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Frightening maternal behavior is linked to infant disorganization, which predicts child behavioral problems. We examined continuity in frightening maternal behavior across the first 2 years by developing a new measure of anomalous/frightening (AN/FR) behavior that incorporates changes in parent-child interactions as children acquire symbolic representation. Maternal AN/FR behavior in toddlerhood also was examined in relation to later internalizing and externalizing symptoms. First-time mothers ( N  = 125) completed the Adult Attachment Interview (AAI) prenatally, and mother-child dyads were observed interacting at 8 months, in Strange Situations at 12-15 months, and playing at 24 months. Teachers rated children's behavior problems at 7 years. Mothers classified as Unresolved on the AAI displayed more Frightening (FR) behavior at 8 months. Mothers' FR behavior predicted both attachment disorganization at 12-15 months and maternal AN/FR behavior at 24 months, which then predicted children's internalizing symptoms at age 7. Infant disorganization was indirectly related to internalizing symptoms, mediated by maternal AN/FR behavior.

Parenting stress reflects a discrepancy between a parent's perception of their resources, the demands of their child's needs, and the caregiving relationship and contexts (Abidin, 1992). Parenting stress can increase the risk of issues in the parent-child relationship, as well as child behavioral and emotional outcomes (Neece et al., 2012; Spinelli et al., 2021). Chronic stressors, such as living through the COVID-19 pandemic, have the potential to increase the demands of parenting and thus parenting stress. Using latent growth curve modeling, we examined parenting stress trajectories of 298 American parents with young children ( M age = 15.02 months, range = 1-34 months) over the first year of the COVID-19 pandemic. We also examined the effects of parental mental health on parenting stress, and the effects of parental mental health and parenting stress on child problem behaviors using data gathered through the Prolific survey platform. Parental mental health, measured by depressive symptoms Centre for Epidemiological Studies Depression Scale-10, anxiety symptoms Generalized Anxiety Disorder Scale (GAD-7), and overall stress levels 10-item Perceived Stress Scale, was related to higher initial parenting stress index-short form. Changes in parenting stress over time were linked with higher levels of children's problem behaviors (CBCL). Child temperament was also related to initial parenting stress. Lower levels of household income were linked with higher levels of parental mental health symptoms and higher rates of parenting stress increases over time. These results highlight the importance of considering the well-being of all family members in child outcomes, and the ways in which different experiences and resources during the COVID-19 pandemic affect parental and child well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Greater maternal depressive symptoms are consistently associated with higher levels of behavioral difficulties in children, emerging in early childhood and with long-lasting consequences for children's development. Interventions promoting early relational health have been shown to have benefits for children's behavior; however, these impacts are not always realized in the context of maternal depression. This study examined whether tiered programs could address this limitation by focusing on both parenting, through universal primary prevention, and psychosocial stressors and parent mental health, through tailored secondary prevention. Analysis of a randomized controlled trial (RCT) of the Smart Beginnings (SB) intervention was conducted to determine whether SB attenuated the association between maternal depression and early childhood internalizing and externalizing behaviors. Maternal depression significantly predicted both internalizing and externalizing behaviors in linear regression models. Further, there was a significant interaction between maternal depression and treatment group, such that among mothers with higher depressive symptoms, the SB treatment attenuated the magnitude of the association between depression and child behavior. Findings suggest that while parenting support is important for all families, it may be particularly critical for those with higher levels of depression and underscores the need to consider multidimensional family processes in both research and clinical practice.

The present study examined the influence of fathers' parenting quality during infancy on children's emotion regulation during toddlerhood and, subsequently, attention-deficit/hyperactivity disorder (ADHD) symptoms in middle childhood. Fathers and their 8-month-old infants ( N = 124) were followed over time to obtain home observations of parenting quality at 8 and 24 months, laboratory observations of children's emotion regulation at 24 months, and teacher reports of children's ADHD symptoms at 7 years. A path analysis revealed that fathers' emotional disengagement in infancy and minimizing responses to children's distress in toddlerhood forecast children's development of ADHD symptoms in middle childhood. Further, a significant indirect effect was found such that fathers' parenting at 8 and 24 months predicted subsequent development of ADHD symptoms at age 7 through toddlers' difficulty regulating emotion. Implications of this study for early intervention and directions for future research are discussed.

The present study examined the role of father sensitivity and couple coparenting quality in the first 2 years of life in relation to the development of externalizing behavior problems in middle childhood, focusing on the unique role of fathers. In this study, 125 mothers, fathers, and their first-born children were followed from 8 months to age 7 years. Paternal sensitivity was rated when infants were 8 and 24 months old. Fathers were videotaped at home playing, feeding, and changing their 8-month-old infants' clothes. They also were videotaped in a lab playing with their 24-month-olds and solving a variety of challenging tasks. At 24 months, competitive coparenting was assessed via videotaped triadic family interactions at home in which families participated in a variety of tasks (i.e., clothes change, eating a snack together and solving tasks). Teachers rated externalizing behavior problems when the children were age 7. Continuity in paternal sensitivity was documented from 8 to 24 months, and paternal sensitivity at 8 months predicted externalizing behavior in middle childhood through father sensitivity at 24 months. Moreover, paternal sensitivity at 8 months predicted competitive coparenting which, in turn, forecast externalizing behavior problems in middle childhood, even after controlling for maternal sensitivity at 8 and 24 months. These findings highlight the unique role of paternal caregiving quality during the first year of life on couple coparenting and children's subsequent development of externalizing problems and have implications for creating effective interventions to prevent children from developing externalizing disorders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jacobvitz, Aviles, Aquino, Tian, Zhang and Hazen.)

This study examined how fathers' adult attachment representations, assessed before the birth of their first child, predict feeding practices with their 8-month-old infants. Fathers have been underrepresented in child feeding research, particularly in longitudinal and observational studies. Feeding is a key parenting task of infancy and a growing number of studies have begun to explore the connection between attachment and parental feeding practices and behavior, revealing a clear link between mothers' adult attachment and how they feed their children. This is the first longitudinal examination of attachment as a prenatal predictor of fathers' infant feeding behavior. Participants were 118 first-time fathers and their infants. Adult Attachment Interviews were conducted in the third trimester of pregnancy, and father-infant feeding interactions were observed at home when the infant was 8-months-old. Videotaped feedings were coded using Chatoor's Feeding Scale (1997). Compared to other fathers, (1) those with secure attachment representations were more attuned to their infants during feeding, (2) those with dismissing representations were less attuned, and (3) those with unresolved trauma displayed more controlling behaviors. Fathers were more controlling with their sons than their daughters across all attachment representations. Study results suggest that father's infant feeding behaviors may influence by their own attachment representations. The links to fathers' controlling feeding practices are noteworthy because of the negative implications controlling parental feeding practices can have on child outcomes. The prediction of paternal feeding behaviors from assessments conducted prenatally has important intervention implications., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Robotic-assisted minimally invasive surgeries have gained a lot of popularity over conventional procedures as they offer many benefits to both surgeons and patients. Nonetheless, they still suffer from some limitations that affect their outcome. One of them is the lack of force feedback which restricts the surgeon's sense of touch and might reduce precision during a procedure. To overcome this limitation, we propose a novel force estimation approach that combines a vision based solution with supervised learning to estimate the applied force and provide the surgeon with a suitable representation of it. The proposed solution starts with extracting the geometry of motion of the heart's surface by minimizing an energy functional to recover its 3D deformable structure. A deep network, based on a LSTM-RNN architecture, is then used to learn the relationship between the extracted visual-geometric information and the applied force, and to find accurate mapping between the two. Our proposed force estimation solution avoids the drawbacks usually associated with force sensing devices, such as biocompatibility and integration issues. We evaluate our approach on phantom and realistic tissues in which we report an average root-mean square error of 0.02 N.

Cardiac motion estimation is an important diagnostic tool for detecting heart diseases and it has been explored with modalities such as MRI and conventional ultrasound (US) sequences. US cardiac motion estimation still presents challenges because of complex motion patterns and the presence of noise. In this work, we propose a novel approach to estimate cardiac motion using ultrafast ultrasound data. Our solution is based on a variational formulation characterized by the L 2 -regularized class. Displacement is represented by a lattice of b-splines and we ensure robustness, in the sense of eliminating outliers, by applying a maximum likelihood type estimator. While this is an important part of our solution, the main object of this work is to combine low-rank data representation with topology preservation. Low-rank data representation (achieved by finding the k-dominant singular values of a Casorati matrix arranged from the data sequence) speeds up the global solution and achieves noise reduction. On the other hand, topology preservation (achieved by monitoring the Jacobian determinant) allows one to radically rule out distortions while carefully controlling the size of allowed expansions and contractions. Our variational approach is carried out on a realistic dataset as well as on a simulated one. We demonstrate how our proposed variational solution deals with complex deformations through careful numerical experiments. The low-rank constraint speeds up the convergence of the optimization problem while topology preservation ensures a more accurate displacement. Beyond cardiac motion estimation, our approach is promising for the analysis of other organs that exhibit motion.

Minimally invasive surgical and diagnostic systems rely on endoscopic images of internal organs to assist medical tasks. Specular highlights are common on those images due to the strong reflectivity of the mucus layer on the organs and the relatively high intensity of the light source. This is a significant source of error that can affect the systems' performance. In this paper, we propose a segmentation method of the specular regions based on an automatic color-adaptive threshold and a gradient-based edge detector. The segmented regions are then recovered using a robust mask-specific Sobolev inpainting approach. Experimental results demonstrate the precision and efficiency of the proposed method. In contrast to the existing approaches, the proposed solution does not require manual threshold selection or complex computations to achieve accurate results. Moreover, our method has a real-time performance and can be generalized to various applications.

Estimation of the cardiac motion is very important in order to detect heart diseases. This work presents a cardiac motion estimation approach using ultrafast ultrasound data. We optimize a variational framework which has the benefits of combining low-rank data representation with topology preservation. We show through the analysis of experimental results that this combination offers a radical reduction in computational time and noise while ensuring preservation of the anatomical structure of the heart under complex deformations. Although in this work we use the heart as a study case, our solution is promising to analyze other organs experiencing motion.

In computer-assisted beating heart surgeries, accurate tracking of the heart's motion is of huge importance and there is a continuous need to eliminate any source of error that might disturb the tracking process. One source of error is the specular reflection that appears on the glossy surface of the heart. In this paper, we propose a robust solution for the detection and removal of specular highlights. A hybrid color attributes and wavelet based edge projection approach is applied to accurately identify the affected regions. These regions are then recovered using a dynamic search-based inpainting with adaptive windowing. Experimental results demonstrate the precision and efficiency of the proposed method. Moreover, it has a real-time performance and can be generalized to various other applications.

The lack of force feedback is considered one of the major limitations in Robot Assisted Minimally Invasive Surgeries. Since add-on sensors are not a practical solution for clinical environments, in this paper we present a force estimation approach that starts with the reconstruction of a 3D deformation structure of the tissue surface by minimizing an energy functional. A Recurrent Neural Network-Long Short Term Memory (RNN-LSTM) based architecture is then presented to accurately estimate the applied forces. According to the results, our solution offers long-term stability and shows a significant percentage of accuracy improvement, ranging from about 54% to 78%, over existing approaches.

Motion compensation constitutes a challenging issue in minimally invasive beating heart surgery. Since the zone to be repaired has a dynamic behaviour, precision and surgeon's dexterity decrease. In order to solve this problem, various proposals have been presented using ℓ2-norm. However, as they present some limitations in terms of robustness and efficiency, motion compensation is still considered an open problem. In this work, a solution based on the class of ℓ1 Regularized Optimization is proposed. It has been selected due to its mathematical properties and practical benefits. In particular, deformation is characterized by cubic B-splines since they offer an excellent balance between computational cost and accuracy. Moreover, due to the non-differentiability of the functional, the logarithmic barrier function is used for generating a standard optimization problem. Results have provided a very good tradeoff between accuracy and efficiency, indicating the potential of the proposed approach and proving its stability even under complex deformations.

The experiences of a group of volunteer clinical pharmacists who provided pharmacy services as part of a disaster relief effort following a hurricane are reported. Hurricane Andrew left many people in southern Florida without shelter and other basic necessities, including health care services. A group of seven pharmacists volunteered to provide services at a temporary medical site set up in a community center. The pharmacy stock consisted of donated drugs. The pharmacists dispensed medications directly to patients and worked closely with other volunteer medical personnel to make sure proper medications were used. Because the pharmacy stock was limited, physicians relied upon the pharmacists for information about therapeutic interchanges, dosage conversions, and new medications. Prescriptions were often ordered and dispensed with only oral instructions. The pharmacists also provided patient counseling, although problems caused by inexperience with certain types of patients, a language barrier, and substandard living conditions after the hurricane made counseling more difficult. The contributions of seven pharmacists who provided services at an emergency medical site after Hurricane Andrew were well received by other health care personnel and by the community.

The stability of verapamil hydrochloride injection when mixed with a commercial product of premixed theophylline in 5% dextrose injection was studied. Solutions containing theophylline in concentrations of 4.0 and 0.4 mg/mL were used. Verapamil hydrochloride was added to each theophylline solution to produce final verapamil concentrations of 0.4 mg/mL and 0.1 mg/mL. Each admixture was prepared in triplicate, and samples were kept at room temperature in glass. Immediately after mixing and at 4, 8, 12, and 24 hours, samples were visually inspected, tested for pH, filtered, and assayed in duplicate by high-performance liquid chromatography for theophylline and verapamil concentrations. Control solutions containing only one of the two drugs were also tested. No visual changes were observed. The addition of the verapamil hydrochloride injection to the theophylline in 5% dextrose injection resulted in decreased mean pH values of 4.29 and 4.37 for all solutions compared with 4.80 and 4.90 for the verapamil control samples at concentrations of 0.4 and 0.1 mg/mL. These values did not vary significantly throughout the study period. Theophylline and verapamil concentrations did not change significantly compared with baseline or control solutions during the study period. Verapamil hydrochloride injection in final concentrations of 0.1 to 0.4 mg/mL can be added to a commercial preparation of premixed theophylline in 5% dextrose injection in concentrations of 0.4 to 4.0 mg/mL and administered intravenously within 24 hours of mixing without loss of potency of either drug.