Maternal versus nonmaternal care and seven domains of children's development.

A series of meta-analyses was conducted on findings from 59 studies to examine the linkage between maternal versus nonmaternal care, 7 indices of child behavior, and 10 potential moderators. Results indicate that children receiving nonmaternal care do not differ from children receiving maternal care on any of the 7 indices. Year of publication and psychometrics of outcome index were found to moderate the linkage between maternal versus nonmaternal care and attachment classification and between maternal versus nonmaternal care and child adjustment, respectively. Examination of the simultaneous impact of extent of care and age of entry on attachment behaviors revealed the moderating impact of the latter. Although it cannot be concluded that nonmaternal care has no impact on children, most of the analyses suggest that in and of itself, or in interaction with one factor at a time, nonmaternal care does not affect child development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child-care debate: Transformed or distorted?

Attempts to correct misconceptions and comments on issues in L. B. Silverstein's (see record 1992-05293-001) article on child care and maternal employment which cited a study by the National Institute of Child Health and Human Development (NICHD) as an example of the search for negative consequences. The authors emphasize that hypotheses in the NICHD study were formulated to search for both positive and negative consequences of varied types and qualities of nonmaternal care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of concerns about child care among single, employed black mothers with preschool children

This study investigated whether differences in child care arrangements and mothers' attitudes about leaving their child in nonmaternal care were associated with maternal psychological well-being and perceptions of children in a sample of single, employed, low-income, Black mothers who were former welfare recipients. Feelings of discomfort with regard to nonmaternal care were associated with higher levels of maternal depressive symptomatology, which, in turn, predicted more negative perceptions of children. Preference for employment and increased working hours were associated with greater life satisfaction. Maternal education and the gender of the child were important moderating variables. Type of child care arrangement was nonsignificant. Policy implications are discussed.     

Nonmaternal care in infancy and emotional/behavioral difficulties at 4 years old: Moderation by family risk characteristics.

The authors examined the role of familial risk and child characteristics in the association between the type of child care in infancy (maternal care [MC]) versus nonmaternal care [NMC]) and emotional/behavioral difficulties at 4 years old. Canadian families (N=1,358) with children between 1 and 12 months old were followed over 4 years. Family risks were found to moderate the association between type of child care and physical aggression. MC in infancy was associated with lower levels of physical aggression among children from a low-risk family background but not among those from a high-risk family background. The effect size was small (d=-0.16; confidence interval [CI]=-0.3, -0.01). Family risk and the sex of the child moderated the association between child care and emotional problems. MC in infancy was associated with a lower level of emotional difficulties among girls from low-risk families but not among boys or among children from high-risk families. The effect size was moderate (d=-0.44; CI=-0.65, -0.23). The study indicates that the effect of child care type in infancy varies by family and child characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal employment and child cognitive outcomes: The importance of analytic approach.

J. Brooks-Gunn, W. J. Han, and J. Waldfogel (2002; see record 2002-17576-005) and the National Institute of Child Health and Human Development Early Child Care Research Network (ECCRN; 2000b; see record 2000-02736-015) came to different conclusions about the effects of maternal employment--although they were addressing similar questions using the same data set. Brooks-Gunn et al. concluded that maternal employment in infancy has a negative effect on children's cognitive abilities at age 3, whereas the ECCRN found that early nonmaternal care is not related to children's cognitive abilities in their first 3 years. The authors account for this difference by comparing 2 approaches to data analysis: a top-down testing of continuous variables (the approach used by the ECCRN, 2000b) and an a priori comparison approach that involves pairwise testing of specific dichotomous contrasts (the approach used by Brooks-Gunn et al., 2002). This comparison illustrates the critical importance of analytic approach. It also suggests that Brooks-Gunn et al.'s conclusion from this data set is overstated and should not be used on its own as the basis for practical or policy decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective retrieving by maternal and nonmaternal female rats.

Conducted an investigation to learn whether nonpregnant female rats made maternal by exposure to pups would act more like nonmaternal females than lactating mothers. Ss were 32 nulliparous females of the Charles River CD strain and an additional number of females that provided pups for inducing maternal behavior in virgins and in testing all Ss in pup vs toy tests. The behavior toward a pup and a toy was studied in 1 group of nonmaternal virgins, 2 groups of maternal virgins, and 1 group of lactating mothers, during 7 daily 5-min tests. Measures of the frequency and duration of retrieving-related behavior and analysis of behavioral sequences in relation to the pup or toy showed that pup-induced maternal virgins more closely resemble the lactating mothers than nonmaternal virgins. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child care and mother–child interaction in the first three years of life.

Relations between nonmaternal child care and ratings of maternal sensitivity and child positive engagement during mother–child interaction at 6, 15, 24, and 36 months were examined for 1,274 mothers and their children participating in the National Institute of Child Health and Human Development(NICHD) Study of Early Child Care. In longitudinal analyses that controlled for selection, child, and family predictors, child care was a small but significant predictor of maternal sensitivity and child engagement. For the whole sample, including families who did and did not use child care, more hours of child care predicted less maternal sensitivity and less positive child engagement. For children who were observed in child care, higher quality child care predicted greater maternal sensitivity, and more child-care hours predicted less child engagement. The effects of child care on mother–child interaction were much smaller in the analytical models than the effects of maternal education but were similar in size to the effects of maternal depression and child difficult temperament. Patterns of association with child care did not differ significantly across ages of assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using c-Fos immunocytochemistry to identify forebrain regions that may inhibit maternal behavior in rats.

Evidence indicates there is a neural system that inhibits maternal behavior in virgin rats. It has been suggested that pregnancy hormones promote the onset of maternal behavior by reducing the behavioral influence of this system. The authors used c-Fos immunocytochemistry to identify brain regions more activated by pup exposure in nonmaternal rats than in maternal rats. Previous experiments indicated that some of these regions, such as the posterodorsal medial amygdala and several medial hypothalamic sites, inhibit maternal behavior. For others, such as the ventral lateral septum, dorsal premammillary nucleus, and principal bed nucleus of the stria terminalis, this is the first indication that they could also inhibit maternal responding. These regions have previously been implicated in promoting defensive behaviors, consistent with the finding that nonmaternal rats actively avoid pups. These findings suggest the existence of a neural circuit through which pup exposure could promote defensive responses in virgin rats, and how pregnancy hormones could reduce such activity to stimulate maternal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of maternal behavior in nulliparous rats (Rattus norvegicus): Effects of sex and early maternal experience.

72 weanling female and male CD rats were exposed to either pups or pup-sized toys for 10 days beginning at 22 days of age in order to assess differences between pup-directed and toy-directed behaviors and to determine whether exposure to pups at this time increases susceptibility to maternal sensitization in adulthood. Adult sensitization involved exposing each S to pups for 10 days beginning at 78 days of age. Weanlings retrieved, licked, and lay over pups but not toys, and chewed on toys but not pups. Weanling males showed more pup retrieval than weanling females. Females and males preexposed to pups showed more retrieval and licking of pups in adulthood than those not preexposed to pups. Adult females were more fully maternal or nonmaternal than were adult males or weanlings of either sex, as indicated by their lower "partial retrieval" and "inconsistent retrieval" scores, their tendency to retrieve rapidly or not at all, and the greater correlation between their retrieval and nest construction. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are behavioral effects of infant day care program specific?

Eight pairs of 2-yr-olds in a toddler day care center were matched on age and sex. One member of each pair had been in day care for at least 13 mo, while the other member had been in day care 6 mo or less. Those Ss who had been in day care longer were rated higher by 4 care givers on (a) ability to get along with peers, (b) problem-solving, (c) ability to abstract, and (d) planfulness. These results contrast with the findings of a similar study by J. C. Schwarz et al (see record 1974-31999-001) in which the effects of day care at another center were studied in pairs of 4-yr-olds. None of the significant differences found in the previous study appeared in the present study. It is concluded that caution is necessry in generalizing the effects of infant day care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dopamine D1 and D2 Receptor Antagonism in the Preoptic Area Produces Different Effects on Maternal Behavior in Lactating Rats.

The preoptic area (POA) is critical for maternal behavior in rats but little is known about what neurotransmitters released here influence maternal responding. POA infusion of 10 μg (but not 2 μg) of the dopamine D1 receptor antagonist SCH-23390 greatly impaired retrieval and licking of pups but not other maternal or nonmaternal behaviors in lactating rats. In contrast, POA infusion of 10 μg (but not 2 μg) of the D2 receptor antagonist raclopride facilitated nursing but did not affect oral maternal behaviors. SCH-23390 in the medial hypothalamus tended to impair licking but not retrieval. Raclopride in the medial hypothalamus had no effects. Therefore, D1 and D2 receptor activity, particularly in the POA, is important for regulating different maternal behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Plasma cocaine levels and locomotor activity after systemic injection in virgin and in lactating maternal female rats

We have determined the temporal pattern of plasma cocaine levels and increased activity that result from acute systemic injections of cocaine to female rats in two different endocrine and behavioral states, in nonmaternal virgins and in lactating maternal dams. Plasma levels of cocaine as well as ambulatory and rearing activity were determined every 30 min for a total of 300 min after subcutaneous injections of either 10, 20, or 40 mg/kg of cocaine. Virgin females had no prior drug history, whereas lactating, maternal dams had received two cocaine injections before activity testing. Within 30 min after an injection, cocaine in the plasma and activity were substantially elevated, and generally remained so for 270-300 min. Overall, plasma cocaine levels and activity were well correlated and followed a predictable dose-response pattern. The onset, peak, duration, and decline of activity corresponded generally to the onset, peak, duration, and decline of plasma cocaine. For virgins, mean ambulatory activity increased 2.5-4.0-fold over baseline, whereas in lactating females activity increased 5-11-fold over baseline. Stereotypy did not occur. Although the general responsivity of these females to cocaine was very similar to that reported for males, there are differences in the timing of peak activity and the return of activity to baseline when the virgins and the lactating dams are compared to each other and to reports by others on male rats. These data support the hypothesis that endocrine or behavioral state may influence the responsiveness of animals to cocaine.     

Sex differences in urinary odors produced by young laboratory rats (Rattus norvegicus).

Examined the responses of 75 primiparous Long-Evans rat dams and 20 nonmaternal Long-Evans females to male and female pup urine in 3 experiments. Investigatory sniffing of male and female pup urine deposits by maternal Ss was compared in a series of simultaneous choice tests given at 3-day intervals between Day 2 and Day 17 postpartum. Male urine was consistently preferred. Introduction of male but not female pup urine to the nest was found to significantly elevate maternal licking of anogenital regions of pups. Thus, urine from pups of various ages contains sex-identifying odors that differentially elicit spontaneous maternal interest. The odor of male urine may provide a sufficient stimulus to account for the greater anogenital licking that males of this species normally receive. Nonmaternal, naive, adult Ss behaved like maternal Ss, preferring male urine in the choice test, which indicates that the maternal condition of a dam is not necessary either for the olfactory discrimination or for the male odor preference. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarification on Psychological Treatments and Psychotherapy.

In this article, the author responds to a set of comments (see record 2005-11834-009; 2005-11834-010; 2005-11834-011) on his original article, "Psychological Treatments" (see record 2004-21168-001). The author responds to each comment. Hal Arkowitz (2005) misread the proposed distinction between "psychological treatments" and "psychotherapy" by presuming that the author was implying that the former is evidence based and the latter is not. Kwekkeboom et al. (2005), representing the nursing profession, noted quite correctly that nurses often deliver psychological treatments on the frontlines of primary care and are independently licensed to provide nursing services, including many approaches that could be categorized as "psychological." Ahmed and Boisvert (2005) agreed that psychological treatments are a core strength of psychology and also go on to provide additional interesting examples and to identify other areas of practice in which psychologists may be uniquely qualified. Overall, the author notes that only certain well-defined pathologies will be included in any health care system, and treatment for these conditions will increasingly need to be based on evidence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confocal microscopy. Applications in research and practice of pathology

Three 4-hour bus rounds were organized as part of an international palliative care congress, to promote patient-based education both at home and in acute care hospitals. Patient cases were presented and discussed en route to and from each visit. A total of 23 medical specialists visited 16 patients (10 in three different hospitals and 6 at home). A mean of 5.3 cases were presented during each round. A total of nine journal club articles were presented, a mean of three (2-4) articles per round. A questionnaire was filled out anonymously by all 23 participants. On a scale of 1 (worst) to 5 (best) they gave the rounds an overall rating of 5 (range 4-5). These findings suggest bus rounds provide an opportunity for intensive exposure to patient-based learning, both in acute care hospitals and at home.     

Comparison of oxidized low-density lipoprotein toxicity on EA.hy 926 cells and human vein endothelial cells: influence of antioxidant systems

BACKGROUND: The Government's policy of Changing childbirth gives priority to user-oriented outcomes, such as continuity of carer. It has been assumed that the organization (or pattern) of maternity care is the main determinant of continuity, with relatively little attention paid to sociodemographic factors. The aim of this study was to assess the relative contribution of social class, spoken language and pattern of care in determining continuity of carer. METHOD: Postal questionnaires were sent 14 days after delivery to East London and the City Health Authority residents delivering within a three-week period in May 1994. Bilingual interviews were carried out for non-English-speaking women. Pattern of care was assigned by the midwife as either hospital or community (including team based care, 'domino' and home births). The main outcome measure was self-reported continuity of carer in antenatal, delivery and postnatal care. RESULTS: The response rate was 69 per cent (370/533). The community pattern of care affected only antenatal continuity (62 per cent community vs 50 per cent hospital, p < 0.05). Women whose main spoken language was English or whose social class was I-IIIn reported higher levels of continuity at each phase of care, although this effect was largely confined to the community pattern of care. The odds ratios (95 per cent confidence intervals) for the effect of social class (I-IIIn vs other) on antenatal, labour and postnatal continuity within the community pattern of care were 3.64 (1.09-12.18), 3.08 (1.09-8.74) and 4.93 (1.48-16.46), respectively. CONCLUSION: Spoken English and high social class were associated with continuity of carer, although this effect was mainly confined to women with a community pattern of care. Achievement of national targets for continuity of carer may not be possible in east London without explicit consideration of sociodemographic factors.     

The reproductive stage and experience of sexually receptive mothers alter their preference for pups or males.

Female rats show postpartum estrus, a unique stage in their reproductive cycle in which they are able to display maternal and sexual responses at the same time. To assess the relative value of pups or males for sexually receptive mothers with different hormonal profiles and reproductive experiences, we employed a 3-point star maze with 3 choice compartments containing: pups, a sexually active male, or no stimulus (neutral). Cycling maternal and nonmaternal females in late proestrus, independently of their previous reproductive experience, strongly preferred the male to the pups, although most postpartum estrous dams did not exhibit preference for the male. The majority of the postpartum primiparous females did not prefer the litter's chamber either, but a previous reproductive experience strongly determined their preference for the pups. These results suggest that the hormonal changes of the proestrus, in contrast to those of the postpartum estrus, promote a strong preference for the male that is not diminished by the maternal condition. Conversely, the endocrine changes of the postpartum facilitate the effect of previous reproductive experience in strengthening the incentive value of the pups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

People who live in glass houses …: A response to the critique of the article "All That Glitters Is Not Always Gold".

Replies to the comment by I. J. Miller (see record 1998-11734-019) regarding J. S. Fraser's article (see record 1996-00461-003) examining medical offset effects in marketing managed behavioral care services. Fraser responds to each criticism in turn, makes corrections where necessary, and re-examines points made in the original article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed care: rationing without justice, but not unjustly

Three ethical criticisms of managed care are often voiced: (1) by "skimming the cream" of the patient population, managed care organizations fail to discharge their obligations to improve access, or at least, to not worsen it; (2) managed care organizations engage in rationing, thereby depriving patients of care to which they are entitled; and (3) by pressuring physicians to ration care, managed care organizations interfere with physicians' fulfillment of their fiduciary obligations to provide the best care for each patient. This article argues that each of these criticisms is misconceived. The first rests on the false assumption that the health care system includes a workable division of responsibility regarding access that assigns obligations concerning access to managed care organizations. The second and third criticisms wrongly assume that we in the United States have taken the first step toward assuring equitable access to care for all, articulating a standard for what counts as an "adequate level of care" to which all are entitled. These three misguided criticisms obscure the most fundamental ethical flaw of managed care: the fact that it operates in an institutional setting within which no connection can be made between the activity of rationing and the basic requirements of justice.     

A proposal to unite two different worlds of children's mental health.

Responds to comments made by Holden and Blau (see record 2006-11202-017) on the current authors' original article (see record 2005-11115-005). The current authors suggest combining the complementary strengths of the community-based approaches identified by Holden and Blau (2006) and the evidence-based approaches discussed in their original article, rather than argue about the comparative limitations of each approach. Given that the contents of both systems of care and wraparound are free to vary with available services in the community, they suggest ensuring that those specific services are, in fact, interventions that have been tested and shown to work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)