Carry that weight: Parental separation and children's Body Mass Index from childhood to young adulthood.

Research has shown that parental separation is associated with worse physical health and unhealthy weight gains during childhood. However, limited empirical attention has been given to the evolution of child health before, upon and following parental union dissolution. Drawing on data from the Child Development Supplement and the Transition to Adulthood Supplement of the Panel Study of Income Dynamics (1997-2017), I investigate whether parental union dissolution during childhood is associated with children's Body Mass Index (BMI) and the risk of developing overweight/obesity in the short and long run (n = 2675 children aged 0-12 in 1997). The results from a combination of propensity score matching and fixed-effects linear regression models show that union dissolution is associated with increases in child BMI and an increased risk of developing overweight/obesity. These changes in children's weight status persist for at least ten years after parental separation. Unhealthy weight gains following parental separation are more pronounced among female children and those with lower-educated and non-White parents. The findings suggest that in the United States parental union dissolution contributes to increase socioeconomic inequalities in child health. Therefore, children with separated parents and lower socioeconomic backgrounds have greater risks of developing overweight/obesity and other obesity-related morbidities over their life courses.

Effect of syringe underfilling on the quality of venous blood gas analysis.

OBJECTIVES: There is limited information on the influence of collecting small amounts of blood on the quality of blood gas analysis. Therefore, the purpose of this study was to investigate the effects of different degrees of underfilling of syringes on test results of venous blood gas analysis. METHODS: Venous blood was collected by venipuncture from 19 healthcare workers in three 1.0 mL syringes for blood gas analysis, by manually aspirating different volumes of blood (i.e., 1.0, 0.5 and 0.25 mL). Routine blood gas analysis was then immediately performed with GEM Premier 5,000. The results of the two underfilled syringes were compared with those of the reference syringe filled with appropriate blood volume. RESULTS: The values of most assayed parameters did not differ significantly in the two underfilled syringes. Statistically significant variations were found for lactate, hematocrit and total hemoglobin, the values of which gradually increased as the fill volume diminished, as well as for sodium concentration, which decreased in both insufficiently filled blood gas syringes. The bias was clinically meaningful for lactate in syringe filled with 0.25 mL of blood, and for hematocrit, total hemoglobin and sodium in both syringes containing 0.5 and 0.25 mL of blood. CONCLUSIONS: Collection of smaller volumes of venous blood than the specified filling volume in blood gas syringes may have an effect on the quality of some test results, namely lactate, hematocrit, total hemoglobin and sodium. Specific indications must be given for standardizing the volume of blood to be collected within these syringes.

Incomplete filling of spray-dried K2EDTA evacuated blood tubes: impact on measuring routine hematological parameters on Sysmex XN-10.

OBJECTIVES: Because there is little published evidence on the effects of incomplete filling of K2EDTA evacuated blood tubes on routine hematological testing, this original study aimed to provide updated information on this preanalytical aspect. METHODS: The study population consisted of 17 ostensibly healthy volunteers. Blood was drawn by venipuncture with a 10 mL syringe and dispensed in varying amounts (0.2, 0.5, 1.0, 2.0, and 3.0 mL) into 3.0 mL blood tubes containing spray-dried 5.4 mg K2EDTA. All tubes were gently mixed and used to perform routine hematology tests on the Sysmex XN-10. Clinically significant variations were defined when the limits of desirable specifications of bias derived from biologic variation were exceeded. RESULTS: The desirable bias was exceeded in 33 % filled tubes (1.0 mL) for hematocrit and MCV (increased values) and for MCHC (decreased values), while it was exceeded in 17 % filled tubes (0.5 mL) for hemoglobin, hematocrit and MCV (increased values), and for MCHC (decreased values). Finally, the variation of values was higher than the desirable bias for RBC, hemoglobin, hematocrit and MCV (increase), and for MCHC and MPV (decrease) in 7 % filled tubes (0.2 mL). No clinically significant variations were observed in tubes filled up to 67 % of their nominal volume (i.e., 2.0 mL). CONCLUSIONS: Consideration should be given to reject spray-dried K2EDTA blood tubes that contain a blood volume <67 % of the nominal fill volume, as biased laboratory data in these samples may interfere with clinical decision making and care management.

Medically assisted reproduction and mental health: a 24-year longitudinal analysis using Finnish register data.

BACKGROUND: Medically assisted reproduction can negatively affect women's mental health, particularly when the treatments do not result in a live birth. Although the number of women relying on medically assisted reproduction to conceive has grown rapidly, our knowledge about the mental health effects before, during, and after treatment is limited. OBJECTIVE: This study aimed to understand the long-term association between medically assisted reproduction and mental health outcomes for women before, during, and after their treatments, and according to whether the treatment resulted in a live birth. STUDY DESIGN: Using Finnish register data for the period from 1995 to 2018, we estimated the probability of psychotropic purchases (antidepressants, anxiolytics, hypnotics, and sedatives) for 3 groups of women who: (1) gave birth after natural conception, (2) gave birth after medically assisted reproduction treatments, or (3) underwent medically assisted reproduction but remained childless. We followed up women for up to 12 years before and 12 years after the reference date, which corresponded to the conception date for women who had a first live birth either after a natural or a medically assisted conception, or the date of the last medically assisted reproduction treatment for women with no live birth by the end of 2017. We estimated linear probability models before and after adjustment for sociodemographic characteristics. RESULTS: The results show that women who did not have a live birth after undergoing medically assisted reproduction treatments purchased more psychotropics than women who gave birth after conceiving naturally or through medically assisted reproduction, and that these differences did not attenuate over time. Twelve years after the reference date, 17.73% (95% confidence interval, 16.82-18.63) of women who underwent medically assisted reproduction but remained childless purchased psychotropics vs 11.11% of women who gave birth after natural conception (95% confidence interval, 10.98-11.26) and 12.17% (95% confidence interval, 11.65-12.69) of women who gave birth after medically assisted reproduction treatments. In addition, women who conceived naturally and through medically assisted reproduction had very similar psychotropic use patterns from 3 years before conception to 4 years after, and over the long term. Adjustment for women's sociodemographic characteristics did not change the results. CONCLUSION: The similarities in psychotropic purchases of women who had a live birth, whether naturally or through medically assisted reproduction, suggest that the higher psychotropic use among women who remained childless after undergoing medically assisted reproduction were likely driven more by involuntary childlessness than by treatment-related stress. The results highlight the importance of counseling for women undergoing medically assisted reproduction treatments, especially if their attempts to conceive are unsuccessful.

Hand Hygiene Social Norms Among Healthcare Workers During Early COVID-19: Results of a Global Survey.

Objectives: Poor hand hygiene among healthcare workers is an important driver of infectious disease transmission. Although social norms are considered a key determinant of hand hygiene behaviour, little is known about them among healthcare workers. This study describes hand hygiene social norms among health workers, assesses their predictors, and tests if social expectations increased during the early stages of COVID-19. Methods: We conducted a cross-sectional survey of healthcare workers from 77 countries (n = 1,233) from April to August 2020 assessing healthcare workers' hand hygiene social expectations, personal normative beliefs, punishment and reward, and demographic factors. Linear regressions and hierarchical linear modelling were used to analyse the responses. Results: We find high social expectations, personal beliefs, punishment, and rewards. Doctors tend to have lower social expectations than other occupation groups (e.g., nurses/midwives) and older respondents have higher social expectations. Social expectations increased during our survey, which may have been driven by COVID-19. Conclusion: Our findings suggest that hand hygiene social norms are strong among healthcare workers with variation across occupation and age; their strength increased during the COVID-19 pandemic. These have implications for behaviour change in healthcare environments that could leverage more norm-targeting interventions.

Intrapartum cardiotocography: an exploratory analysis of interpretational variation.

Our aim was to evaluate the intra- and inter-operator agreement in cardiotocography (CTG) traces analysis using the 2015 FIGO classification guidelines, and whether the educational background and the knowledge of anamnestic data can influence the interpretation of CTG traces. A retrospective interpretation of 73 intrapartum CTGs at time 0 (T0) for a first blind interpretation and at time 1 (T1) two months later with additional anamnestic pregnancy information was made by eight different operators (four obstetricians and four midwives with different years of work experience). The intra-observer agreement demonstrates that midwifes are more concordant than obstetricians with a mean of 77.05% versus a mean of 65.75%. There is moderate inter-observer agreement in classifying a CTG trace as 'normal'; on the contrary, there is no consensus on the 'suspect' and 'pathological' classification category.IMPACT STATEMENTWhat is already known on this subject? Interpretation of intrapartum CTG is affected by significant subjective variables with relevant intra- and inter-observer lack of optimal agreement, especially in case of abnormal o pathologic findings.What do the results of this study add? Clinical data seem to play a role in interpretation of suspicious and pathological traces while they do not affect the rate of agreement for normal traces. Midwives tend to be less influenced by anamnestic data in visual CTG interpretation. Instead, obstetricians tend to be more focussed on clinical data and clinical setting that, as a consequence, tend to have great impact on CTG trace interpretation.What are the implications of these findings for clinical practice and/or further research? Cooperation among obstetricians and between obstetricians and midwives should be encouraged in order to optimise CTG reading and improve maternal and neonatal outcomes. Regarding the influence of clinical parameters in classification of intrapartum CTG traces, especially in case of abnormal CTG traces, it should be conceivable to improve medical skills in CTG blind interpretation and further investigate which clinical parameters are mainly related with an augmented risk of foetal asphyxia and adverse neonatal outcomes.

Grandparents, family solidarity and the division of housework: evidence from the Italian case.

As a consequence of recent socio-demographic trends and labour market transformations the role of grandparental support has become pivotal in individuals' and households' life courses. In Southern European countries the availability of grandparents affects young couples' labour market participation and fertility decisions. In the present paper, it is asked if the potential availability of social support from the older family generation is associated with more or less inequality in the division of unpaid housework in couples with minor children, in Italy. Using data from the 2016 Family and Social Subjects survey it is shown that while there is not a clear relation between intergenerational face-to-face contacts and the symmetry of the division of household labour, adult children and older (grand)parents coresidence is associated with a more gender-equal sharing of housework within couples, arguably because co-residing grandparents take on the execution of a number of household tasks. The observed effect is comparable to that of hiring a paid housekeeper and higher than hiring a babysitter. Thus, despite one may think that three-generation households are characterized by a culture of traditional norms, our findings indicate that they have a more gender-equal division of housework.

Mental Health Around the Transition to First Birth: Does Medically Assisted Reproduction Matter?

Previous research has shown that childbearing is associated with short-term improvements in women's subjective well-being but that these effects depend on the timing and quantum of the birth as well as on the parents' education and socioeconomic status. These studies did not address whether and, if so, how this effect varies according to the mode of conception. This represents an important knowledge gap, given that conceptions through medically assisted reproduction (MAR) have been increasing rapidly in recent decades, exceeding 5% of live births in some European countries. Drawing on nine waves (2009/2010-2017/2018) of the UK Household Longitudinal Study, we use distributed fixed-effects linear regression models to examine changes in women's mental health before, during, and after natural and MAR conceptions. The results show that the mental health of women who conceived naturally improved around the time of conception and then gradually returned to baseline levels; comparatively, the mental health of women who conceived through MAR declined in the year before pregnancy and then gradually recovered. The findings also indicate that women's happiness decreased both two years and one year before an MAR conception and then increased above the baseline in the year of pregnancy. We further show that the deterioration in mental health and subjective well-being before an MAR conception affects both partners, which could be part of a longer process in which the partners potentially suffer from stress related not solely to the MAR treatments themselves but also to the experience of subfertility.

Gray divorce and mental health in the United Kingdom.

The number of older people who experience marital break-up has increased in many Western countries. However, limited empirical attention has been given to the study of the consequences of later-life divorce or separation. Previous studies on gray divorce are often cross-sectional and tend to capture a mix of short- and long-term effects of divorce and possibly selection effects into divorce. Drawing on data from nine waves of the UK Household Longitudinal Study (2009/2010-2017/2018), we analyze the effect of marital break-up on the mental health of 909 adults aged 50 or over to test the crisis model and the chronic strain model of divorce. We use fixed effects linear regression models to account for time-invariant confounders and distinguish between pre- and post-divorce effects. Our results indicate that older adults' depressive symptoms (GHQ) increase in the years before and upon union dissolution. After separation, depressive symptoms decrease and return to approximately previous baseline levels. Our analyses on heterogeneity in the effects of gray divorce show that post-divorce adjustment is faster for childless adults than for parents. We find no evidence that adjustment after gray divorce is slower for women than for men, or for persons who already experienced a prior union dissolution than for those who separate for the first time. The results are consistent with the crisis model of divorce but in contrast with the chronic strain model of divorce. Older adults are able to adjust to marital break-up, and their fertility histories tend to moderate the negative effect of later-life divorce on mental health.

Influence of post-migration living difficulties on post-traumatic symptoms in Chinese asylum seekers resettled in Italy.

BACKGROUND: Little is known about mental health and resettlement difficulties of Chinese asylum seekers fleeing China due to religious persecutions. AIM: This study explores main post-migration living difficulties (PMLD) in this population, with a focus on their role in post-traumatic stress disorder (PTSD). METHODS: A total of 67 patients (95.52% women, mean age 34.75 ± 7.63) were included in the study. The Harvard Trauma Questionnaire (HTQ) was used to assess PTSD, the List of Migration Experiences (LiMEs) was used for pre-migration and post-migration experiences (potentially traumatic events as well as living difficulties). The t-test was used to examine the differences in pre-migration and post-migration mean scores. Logistic regression was used to test the effect of pre-migration traumatic experiences (PMTE) and most frequent PMLD on having a PTSD. RESULTS: A total of 49 patients scored above the HTQ cut-off score for PTSD. As expected, traumatic experiences were concentrated in the pre-migration phase, while living difficulties were present in both phases but more frequently in the post-migration period. PMTE were significantly related to PTSD (OR 1.29, p = .01). However, three PMLD ('Feeling that you do not know where you will lend up tomorrow', 'Loneliness and boredom' and 'Not being able to find work') showed a significant interaction with PMTE, suggesting that their presence in the post-migration phase has a modulation effect by increasing the likelihood of PTSD. CONCLUSION: This study extends to Chinese asylum seekers the previous evidence that PMLD have a significant role in the likelihood to have a PTSD after landing in the host country.

Does Children's Union Dissolution Hurt Elderly Parents? Linked Lives, Divorce and Mental Health in Europe.

Previous research has shown that parent's union dissolution has negative consequences for individuals' well-being, parent-child relationships and children's outcomes. However, less attention has been devoted to the effects in the opposite direction, i.e. how children's divorce affects parents' well-being. We adopted a cross-country, longitudinal and multigenerational perspective to analyse whether children's marital break-up is associated with changes in parents' depressive symptoms. Using data from 17 countries and 5 waves of the Survey of Health, Ageing and Retirement in Europe (2004-2015), fixed effect linear regression models were estimated to account for time-constant social selection processes into divorce/separation. The results show that across European contexts parents' depressive symptoms increased as one of their children divorced. Furthermore, we found that parents living in more traditional societies, such as Southern European ones, experienced higher increases in depression symptoms when a child divorced than those living in Nordic countries. Overall, the findings provide new evidence in support of both the notion of "linked lives" and a normative perspective of family life course events.

Intergenerational contacts and depressive symptoms among older parents in Eastern Europe.

OBJECTIVE: We investigate the association between parent-child contact frequency and changes in older parents' depressive symptoms in Bulgaria, Georgia and Russia. These are countries in which societal transformations may mean that psychological feelings of security engendered by having children in close contact may have particularly important implications for the mental health of older parents. METHODS: We analysed data from two waves of the Generation and Gender Surveys conducted three years apart and took account of relationships with more than one child. Analyses were performed using OLS regression models, adjusted for depressive symptoms at baseline. RESULTS: Among mothers increases in depressive symptoms were greater for those who lacked at least weekly contact with any child than for those with frequent contact with at least one child (b = 0.64; p<0.01). Increases in depressive symptoms were associated with infrequent contacts with children, even after controlling for relationship quality (b = 0.55; p<0.05). Among unpartnered fathers, less than weekly meetings with children were associated with increases in depressive symptoms. CONCLUSIONS: Among mothers and unpartnered fathers changes in depressive symptoms varied by parent-child contact. The adverse effect of not having a partner on fathers' mental health was reduced, but not eliminated, by having frequent contacts with adult children.

Grandparenting after parental divorce: The association between non-resident parent-child meetings and grandparenting in Italy.

Previous studies have shown that parental divorce has negative consequences on parent-child relationships and that these effects extend to relations between grandchildren and their grandparents. After parental divorce, grandchildren have less intense and lower quality relations with their grandparents. Some studies suggest that this negative association between union dissolution in the middle generation and grandparent-grandchild relations is explained by the post-divorce residential arrangements and, to a lesser extent, by the gatekeeping role exercised by the resident parent. The role of the frequency of meetings between the non-resident parent and his/her children, however, has been often overlooked in this literature. Using cross-sectional data from the Italian Family and Social Subject Survey, our study explores the extent to which frequent meetings between non-resident separated or divorced parents and their children below age 14 are correlated with grandparent involvement in looking after their grandchildren. The results show that young children who have very frequent meetings with their non-resident parents are more likely to receive care from their grandparents than are those who meet the non-resident parents once a week or less frequently.

Returns home by children and changes in parents' well-being in Europe.

Co-resident adult children may be a source of emotional and instrumental support for older parents, but also a source of conflict and stress. Results from previous research are far from conclusive and indicate that intergenerational co-residence may have both negative and positive effects on parents' depressive symptoms and physical health. We analyse longitudinal data from four waves of the Survey of Health, Ageing and Retirement in Europe (2007-2015) to examine whether returns to the parental home by adult children are associated with changes in the quality of life of parents aged 50-75. Results from fixed effects linear regression models show that returns to the parental home by adult children were associated with decreases in parents' quality of life and that this largely reflected declines associated with the return of a child to an 'empty nest' where no other children were still co-resident. In line with previous research which has indicated differing effects of co-residence on parents' depressive symptoms by cultural tradition, this effect was largely driven by decreases in parents' quality of life in a grouping of Nordic/social-democratic. There were no associations between changes in parental quality of life and the returning child's characteristics, although unemployment of a child was negatively, and new partnership of a child, positively associated with changes in parental quality of life.

A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric method for the simultaneous determination of cyclophosphamide, methotrexate and 5-fluorouracil as markers of surface contamination for occupational exposure monitoring.

A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric (HPLC/ESI-MS/MS) method was developed for the simultaneous quantification of 5-fluorouracil (5FU), methotrexate (MTX) and cyclophosphamide (CP) in environmental samples. These compounds, commonly used in the treatment of cancer, are recognized as genotoxic. In order to estimate the occupational exposure of hospital personnel handling these drugs, wipe samples were taken from the working surfaces and directly analyzed (with trophosphamide as internal standard) using a reversed-phase capillary column and MS/MS detection. This is the first HPLC/MS/MS method for the simultaneous determination of 5FU, MTX and CP. The present method offers high sensitivity, with detection limits of 1.1 microg l(-1) for MTX and CP and 33.3 microg l(-1) for 5FU, avoiding any sample preconcentration procedure. Rapidity, specificity, high accuracy (mean values between 92.4 and 99.9%) and precision (mean RSD values between 3.4 and 12.1%) make the method suitable for the routine determination of these three antineoplastic drugs.

A method for routine quantitation of urinary 8-hydroxy-2'-deoxyguanosine based on solid-phase extraction and micro-high-performance liquid chromatography/electrospray ionization tandem mass spectrometry.

8-Hydroxy-2'-deoxyguanosine (8OHdG), one of the major oxidative DNA lesions induced by radical agents, is commonly used as a biomarker for oxidative stress, nowadays preferably in urine. In the absence of a commercially available internal standard a micro-high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (micro-HPLC/ESI-MS/MS) method, suitable for routine analysis of 8OHdG in human urine using external calibration, was developed. Evaluation of the matrix effect showed that the method allows highly sensitive and accurate quantitation despite the absence of an internal standard. HPLC analysis was performed using gradient elution at a flow rate of 10 microL min(-1) using a capillary reversed-phase column and an injection volume of 0.5 microL, with detection of 8OHdG in positive multiple reaction monitoring (MRM) mode. The absolute limit of detection was 0.35 fmol using m/z 168 as a quantifier (fragment) ion. A linear (R2> 0.999) calibration curve in urine was obtained over a range 0.2-10 ng mL(-1). This method is about 20 times more sensitive than previously described procedures, and is characterized by high accuracy (mean 90%) and good reproducibility (RSD <10%). The optimized method was applied to determination of 8OHdG in 18 urinary samples derived from three healthy volunteers. 8OHdG urinary excretion ranged from 3.0-7.9 microg/day, and a large intra-individual variation was found. This method, which effectively circumvents the need for isotopically labeled 8OHdG (internal standard), is suitable for routine monitoring of exposure to DNA-damaging factors in a large number of subjects.