less competitive and did not colonize the soil. The resistance of the fungus was dependent on the duration of fungal preincubation. Mineralization of [14C]pyrene by mixed cultures of D. squalens and soil microorganisms was higher than by the fungus or the soil microflora alone when soil was added after 3 weeks of incubation or later. With Pleurotus sp., the mineralization of [14C]pyrene was enhanced by the soil microflora irrespective of the time of soil application. With D. squalens, which in pure culture mineralized less [14C]pyrene than did Pleurotus sp., the increase of [14C]pyrene mineralization caused by soil application was higher than with Pleurotus sp.

Degradation of the fluoroquinolone enrofloxacin by wood-rotting fungi

The veterinary fluoroquinolone enrofloxacin was degraded in vitro by four species of wood-rotting fungi growing on wetted wheat straw containing carbonyl-14C-labeled drug. A maximum 14CO2 production of 17% per week was observed with the brown rot fungus Gloeophyllum striatum, resulting in up to 53% after 8 weeks. However, rates reached at most 0.2 and 0.9% per week, if enrofloxacin was preadsorbed to native or gamma ray-sterilized soil, respectively.

Geophysical variables and behavior: LXXVIII. Lunar phase and birthrate: an update

Martens, Kelly, and Saklofske in 1988 examined 21 studies considering the possible relationship between lunar periodicities and birthrate. They reported that the majority of studies uncovered no relationship and that the positive studies were inconsistent in their findings. The present update reports on six additional studies on birthrate and lunar periodicities from five different countries. None of these studies produced evidence of lunar periodicities consistent with folklore or some previous studies.

Safety and efficacy of a thymidine kinase negative equine herpesvirus-1 vaccine in young horses

A drug induced equine herpesvirus-1 (EHV-1) mutant lacking thymidine kinase inducing activity was developed and evaluated as a vaccine. The safety and effectiveness of the vaccine to protect against experimentally induced EHV-1 respiratory disease were evaluated in weanling horses free of EHV-1 neutralizing antibody. The vaccine was safe when administered either intramuscularly or intravenously, and EHV-1 was not shed intranasally during the 12 days following administration. Intranasal challenge with virulent EHV-1 was used to evaluate vaccine efficacy. Following challenge, there was a significantly (p less than 0.05) greater increase in peak body temperatures and duration of nasal virus shedding in the nonvaccinates, and a significant (p less than 0.05) increase in serum neutralizing antibody titers in the vaccinates.

Lunar phase and birthrate: a 50-year critical review

This review examines 21 studies for which data relating to lunar periodicities and birth have been analyzed. There is insufficient evidence to support such a relationship. Most studies have reported negative results, and the positive studies contradict each other.

The uniqueness of the young athlete: psychologic considerations

Through a review of the major reasons young athletes drop out of sports the basic psychologic needs of youngsters are identified. Although young athletes are not unique in these psychologic needs, each youngster is unique in how these needs are met. The paper concludes by countering some of the negative publicity youth sports program have received.

The significance of nonsignificant findings

The replication by Landers et al. (1978) of the Martens' (1969) social-facilitation study is evaluated. The atypical constant error (CE) performance curve obtained in the Martens' study may diminish the external validity of the CE results, but not the internal validity. Furthermore, the validity of the AE results as well as the highly significant physiological corroborative data remain unscathed. Finally, the conclusions about social facilitation research reached by Landers et al. are questioned in light of their nonsignificant, noncorroborated, and statistically nonpowerful results.

Competitive trait anxiety, success-failure and sex as determinants of motor performance

Two experiments determined the effects of competitive trait anxiety, success-failure, and sex on the performance of 10- to 12 yr.-old children competing on a complex motor maze. Competitive trait anxiety was assessed by the Sport Competition Anxiety Test and success-failure was induced by giving bogus win-loss feedback. High and low competitive trait-anxiety children were randomly assigned to one of three conditions: winning 80%, 50% or 20% of 20 contests. The average completion time and the variability of times within each of two blocks of 10 contests were the two performance measures. State-anxiety was assessed with Spielberger's State Anxiety Inventory for Children as an indicant of arousal prior to and during competition. The findings of Exp. 1 yielded no significant performance differences. In Exp. 2 a significant interaction of competitive trait anxiety X success-failure X sex for performance time and variability was obtained. This interaction was largely attributed to sex differences.

Degradation of [8,9,-14C]endosulfan by soil microorganisms

Twenty-eight soil fungi, 49 soil bacteria, and 10 actinomycetes were tested as to their ability to degrade the insecticide endosulfan. Using 14C-labeled material, the qualitative as well as the quantitative formation of metabolities, as well as of 14CO2, could be followed. Sixteen fungi, 15 bacteria, and 3 actinomycetes were found capable of metabolizing more than 30% of the applied endosulfan. The major metabolities detected were endosulfate, formed by oxidation of the sulfite group, and endodiol, formed by hydrolysis of the ester bond. The majority of highly active fungi formed endosulfate as the major metabolite, whereas the majority of active bacteria formed endodiol. In addition to endosulfate and endodiol, individual cultures contained small quantities of endohydroxyether and two unidentified products. The very small quantities of 14CO2 evolved from cultures indicated that an extensive mineralization of the carbon skeleton of endosulfan did not occur.

Social reinforcement effects on motor performance as a function of socio-economic status

The influence of social reinforcement as a function of social position on motor performance was investigated. 2 social positions (high and low) and 3 social reinforcement conditions (praise, reproof and non-reinforcement) were used in a 2 × 3 factorial design. 10 Ss were randomly assigned to each of the social reinforcement conditions for each level of social position. The motor task involved rolling a ball up an inclined board to a target area. No significant differences for the 2 main effects or their interaction appeared. The importance of the nonsignificant was explained in terms of information feedback.

Anxiety and Motor Behavior

Anxiety and related terms were defined by conceptually distinguishing between "state" and "trait" anxiety and between anxiety, stress and fear. The literature concerned with the anxiety-motor behavior relationship was reviewed using the state-trait anxiety distinction. After outlining the general notions of drive theory as related between the Taylor Manifest Anxiety Scale (MAS) and motor behavior in the absence or in the presence of a stressor, and on those studies using anxiety scales other than MAS. The accumulated evidence failed to reveal any consistent trends in these three areas. The use of drive theory and the MAS to predict motor behavior ws shown not to be a viable approach. Two alternative approaches were briefly outlined.

Social reinforcement effects on preschool children's motor performance

The effects of positive, negative, and combined social reinforcement on the accuracy of motor performance among 25 preschool boys and 25 girls was determined. Reinforcement was administered on a contingency basis. Arithmetic error indicated significant differences between the sexes for initial trials. No significant social reinforcement effects were obtained. The failure of social reinforcement to influence complex motor performance was explained by the lack of control by an individual in varying his own performance.