Maternal perinatal social support and infant social-emotional problems and competencies: a longitudinal cross-cohort replication study.

PURPOSE: Maternal perinatal social support is theorised to promote offspring social-emotional development, yet few studies have prospectively examined this relationship. Findings may inform preventative intervention efforts, to support a healthy start to emotional life. METHODS: This study examined whether maternal social support perinatally predicts infant social-emotional development at 12 months of age in two longitudinal cohort studies: The Australian Temperament Project (ATP) (n = 1,052 mother-infant dyads [653 mothers, M age_at_birth = 32.03, 88% Australian-born; 1,052 infants, 52% girls]) and The Triple B Pregnancy Cohort Study (Triple B) (n = 1,537 dyads [1,498 mothers, M age_at_birth = 32.53, 56% Australian-born; 1,537 infants, 49% girls]). Social support was assessed at pregnancy (third trimester) and eight-weeks post-birth. Infant social-emotional competencies (ATP: Brief Infant and Toddler Social and Emotional Assessment (BITSEA), Competencies Scale; Triple B: Bayley Scales of Infant and Toddler Development-Social Emotional Scale) and problems (ATP: BITSEA, Problems Scale; Triple B: Ages and Stages Questionnaires: Social-Emotional Scale), were assessed at 12-months of age. RESULTS: In ATP, social support was associated with lower offspring problems (pregnancy: ß = -0.15; post-birth: ß = -0.12) and greater competencies (pregnancy: ß = 0.12; post-birth: ß = 0.16) at 12 months. In Triple B, social support also predicted lower offspring problems (pregnancy: ß = -0.11; post-birth: ß = -0.07) and greater competencies (pregnancy: ß = 0.07) at 12 months. Findings did not indicate an association between support at eight-weeks post-birth and subsequent competencies (ß = 0.06). CONCLUSIONS: Evidence suggests that perinatal social support promotes healthy infant social and emotional development. These results underscore the critical importance of social support for mothers transitioning into parenthood.

Comparing the healthy development of youth Australian Rules Footballers across talent development and community settings.

Objectives: This study aimed to compare talent development athletes to community-level athletes in Australian Rules Football across various markers of healthy youth development. Methods: Survey data were collected from 363 youth athletes (126 women, 232 men, 5 not reported; Mage=18.69 years, SDage=2.62 years, age range 16-25 years) playing Australian Rules Football at a talent development (recruited from Australian Football League Talent Pathway, n=220) or community (n=143) level. Measures included markers of physical health (eg, general health, risk-taking behaviours), psychological and emotional well-being (eg, mental health symptoms, life satisfaction), family and social relationships (eg, social support, relationship status), educational and occupational attainment/engagement (eg, career satisfaction, education), ethical behaviour (eg, moral self-image), civic engagement, life skills (eg, self-mastery, coping), and demographics. Results: Based on regression models, relative to community-level athletes, talent development athletes reported better physical health (d=0.51), lower injury rates (OR=0.50) and less problematic drug use (d=-0.46). Talent development athletes also reported better psychological and emotional well-being, evidenced by lower stress (d=-0.30), higher life satisfaction (d=0.47) and less problematic gambling (d=-0.34). Additionally, talent development athletes reported higher family support (d=0.49), lower likelihood of poor educational outcomes (less than expected educational stage; OR=0.37), lower intention to complete less than year 12 education (OR=0.18), higher career satisfaction (d=0.42), higher self-mastery (d=0.37) and higher perfectionistic striving (d=0.59). Conclusion: Findings demonstrate markers of healthier development within talent development athletes relative to community athlete peers. Investment in community-level sports may be warranted to improve healthy development. However, further causal evidence is required.

Feasibility Study of Experimental Protocol for the Time-Dependent Mechanical Response of Synthetic Tibia.

In this research, an experimental biomechanics construct was developed to reveal the mechanics of distal tibial fracture by submitting synthetic tibiae to cyclic loading, resulting in a combined stress state due to axial compression and bending loads. The synthetic tibia was fixed at the knee but allowed to rotate in the coronal and sagittal planes at the ankle. The first three loading regimes lasted for 4000 cycles/each, and the final until ultimate failure. After 12k±80 cycles, the observed failure patterns closely resembled distal tibial fractures. The collected data during cyclic loading were fitted into a phenomenological model to deduce the time-dependent response of the synthetic tibiae. Images were also collected and analyzed using digital image correlation to deduce the full-field state of strain. The latter revealed that longitudinal strain contours extended in the proximal-distal direction. The transverse strain contours exemplified a medial-to-lateral distribution, attributed to the combined contributions of the Poisson's effect and the flexural deformation from axial and bending components of the applied load, respectively. The experimental construct, full-field characterization, and data analysis approaches can be extended to elucidate the effect of different fixation devices on the overall mechanical behavior of the bone and validate computational models in future research.

Preeclampsia-Associated Cardiovascular Risk Factors 6 Months and 2 Years After Pregnancy: The P4 Study.

BACKGROUND: Increased cardiovascular risk following preeclampsia is well established and there are signs of early cardiovascular aging 6 months postpartum. This study assessed whether blood pressure (BP) and other cardiovascular measures are abnormal 2 years postpartum in the same cohort to determine ongoing risk markers. METHODS: Six months and 2 years postpartum, BP was measured using sphygmomanometry, 24-hour ambulatory BP monitoring, and noninvasive central BP. Anthropometric measures, blood, and urine biochemistry were performed. Cross-sectional comparisons between preeclampsia and normotensive pregnancy (NP) groups and longitudinal comparisons within each group were made at 6 months and 2 years. RESULTS: Two years postpartum, 129 NP, and 52 preeclampsia women were studied who also had 6 months measures. At both time points, preeclampsia group had significantly higher BP (office BP 2 years, 112±12/72±8 versus 104±9/67±7 mm Hg NP; [P<0.001]; mean ambulatory BP monitoring 116±9/73±8 versus 106±8/67±6 mm Hg NP; [P<0.001]). No significant BP changes noted 6 months to 2 years within either group. Office BP thresholds of 140 mm Hg systolic and 90 mm Hg diastolic classified 2% preeclampsia and 0% NP at 2 years. American Heart Association 2017 criteria (above normal, >120/80 mm Hg) classified 25% versus 8% (P<0.002), as did our reference range threshold of 122/79 mm Hg. American Heart Association criteria classified 60% post-preeclampsia versus 16% after NP with above-normal ambulatory BP monitoring (P<0.001). Other cardiovascular risk markers more common 2 years post-preeclampsia included higher body mass index (median 26.6 versus 23.1, P=0.003) and insulin resistance. CONCLUSIONS: After preeclampsia, women have significantly higher BP 6 months and 2 years postpartum, and have higher body mass index and insulin-resistance scores, increasing their future cardiovascular risk. Regular cardiovascular risk screening should be implemented for all who have experienced preeclampsia.

Spectroscopic probing of ultraviolet-induced degradation in elastomeric polyurea.

Aromatic polyurea has garnered assiduous research due to its excellent impact, shock, abrasion, moisture, and chemical resistance properties. Polyurea can be used in protective coating and impact mitigation applications but is inevitably exposed to harsh deployment conditions such as extended ultraviolet (UV) radiation. Fourier Transform Infrared (FTIR) spectroscopy, Terahertz-time domain spectroscopy (THz-TDS), and Excitation-Emission Matrix spectroscopy (EEMS) deciphered the effects of UV radiation on radiated polyurea samples under ambient and nitrogen-rich conditions. Samples were radiated continuously for up to 15 weeks in increments of 3 weeks. Comprehensive FTIR analyses revealed a monotonic increase in disordered hydrogen bonding as a function of exposure duration in an ambient environment. Otherwise, marginal changes were observed in UV-radiated samples under nitrogen. The hydrogen bond length exhibited significant variations in the former compared to their nitrogen atmosphere counterparts. The results infer the nitrogen shielding effect, protecting polyurea from the photodegradation and photo-oxidation observed in samples radiated under the ambient atmosphere. THz-TDS spectra affirmed the FTIR results by probing changes in the complex refractive index. Terahertz spectral peaks associated with torsional vibrations of intermolecular hydrogen bonds in polyurea were notably correlated with increased exposure duration in the ambient atmosphere. Changes in the complex index as a function of exposure duration under nitrogen are minimal. The excitation-emission spectra of polyurea samples reveal a strong fluorescent behavior in 9-week and 12-week ambient-exposed polyurea due to cluster-triggered emission mechanisms. The results synthesized based on three different spectroscopy techniques paint a holistic portrait of the adverse effects of extended ultraviolet radiation of macromolecules deployed in harsh environmental conditions.

Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people.

OBJECTIVE: Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. METHOD: Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. RESULTS: Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. CONCLUSIONS: These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.

The Social Determinants of Emotional and Behavioral Problems in Adolescents Experiencing Early Puberty.

PURPOSE: Earlier pubertal timing is an important predictor of emotional and behavioral problems during adolescence. The current study undertook a comprehensive investigation of whether the social environment can buffer or amplify the associations between pubertal timing and emotional and behavioral problems. METHODS: Research questions were examined in the Adolescent Brain Cognitive Development (ABCD) Study, a large population representative sample in the United States. We examined interactions between pubertal timing and the shared effects of a range of proximal and distal social environmental influences (i.e., parents, peers, schools, neighborhoods, socioeconomic status) in 10- to 13-year-olds. RESULTS: Results revealed significant interaction between timing and proximal social influences (i.e., the "microsystem") in predicting emotional and behavioral problems. In general, adolescents with earlier pubertal timing and unfavorable (high levels of negative and low levels of positive) influences in the microsystem exhibited greater problems. Both males and females exhibited such associations for rule-breaking problems, while females alone exhibited associations for depressive problems. Results also illustrate the relative strength of each social context at moderating risk for emotional and behavioral problems in earlier versus later pubertal maturers. DISCUSSION: These findings highlight the importance of proximal social influences in buffering vulnerability for emotional and behavioral problems related to earlier puberty. Findings also illustrate the broad implications of latent environmental factors, reflecting common variance of multiple social influences that typically covary with one another.

Profiles of parents' emotion socialization within a multinational sample of parents.

Introduction: Seminal emotion socialization theories classify parents according to two patterns of parent emotion socialization processes: 'emotion coaching' (i.e., parents validate and teach children about emotions) versus 'emotion dismissing' parenting (i.e., parents minimize and dismiss their children's emotions). However, empirical evidence supporting this binary distinction of parents remains limited. Our objective was to investigate whether parents can be differentiated by distinct patterns in their (1) beliefs about children's emotions, (2) emotion regulation, and (3) emotion-related parenting practices. Method: Participants were parents of children aged 4-10 years from the Child and Parent Emotion Study (N = 869) (https://bmjopen.bmj.com/content/10/10/e038124). Parents completed self-reported measures of emotion socialization processes via an online survey, which took 20-30 min to complete. Data included in the current study were collected May-August 2019. We conducted a latent profile analysis of parents' emotion socialization (13 indicators). To assess reliability of the profiles, we examined stability of the profiles across (1) parents of children in early versus middle childhood, and (2) fathers versus mothers, via measurement invariance testing. Further, to assess for construct validity of the profiles, we examined concurrent associations between six criterion constructs and parents' emotion socialization profiles. Results: A three-profile model emerged characterizing parents by: (1) emotion coaching; (2) emotion dismissing; (3) emotion disengaged. There was strong support for construct validity and reliability. Discussion: Our study provides empirical support for distinct differentiated classifications of emotion coaching and emotion dismissing parenting, aligned with emotion socialization theories. We further extend on extant theory and suggest a third 'emotion disengaged' classification, describing parents with moderate levels of emotion dismissing parenting and low levels of emotion coaching parenting. It should be noted that the profiles were derived with self-report data, therefore, data may have been biased by contextual factors. Furthermore, the study sample consisted of Western families from affluent backgrounds. The field should focus efforts on conducting person-centered studies with more diverse samples in future.

Arrhythmia and Death Following Percutaneous Revascularization in Ischemic Left Ventricular Dysfunction: Prespecified Analyses From the REVIVED-BCIS2 Trial.

BACKGROUND: Ventricular arrhythmia is an important cause of mortality in patients with ischemic left ventricular dysfunction. Revascularization with coronary artery bypass graft or percutaneous coronary intervention is often recommended for these patients before implantation of a cardiac defibrillator because it is assumed that this may reduce the incidence of fatal and potentially fatal ventricular arrhythmias, although this premise has not been evaluated in a randomized trial to date. METHODS: Patients with severe left ventricular dysfunction, extensive coronary disease, and viable myocardium were randomly assigned to receive either percutaneous coronary intervention (PCI) plus optimal medical and device therapy (OMT) or OMT alone. The composite primary outcome was all-cause death or aborted sudden death (defined as an appropriate implantable cardioverter defibrillator therapy or a resuscitated cardiac arrest) at a minimum of 24 months, analyzed as time to first event on an intention-to-treat basis. Secondary outcomes included cardiovascular death or aborted sudden death, appropriate implantable cardioverter defibrillator (ICD) therapy or sustained ventricular arrhythmia, and number of appropriate ICD therapies. RESULTS: Between August 28, 2013, and March 19, 2020, 700 patients were enrolled across 40 centers in the United Kingdom. A total of 347 patients were assigned to the PCI+OMT group and 353 to the OMT alone group. The mean age of participants was 69 years; 88% were male; 56% had hypertension; 41% had diabetes; and 53% had a clinical history of myocardial infarction. The median left ventricular ejection fraction was 28%; 53.1% had an implantable defibrillator inserted before randomization or during follow-up. All-cause death or aborted sudden death occurred in 144 patients (41.6%) in the PCI group and 142 patients (40.2%) in the OMT group (hazard ratio, 1.03 [95% CI, 0.82-1.30]; P=0.80). There was no between-group difference in the occurrence of any of the secondary outcomes. CONCLUSIONS: PCI was not associated with a reduction in all-cause mortality or aborted sudden death. In patients with ischemic cardiomyopathy, PCI is not beneficial solely for the purpose of reducing potentially fatal ventricular arrhythmias. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01920048.

Associations between unintended fatherhood and paternal mental health problems: A systematic review and meta-analysis.

BACKGROUND: Unintended pregnancies are linked to adverse parental mental health, yet little attention has been given to this relationship in fathers specifically. We aimed to meta-analyse associations between unintended pregnancies and mental health problems in fathers with children aged ≤36 months. METHODS: We conducted keyword searches of Medline, CINAHL, Academic Search Complete, PsycInfo and Embase to February 2, 2022, and hand searched included reference lists. RESULTS: Of 2826 records identified, 23 studies (N = 8085 fathers), reporting 29 effects, were eligible for meta-analysis. Included studies assessed depression, anxiety, stress, parenting stress, post-traumatic stress disorder (PTSD), alcohol misuse and psychological distress. Pooled estimates, from random effects meta-analyses, for all mental health outcomes (k = 29; OR = 2.28) and depression only (k = 19; OR = 2.36), showed that the odds of reporting mental health difficulties were >2-fold higher in men reporting unintended births compared with those reporting intended births. However, there was no evidence of association with anxiety (k = 2) or stress (k = 2). Overall, mental health problems were greater in low-income countries. No differences were found across parity, timepoint of mental health assessment, or instruments used to measure mental health symptoms. LIMITATIONS: Analyses were limited by the use of retrospective assessment of pregnancy intention, and heterogeneity of measures used. Further, assessment of fathers' mental health was restricted to the first year postpartum. This review was limited to English language studies. CONCLUSIONS: Unintended pregnancies present an identifiable risk for postpartum mental health problems in fathers.

Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis.

PURPOSE: Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed. METHODS: We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress. RESULTS: We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r = .27 [95% CI 0.20, 0.35] to r = .47 [95% CI 0.41, 0.53]), anxiety (r = .27 [95% CI 0.24, 0.31] to r = .39 [95% CI 0.15, 0.59]), and stress (r = .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r = .20 [95% CI 0.14, 0.50] to r = .25 [95% CI 0.64, 0.85]), anxiety (r = .16 [95% CI 0.10, 0.22]), and stress (r = .15 [95% CI - 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r = - 0.17 [95% CI - 0.22, - 0.11]). CONCLUSION: Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures.

Association of maternal and paternal perinatal depression and anxiety with infant development: A longitudinal study.

BACKGROUND: Maternal and paternal perinatal depression and anxiety are theorised to adversely impact infant development. Yet, few studies have assessed both mental health symptoms and clinical diagnoses within the one study. Moreover, research on fathers is limited. This study therefore aimed to examine the association between symptoms and diagnoses of maternal and paternal perinatal depression and anxiety with infant development. METHOD: Data were from the Triple B Pregnancy Cohort Study. Participants included 1539 mothers and 793 partners. Depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale and Depression Anxiety Stress Scales. Major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, and agoraphobia were assessed using the Composite International Diagnostic Interview in trimester three. Infant development was assessed at 12-months using the Bayley Scales of Infant and Toddler Development. RESULTS: Antepartum, maternal depressive and anxiety symptoms were associated with poorer infant social-emotional (d = -0.11, p = .025) and language development (d = -0.16, p = .001). At 8-weeks postpartum, maternal anxiety symptoms were associated with poorer overall development (d = -0.11, p = .030). No association was observed for clinical diagnoses in mothers, nor paternal depressive and anxiety symptoms or clinical diagnoses; albeit risk estimates were largely in the expected direction of adverse effects on infant development. CONCLUSIONS: Evidence suggests that maternal perinatal depression and anxiety symptoms may adversely impact infant development. Effects were small but findings underscore the importance of prevention, early screening and intervention, alongside consideration of other risk factors during early critical periods.

Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium.

BACKGROUND: This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. METHODS: Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13-18 years), young adulthood (19-29 years) and at ages 29-35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. RESULTS: Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. CONCLUSIONS: Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.

Categorical and dimensional approaches to the developmental relationship between ADHD and irritability.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) and irritability commonly co-occur, and follow similar developmental trajectories from childhood to adolescence. Understanding of the developmental relationship between these co-occurrences is limited. This study provides a longitudinal assessment of how ADHD diagnostic status and symptom patterns predict change in irritability. METHODS: A community sample of 337 participants (45.2% ADHD), recruited for the Childhood Attention Project, completed the Affective Reactivity Index (ARI) to measure irritability at baseline (mean age 10.5 years) and follow-up after 18-months. Latent change score models were used to assess how (a) baseline ADHD vs. control group status, (b) baseline symptom domain (inattention, hyperactivity-impulsivity) and (c) longitudinal change in ADHD symptom severity predicted change in irritability. RESULTS: Irritability was significantly higher among the ADHD group than controls; however, change in irritability over time did not differ between groups. When assessed across the entire cohort, change in irritability was predicted by higher symptom count in the hyperactive-impulsive domain, but not the inattentive domain. Greater declines in ADHD symptoms over time significantly predicted greater declines in irritability. Baseline ADHD symptom severity was found to significantly predict change in irritability; however, baseline irritability did not significantly predict change in ADHD symptoms. CONCLUSIONS: ADHD symptoms-particularly hyperactive-impulsive symptoms-predict the degree and trajectory of irritability during childhood and adolescence, even when symptoms are below diagnostic thresholds. The use of longitudinal, dimensional and symptom domain-specific measures provides additional insight into this relationship.

Quasi-Static Mechanical Response of Density-Graded Polyurea Elastomeric Foams.

Density gradation of foam structures has been investigated and found to be a practical approach to improve the mechanical efficacy of protective padding in several applications based on nature-based evidence of effectiveness. This research aims to disclose a discrete gradation approach without adhesives by relying on the properties of the frothed foam slurry to bond and penetrate through previously cured foam sheets naturally. As confirmed by electron microscopy observations, bilayer- and trilayer-graded elastomeric polyurea foam sheets were fabricated, resulting in seamless interfaces. The mechanical performance of seamless, graded foam samples was compared with monolayer, mono-density benchmark foam, considered the industry standard for impact mitigation. All foam samples were submitted to compressive loading at a quasi-static rate, reporting key performance indicators (KPIs) such as specific energy absorption, efficiency, and ideality. Polyurea foams, irrespective of gradation and interface type, outperformed benchmark foam in several KPIs despite the drastic difference in the effective or average density. The average compressive stress-strain curves were fitted into empirical constitutive models to reveal critical insights into the elastic, plateau, and densification behaviors of the tested foam configuration. The novelty of these outcomes includes (1) a fabrication approach to adhesive-free density-graded foam structures, (2) implementation of a diverse set of KPIs to assess the mechanical efficacy of foams, and (3) elucidation of the superiority of polyurea foam-based lightweight protective paddings. Future research will focus on assessing the dynamic performance of these graded foam structures under impact loading conditions at a wide range of velocities.

Risky alcohol consumption among women in Australia attending breast screening services: an exploratory cross-sectional study.

BACKGROUND AND AIMS: Alcohol is a major modifiable risk factor for female breast cancer, with breast cancer risk now associated with substantially lower consumption levels than those previously deemed safe. This study sought to measure risky drinking among women attending breast screening services in Australia according to new national alcohol guidelines and to compare daily, weekly and recent (past 12 months) consumption to Australian gender and age population norms. DESIGN, SETTING AND PARTICIPANTS: This study was a retrospective analysis of cross-sectional data from the Lifepool Project (collected October 2011-January 2016) in Victoria, Australia, comprising a convenience sample of women attending breast screening services aged 40+ years. MEASUREMENTS: Typical and heavy alcohol consumption patterns over the previous 12 months (frequency, quantity), socio-demographic (e.g. age, education) and health-related (e.g. menopause status, breast cancer history) characteristics. Primary outcomes were the proportion of women drinking at a level exceeding new guidelines for weekly and daily alcohol consumption. FINDINGS: Of 49 240 women, mean age was 59.94 years (standard deviation = 7.14, range = 40-94 years). Most women had consumed alcohol during the past 12 months [41 628, 85.48%, 95% confidence interval (CI) = 85.16, 85.79]. One in five women (8464, 18.34%, 95% CI = 17.99, 18.69) were drinking at a level exceeding new national guidelines for weekly consumption (i.e. greater than 10 standard drinks per week), and one in six (7446, 15.60%, 95% CI = 15.28, 15.93) were exceeding new guidelines for consumption on a single day (i.e. greater than four standard drinks on any 1 day, more than once per month). The proportion of women in this sample drinking daily (4.21-11.19%), weekly (34.73-50.71%) and in the past 12 months (74.96-90.81%) was significantly greater among nearly all age groups (by decade), compared with Australian gender and age norms [drinking daily (3.4-9.1%), weekly (27.1-37.6%) and in the past 12 months (64.4-81.9%)]. CONCLUSIONS: There appears to be a high prevalence of risky alcohol consumption among a large convenience sample of breast screening service clients in Australia using new national alcohol guidelines introduced in December 2020.

Variable Accessibility to Consumer Pricing Among Breast Cancer Operations.

BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) mandate that every US hospital provide public online pricing information for services rendered. This allows patients to compare prices across hospital systems before establishing care. The goal of this project was to evaluate hospital compliance and patient-level accessibility to price transparency for common breast cancer surgical procedures. METHODS: A sample case of a 62-year-old female with a T2N0 breast cancer was chosen. The patient would have the option of undergoing a partial mastectomy or mastectomy, both with sentinel lymph node biopsy (SLNB). Eight Massachusetts academic medical centers were evaluated. Searches were performed by authors for each hospital system and procedure using the sample case. RESULTS: Every hospital had a cost calculator on its website. The average success rate of establishing a cost for partial mastectomy, mastectomy, and SLNB was 58, 35, and 25%, respectively. The median time to reach the cost calculator tool was 32 s (range 25-37 s). In successful attempts, the median pre-insurance estimated cost of a partial mastectomy was $16,509 (range $11,776-22,169), compared with $24,541 (range $16,921-25,543) for mastectomy and $12,342 (range $4034-20,644) for SLNB. SLNB costs varied significantly across hospitals (p = 0.025), but no statistically significant difference was observed for partial mastectomy or mastectomy. CONCLUSION: Despite new regulatory requirements by CMS for increased price transparency for surgical procedures, our results demonstrate poor success rates in obtaining cost estimates and significant variability of reported hospital charges. Further efforts to improve the quality of hospital cost estimate calculators are necessary for informed decision-making for patients with breast cancer.

Father trait anger: Associations with father-infant bonding and subsequent parenting stress.

Introduction: Parent anger presents a risk to family safety and child development. Father trait anger may also compromise the early relational context of fathers and offspring, yet evidence is lacking. The aim of this study is to examine effects of father trait anger on parenting stress in the toddler years, and the mediational role of father-infant bonding. Method: Data were from 177 Australian fathers of 205 children. Trait anger (total, angry temperament, and angry reaction), father-infant bonding subscales (patience and tolerance, affection and pride, and pleasure in interaction), and subsequent parenting stress (parental distress, difficult child, and parent-child dysfunctional interaction) were assessed. At each of the subscale levels, mediational path models examined whether father-infant bonding explained the relationship between trait anger and parenting stress. Models were presented where there was at least a small association between the mediator and both the predictor and outcome. Results: Patience and tolerance was the only domain of father-infant bonding correlated with both trait anger and all parenting stress outcomes. Patience and tolerance partially mediated the effect of total trait anger on parental distress and fully mediated effects on difficult child and parent-child dysfunctional interaction. Patience and tolerance fully mediated relationships between angry temperament and all domains of parenting stress. Angry reactions only had a direct effect on parental distress. Discussion: Father trait anger both directly and indirectly (through patience and tolerance in the father-infant bond) impacts their experiences of parenting stress in the toddler years. Early interventions to manage father trait anger and improve father-infant bonding may benefit fathers and children.