text:
- Research
- Open Access
Associations between clinical and sociodemographic data and patterns of communication in pediatric oncology
- Marina Kohlsdorf1Email author and
- Áderson Luiz Costa Junior2
© Kohlsdorf and Costa Junior. 2016
- Received: 10 March 2016
- Accepted: 7 April 2016
- Published: 18 April 2016
Pediatric communication directly contributes to treatment adherence, fewer symptoms, better clinical responses, healthier treatment adaptation and management of psychosocial issues. This study aimed to evaluate associations between the clinical and sociodemographic data of caregivers and children and the communicative patterns of pediatricians. Three oncohematology physicians and 44 child-caregiver dyads took part, with audio recording of 146 medical consultations. The physicians interacted more often with older children, offering more guidance, clarifying doubts, and asking for information. The number of questions from children and caregivers was positively correlated with the physician's communicative behaviors. However, there was no association between the age of the children and the number of doubts of the patients. The diagnosis, treatment time, family income, marital status and caregiver's level of education were associated with the amount of interaction provided by physicians to the children and caregivers. This study offers subsides relevant to psychosocial interventions that may improve communication in pediatric oncohematology settings.
- Cancer in children
- Physician-patient relationship
Health communication may be defined as a relational process, crucial to the success of the treatment, based on cultural and sociohistorical aspects, in which information and its comprehension are exchanged between people (Gabarra and Crepaldi 2011; Wassmer et al. 2004; Zwaanswijk et al. 2011). This complex interaction has been studied with validated tools: Roter Interaction Analysis System (Wissow, Larson, Anderson & Hadjiisky, 2005), Verona Coding Definitions of Emotional Sequences (Vatne et al. 2010a, b), Rating Scales for Emphatic Communication in Medical Interviews - REM (Nicolai et al. 2007), Communication Assessment Tool - CAT (Makoul et al. 2008), and the Paediatric Consultation Assessment Tool (Howells et al. 2010). However, none of these tools have been translated and validated to Brazilian Portuguese, which prevents researchers from using them in data collection and highlights the need for studying health communication in Brazil from an objective and observable way.
The literature has focused on communication in pediatric settings in the last three decades due to the fact that this process is strongly related to quality of life, treatment adherence, symptom management, satisfaction with health service, fewer outpatient returns and better coping with treatment related difficulties (Ammentorp et al. 2011; Coyne and Gallagher 2011; Croom et al. 2011; Drotar 2009; Sleath et al. 2012).
A desirable interaction during pediatric medical consultations may include: (a) provision of tailored information by physicians, using adapted language; (b) approaching psychosocial issues related to health care (such as daily care and consequently changes in the family routine, expenses related to the treatment, caregiver's anxiety related to clinical responses); (c) emphasizing the active role of physicians, parents, and patients during the interaction; and (d) provision of social support and empathy by pediatricians (Gabarra and Crepaldi 2011; Wassmer et al. 2004; Zwaanswijk et al. 2011).
There is, however, a lack of professional training during medical undergraduate courses that could provide the necessary skills regarding communication in pediatric settings, since it demands specific abilities related to the triad interaction (Rider et al. 2008). The literature shows that the insufficient amount of communicative training during medical undergraduate courses, along with parents' worries about protecting the child from suffering, leads to a disregard for the pediatric patients' contributions during consultations, with them participating mainly in small talk or providing only basic health information (Taylor et al. 2010; Vaknin and Zisk-Rony 2010; Washington et al. 2012). Therefore, more studies concerning the process of pediatric communication are needed, in order to understand its characteristics, which could lead to psychosocial and educational interventions focused on a more efficient interaction.
The literature presents studies concerning associations between the child's clinical condition, social/demographic data and pediatric communication patterns, which are relevant to deepen the understanding of factors that may influence interaction during medical consultations. Studies conducted in the United States of America and in the United Kingdom have highlighted that, considering the characteristics of the caregivers, pediatricians tend to share more decisions and provide more information, of better quality, to white parents (Fiks et al. 2010; Moseley et al. 2006) with higher levels of education (Brinkman et al. 2011; Washington et al. 2012; Zwaanswijk et al. 2011), and higher monthly incomes (Taylor et al. 2010).
Considering communication between physicians and children during medical consultations, the literature shows age as a major differential in pediatric settings, although children at the age of four already understand information about self care, identify symptoms and organs, have doubts and concerns about treatment, and feel emotional responses related to their condition (Gordon et al. 2010; Knighting et al. 2010; Märtenson and Fägerskiöld 2007; Märtenson et al. 2007; Vatne et al. 2010a, b). Older children receive more information from pediatricians and answer more questions directed toward them by physicians (Gabarra and Crepaldi 2011; Stivers 2011, 2012; Stivers and Majid 2007; Taylor et al. 2010; Zwaanswijk et al. 2011).
In addition to age, the level of education of the caregiver and child as well as the prognosis, the race and gender of the child appear to be relevant characteristics: pediatricians communicate more and better with white and female children, with parents and children with higher educational levels and also with children with better prognosis regarding treatment (Drotar 2009; Gabarra and Crepaldi 2011; Stivers 2011, 2012; Stivers and Majid 2007; Taylor et al. 2010; Zwaanswijk et al. 2011). Conversely, studies from Fiks et al. (2010) and Wissow et al., (2005) showed no associations between communicative patterns and sociodemographic data of parents and children.
Although the studies presented in this paper show relevant results concerning communication and sociodemographic data, there are some features that were not included in their analyses, such as type of diagnosis, marital status of the caregivers, and time since diagnosis of chronic conditions, characteristics that may be relevant when considering communication during medical consultations. Furthermore, the pediatric oncohematologic milieu presents a very specific and complex condition - which includes various psychosocial demands, long-term treatment and family challenges - that demands a better understanding related to the communication between physicians, children and caregivers. It is also relevant to note that there are few studies in the Brazilian literature related to pediatric communication, and none of them analyzes the relationship between the personal characteristics of children and caregivers and the way in which physicians communicate with them.
Therefore, this study aimed to analyze associations between communicative patterns from physicians in pediatric settings and sociodemographic data of caregivers and children. Specifically, the authors hypothesized that the physicians might establish a better communication toward parents with higher income and higher levels of education, as well as toward older children with advanced schooling.
Participants in this study were three physicians of a pediatric cancer hospital, aged 49, 34 and 32 years, with seven, 11 and 26 years of medical practice. They were respectively two women and one man, however there were no noticeable differences in communicative patterns among these three participants. The public hospital in which data were collected has a pediatric oncohematology team consisting of ten physicians: two of them were not working at the time of data collection, one of them was in the process of retirement, and two were moving to other services in following weeks. Of the five physicians left, only three had stable clinical practice schedules that allowed the collection of data.
Characteristics of the Caregiver and Child
Characteristics of the caregiver and child
Child's age
4 to 6 years
7 to 10 years
11 to 12 years
Mean (SD)
7.3 years (2.6)
Child's schooling
Primary or none
First year to sixth year
Child's gender
Leukemia or lymphoma
Solid tumors
Time since diagnosis
1 month
2 to 4 months
4 to 6 months
Mean (SD)
2.03 months (1.52)
Caregiver's age
22 to 35 years
36 to 56 years
Mean (SD)
35 years (7,9)
Caregiver's education level
Elementary school
Middle school
High school
Caregiver's marital status
Household income
Low income
Medium income
High income
In the study, 146 consultations were audio recorded and observed in person by the main researcher. The medical visits lasted between 6m30s and 37m36s (mean 19m23s; SD = 13.01). During the consultations, the researcher used an observational protocol, developed ad hoc for the study and presented in Appendix A, in which relevant aspects of the communication were written down e.g., the position of the caregiver, child and physician in the room, and other behaviors that could be relevant for the data analysis, such as whether a participant left the room.
Data collection
Over 18 months, 146 medical visits for childhood cancer were directly audio recorded. The data were classified by the main researcher into 11 categories regarding the communication of the pediatrician with the children and the caregivers, focusing especially on the exchange of information and doubts.
Inter-rater reliability rate regarding the frequencies of communicative behaviors was calculated between two observers: the main researcher and the auxiliary researcher. Thirty percent of all the recorded consultations were randomly chosen and analyzed to provide this reliability, achieving between 55 % and 76 % concordance (mean 64.20 %; SD = 5.03). Disagreements between the two observers related to the data were solved by a third researcher, unaware of the answers given by each observer. This observer works as a psychology professor, has experience in research related to the field of expertise and was mentoring this research. Intra-rater reliability was also calculated for all data recorded and performed solely by the main researcher, which achieved between 75.7 % and 95 % (mean 84.55 %; SD = 4.13). The reliability index was conducted according to Danna and Matos (2006).
Data analysis
This cross-sectional and descriptive research focused on statistical associations between nine characteristics from the dyad child-caregiver and eleven communicative categories observed during pediatric consultations. Based on studies available in the literature, nine variables from the dyad child-parent were chosen, corresponding to the sociodemographic data presented in Table 1, regarding the age, schooling and gender of the child, time since diagnosis, cancer diagnosis, household income, and age, education level, and marital status of the caregiver.
A total of eleven communicative categories were developed by the researchers ad hoc for this study, corresponding to the other variables in this research. Following the proposal of Bardin (1977), the main researcher and the auxiliary researcher listened twice to all the recorded consultations and made an individual list of categories. Each researcher worked independently to develop this first list of communicative behaviors, excluding repetitive issues and/or broadening these categories to include similar themes. Then, these initial lists were compared in order to achieve a second list with the same categories, including their operational definition. Finally, both researchers listened one last time to all the consultations to check for new categories or any necessary adjustments.
Each communicative category was analyzed based on its frequency during the consultations in order to provide statistical data analysis. The six categories focused on physician-child communication and the five categories focused on physician-caregiver communication are described in Appendix B.
The Statistical Package for Social Sciences (SPSS) was used (version 13). Considering the frequencies obtained for each quantitative variable, Shapiro-Wilk normality tests were performed and all data showed p ≤ 0.002, therefore non-parametric tests were applied in the data analysis, including Spearman's correlations, the Mann Whitney U test, and the Kruskal-Wallis test. Results in which p ≤ 0.05 were considered statistically significant.
Ethical considerations
This study was approved by the Ethics Committee of the Foundation for Research and Education in Health Sciences under registration number 289/2009. All audio recordings and other information were sealed in a confidential, password-protected archive. The research took place in a hospital that provides cancer treatment for children and adolescents. All participants - physicians, caregivers and children, through their parents - were first approached and invited to participate in the study, by signing an Informed Consent form.
Correlations between Sociodemographic and Clinical Dimensions and Pediatrician's Communicative Behaviors towards the Child
Child's age
Time since diagnosis
Guidance for child
Asks child about doubts
Child's doubts
Child's schooling
Bonding with child
Time since diagnosis
r = -0.29
p < 0.01
Guidance for child
r = 0.46
r = -0.01
p < 0.01
p = 0.37
Asks child about doubts
r = 0.45
r = -0.05
r = 0.64
p < 0.01
p = 0.11
p < 0.01
Child's doubts
r = -0.01
r = 0.13
r = 0.49
r = 0.23
p = 0.76
p = 0.73
p < 0.01
p < 0.01
r = -0.32
r = 0.18
r = 0.17
r = -0.14
r = 0.15
p = 0.01
p = 0.03
p < 0.01
p = 0.26
p = 0.27
Child's schooling
r = 0.81
r = -0.26
r = 0.52
r = 0.50
r = 0.24
r = -0.17
p < 0.01
p < 0.01
p < 0.01
p < 0.01
p = 0.02
p = 0.05
Bonding with child
r = -0.12
r = 0.23
r = 0.44
r = 0.28
r = 0.38
r = 0.13
r = 0.13
p = 0.41
p = 0.02
p < 0.01
p < 0.01
p < 0.01
p = 0.62
p = 0.25
Obtaining information from the child
r = 0.54
r = -0.11
r = 0.64
r = 0.57
r = 0.24
r = -0.10
r = 0.62
r = 0.30
p < 0.01
p = 0.04
p < 0.01
p < 0.01
p = 0.03
p = 0.27
p < 0.00
p = 0.01
Correlations between Sociodemographic and Clinical Dimensions and Pediatrician's Communicative Behaviors towards the Caregiver
Child's age
Time since diagnosis
Guidance to caregiver
Asks caregiver about doubts
Caregiver's doubts
Caregiver's age
Bonding with caregiver
Time since diagnosis
r = -0.29
p < 0.01
Guidance to caregiver
r = 0.12
r = -0.21
p = 0.02
p = 0.02
Asks caregiver about doubts
r = 0.09
r = -0.11
r = 0.50
p = 0.07
p = 0.06
p < 0.01
Caregiver's doubts
r = -0.07
r = 0.01
r = 0.68
r = 0.32
p = 0.38
p = 0.79
p < 0.01
p < 0.01
Caregiver's age
r = 0.29
r = 0.03
r = 0.08
r = -0.03
r = 0.17
p < 0.01
p = 0.96
p = 0.33
p = 0.54
p = 0.03
Bonding with caregiver
r = -0.08
r = 0.08
r = 0.31
r = 0.43
r = 0.12
r = -0.01
p = 0.43
p = 0.51
p < 0.01
p = 0.01
p = 0.09
p = 0.21
Obtaining information from caregiver
r = 0.05
r = -0.25
r = 0.55
r = 0.18
r = 0.20
r = 0.03
r = 0.13
p = 0.57
p < 0.01
p < 0.01
p = 0.03
p = 0.01
p = 0.69
p = 0.30
The age of the child was positively and moderately associated with the amount of physicians' behaviors directed toward the patient, regarding guidance to children (r = 0.46; p < 0.01), asking about doubts (r = 0.45; p < 0.01) and obtaining information from the child (r = 0.54; p < 0.01); it was also negatively and moderately associated with protesting. Time since diagnosis was weakly and negatively associated with protesting (r = - 0.32; p = 0.01).
Physician's guidance directed toward the child was moderately associated with the following behaviors: asking about doubts (r = 0.64; p < 0.01) and bonding with the child (r = 0.44; p < 0.01), expression of doubts (r = 0.49; p < 0.01), protesting (r = 0.17; p < 0.01), obtaining information from the child (r = 0.64; p < 0.01) and the child's schooling (r = 0.52; p < 0.01). Pediatrician's behavior related to asking about the child's doubts was positively and weakly associated with the child's questions (r = 0.23; p < 0.01). Doubts verbalized by children were positively associated with the child's schooling (r = 0.24; p = 0.02), bonding (r = 0.38; p < 0.01), and obtaining information from the child (r = 0.24; p = 0.03), however it is relevant to point out that this behavior had no association with the child's age (r = 0.01; p = 0.76).
Associations Between Physician's Communicative Behaviors, Caregiver's Marital Status, Diagnosis, and Child's Gender
Marital Status
Child's gender
Single or divorced
Leukemia or Lymphoma
Solid tumors
Physician's guidance to child - M(SD)
6.78 (9.51)
8.51 (8.20)
9.49 (9.54)
5.68 (7.51)
7.36 (9.1)
8.24 (8.71)
t[143] = 1.17; p = 0.24
t[144] = 2.63; p = 0.15
t[144] = 0.59; p = 0.38
Physician's guidance to caregiver - M(SD)
32.1 (23.25)
39.49 (26.48)
41.93 (30.9)
29 (12.37)
35.5 (23.4)
36.75 (27.21)
t[143] = 1.78; p = 0.05
t[144] = 3.41; p < 0.001
t[144] = 0.29; p = 0.52
Asks child about doubts - M(SD)
0.54 (1.27)
1.12 (1.58)
0.96 (1.57)
0.79 (1.47)
0.96 (1.57)
0.79 (1.47)
t[143] = 2.38; p < 0.01
t[144] = 0.69; p = 0.81
t[144] = 0.66; p = 0.52
Asks caregiver about doubts - M(SD)
1.21 (1.75)
1.53 (1.89)
1.73 (1.89)
0.98 (1.67)
1.50 (1.91)
1.26 (1.73)
t[143] = 1.07; p = 0.45
t[144] = 2.47; p = 0.16
t[144] = 0.77; p = 0.35
Child's doubts - M(SD)
1.12 (2.00)
1.12 (2.15)
1.53 (2.54)
0.68 (1.23)
1.19 (2.15)
1.09 (2.03)
t[143] = 0.002; p = 0.75
t[144] = 2.61; p < 0.001
t[144] = 0.29; p = 0.71
Caregiver's doubts - M(SD)
6.32 (4.96)
10.16 (8.66)
10.16 (8.61)
6.12 (4.73)
7.76 (5.97)
9.00 (8.71)
t[143] = 3.31; p < 0.01
t[144] = 3.59; p = 0.001
t[144] = 1.02; p = 0.50
Protesting - M(SD)
2.18 (4.91)
2.60 (4.78)
2.73 (5.57)
1.97 (5.15)
2.01 (5.09)
2.81 (5.11)
t[143] = 0.46; p = 0.80
t[144] = 1.78; p = 0.28
t[144] = 0.99; p = 0.08
Physician's bonding with the child - M(SD)
9.75 (5.44)
9.38 (5.49)
11.41 (5.30)
7.32 (4.74)
10.18 (6.16)
8.81 (4.38)
t[142] = 0.70; p = 0.40
t[143] = 4.84; p = 0.46
t[143] = 1.56; p = 0.10
Physician's bonding with the caregiver - M(SD)
2.70 (3.62)
2.47 (2.78)
2.91 (2.63)
2.21 (3.73)
2.32 (2.37)
2.91 (3.92)
t[142] = 0.43; p = 0.83
t[143] = 1.31; p = 0.67
t[143] = 1.07; p = 0.20
Obtaining information from child - M(SD)
3.63 (4.48)
3.99 (3.57)
4.20 (4.31)
3.42 (3.60)
3.92 (4.4)
3.76 (3.54)
t[142] = 0.53; p = 0.91
t[143] = 1.16; p = 0.53
t[143] = 0.24; p = 0.28
Obtaining information from caregiver - M(SD)
9.78 (5.82)
9.91 (5.20)
9.28 (5.23)
10.61 (5.71)
10.22 (6.21)
9.49 (4.49)
t[142] = 0.14; p = 0.56
t[143] = 1.45; p = 0.78
t[143] = 0.81; p = 0.02
Associations between Communicative Behaviors and the Caregiver's level of education and Monthly Income
Caregiver's level of education
Monthly income
None, primary grade
Junior high school
High school
Low income
Medium income
High income
Physician's guidance to child-M(SD)
3.92 (5.11)
5.46 (7.27)
10.7 (11.1)
10.04 (7.8)
7.4 (9.7)
8.52 (7.8)
6.75 (7.1)
F[3,144] = 5.39; p = 0.002
F[2,144] = 0.33; p = 0.72
Physician's guidance to caregiver-M(SD)
25.69 (14.1)
24.57 (10.8)
46.82 (25.9)
47.04 (25.5)
32.3 (19.7)
34.1 (23.5)
60.94 (39.4)
F[3,144] = 11.07; p < 0.001
F[2,144] = 9.96; p < 0.001
Asks child about doubts - M(SD)
0.46 (1.42)
0.54 (1.17)
1.16 (1.77)
1.21 (1.28)
0.88 (1.57)
0.96 (1.5)
0.38 (0.62)
F[3,144] = 2.57; p = 0.05
F[2,144] = 0.97; p = 0.38
Asks caregiver about doubts- M(SD)
1.15 (1.89)
0.63 (1.22)
1.87 (2.05)
2.04 (1.84)
1.36 (1.93)
1.48 (1.7)
1.19 (1.6)
F[3,144] = 5.42; p = 0.001
F[2,144] = 0.16; p = 0.85
Child's doubts- M(SD)
1.12 (2.01)
0.52 (0.91)
1.27 (2.27)
1.86 (2.87)
1.01 (1.86)
1.39 (2.5)
0.88 (1.71)
F[3,144] = 2.60; p = 0.05
F[2,144] = 0.61; p = 0.54
Caregiver's doubts- M(SD)
6.31 (4.73)
5.74 (4.04)
9.38 (7.27)
12.93 (10.9)
6.76 (4.96)
8.37 (7.3)
16.6 (12.1)
F[3,144] = 7.27; p < 0.001
F[2,144] = 14.09; p < 0.001
Protesting- M(SD)
2.73 (6.87)
1.63 (3.08)
3.31 (5.67)
1.89 (3.15)
2.05 (4.74)
2.8 (5.26)
11.25 (6.5)
F[3,144] = 1.06; p = 0.36
F[2,144] = 0.53; p = 0.59
Physician's bonding with child-M(SD)
8.88 (5.88)
7.30 (5.55)
9.91 (3.85)
13.29 (5.18)
8.07 (5.1)
11.6 (5.1)
11.25 (6.5)
F[3,143] = 8.25; p < 0.001
F[2,143] = 7.63; p = 0.001
Physician's bonding with caregiver-M(SD)
1.81 (1.79)
1.20 (1.99)
3.30 (4.16)
4.43 (2.95)
2.28 (3.5)
2.65 (2.5)
3.88 (3.13)
F[3,143] = 8.36; p < 0.001
F[2,143] = 1.70; p = 0.19
Obtaining information from child- M(SD)
3.15 (2.55)
3.52 (3.96)
4.59 (5.24)
3.71 (2.79)
3.85 (4.18)
3.8 (4.21)
3.69 (2.39)
F[3,143] = 0.87; p = 0.46
F[2,143] = 0.01; p = 0.98
Obtaining information from caregiver-M(SD)
9.69 (5.03)
8.89 (6.24)
11.50 (4.94)
8.96 (5.01)
10.17 (5.8)
8.63 (4.8)
11.69 (5.1)
F[3,143] = 2.09; p = 0.01
F[2,143] = 2.22; p = 0.01
Table 5 highlights relevant associations between the caregiver's level of education, monthly income and communicative behaviors. The caregiver's level of education was associated with physician's guidance towards the child (F[3,144] = 5.39; p = 0.002) and caregiver (F[3,144] = 11.07; p < 0.001), asking about the child's (F[3,144] = 2.57; p = 0.05) and caregiver's doubts (F[3,144] = 5.42; p = 0.001), the child's questions (F[3,144] = 2.60; p = 0.05), the caregiver's doubts (F[3,144] = 7.27; p < 0.001), pediatrician's bonding with the child (F[3,143] = 8.25; p < 0.001) and caregiver (F[3,143] = 8.36; p < 0.001) and also obtaining information from the caregiver by the physician (F[3,143] = 2.09; p = 0.01). All behaviors with higher means were among the caregivers with a high school or college degree level of education.
Monthly income was associated with physician's guidance to caregiver (F[2,144] = 9.96; p < 0.001), questions from parents (F[2,144] = 14.09; p < 0.001), pediatrician's bonding with the child (F[2,143] = 7.63; p = 0.001), and also obtaining information from the caregiver by the physician (F[2,143] = 2.22; p = 0.01). The means in all of these behaviors were elevated for caregivers with higher income.
The results showed that older children with advanced schooling received more interaction, since these variables were associated with more guidance from the physician directed toward the child and more frequently asking about doubts and obtaining information, data also found in the literature (Gabarra and Crepaldi 2011; Gordon et al. 2010; Knighting et al. 2010; Märtenson and Fägerskiöld 2007; Märtenson et al. 2007; Stivers 2011, 2012; Stivers and Majid 2007; Taylor et al. 2010; Vatne et al. 2010a, b; Zwaanswijk et al. 2011).
Pediatrician's behavior related to asking about doubts of the child (e.g., "Do you wanna ask anything, honey?" or "Any questions? Think carefully, ok?") was positively and weakly associated with questions from the child, which may suggest that this specific and simple behavior from the physician could be crucial to promote verbalization of the patients. It is also relevant to state that this physician's behavior was moderately and positively related to child's schooling and age, indicating sociodemographic characteristics that influence communicative behaviors by the physician towards the child. It should be highlighted that there was more interaction between the older children and the pediatricians, which may also have contributed to a better communicative process. The literature, however, highlights that 4-year-old patients can already understand elementary health care behaviors, identify symptoms and, therefore, should contribute within an active role in health related processes, endorsing the need for including these patients during medical consultations (Gordon et al. 2010; Knighting et al. 2010; Märtenson and Fägerskiöld 2007; Märtenson et al. 2007; Vatne et al. 2010a, b).
Considering communication between pediatricians and children, this study also presented relevant associations between several of the physician's behaviors directed towards the patients, including guidance, asking about doubts, bonding, and obtaining information. The results seem to indicate a group of communicative behaviors that usually occur together during the interaction, or, in other words, that pediatricians could have a personal communicative pattern and/or that this interaction is strongly influenced by the child's behavior, stimulating other subsequent interactions.
When considering the interaction between physicians and children, the present study showed no associations between the amount of doubts verbalized by the patients and their age, however, this behavior was associated with the child's schooling, bonding, and the physician obtaining information and asking about doubts. This data highlights the relevance of pediatrician's behavior that may promote child's inclusion in the communication, however, it is important to point out that pediatric cancer treatment may generate clinical conditions - such as pain, nausea, and sleepiness - which directly influence the interaction with the child (Kohlsdorf, 2012).
Considering communication between the physicians and caregivers, monthly income and caregiver's level of education were associated with better communication by the pediatrician, with parents with higher income and higher levels of education receiving more guidance, bonding, and being more frequently asked for information. These results are similar to those found in the literature (Brinkman et al. 2011; Fiks et al. 2010; Moseley et al. 2006; Taylor et al. 2010; Washington et al. 2012; Zwaanswijk et al. 2011). In addition to these results, the present study showed associations between marital status and better communication with physicians, considering guidance from pediatricians, and the amount of questions raised by the parents.
Clinical conditions also seem to play a relevant role in communicative patterns. In the present study, the type of diagnosis was related to physician's guidance to the children, asking about the caregiver's doubts, bonding and the amount of questions asked by the children and parents. It should be noted that children with solid tumors may have a specific clinical condition with more intense symptoms - such as pain, physical impairment or injuries and surgery - which may influence the condition of the child during consultations and, as a consequence, the interaction between the patients and pediatricians (Kohlsdorf, 2012). In addition, time since diagnosis was negatively associated with guidance and asking for information, suggesting that caregivers receive more information during the early stages of the treatment. The positive and weak associations between caregiver's doubts and asking caregivers for information might suggest a relevant pattern from physicians when including parents in communication. All these results are consistent with the literature, however, the gender of the child was not associated with pediatrician's communicative patterns in the present study, which is not consistent with the existing literature (Drotar 2009; Gabarra and Crepaldi 2011; Stivers 2011, 2012; Stivers and Majid 2007; Taylor et al. 2010; Zwaanswijk et al. 2011).
This study has some limitations that should be mentioned. First, the number of participating physicians was very small and, therefore, the results can not be generalized to larger samples and different health conditions. It would be relevant to investigate patterns of pediatric communication with broader and multicentric samples in order to better characterize this phenomena, as well as studying samples from multiple health care settings. However, as already stated in the Method section, few professionals were available in the public health service in which this study was conducted, and all potential and recruitable participants were approached.
In addition, other variables related to the organization of the health care service were not included in this research, with these variables possibly moderating communication in pediatric settings. For example, it is possible to highlight that the amount of patients in the waiting room, the delay regarding examinations and bureaucratic procedures lead to less time for communication (Kohlsdorf, 2012). These factors may be confounding variables, which also moderate communication, beyond the sociodemographic data itself.
Furthermore, as a cross-sectional and descriptive study, it was not possible to assume causality effects among the variables, which restricts the possibilities to apply these data directly to the health communication milieu. Inter-rater reliability scores were low, which could have undermined the internal validity concerning this study. However, it should be highlighted that intra-rater reliability obtained high scores and that the field experience in health psychology and behavior observation was very different between the two observers. These two aspects may explain the low scores obtained, as already proposed by Danna and Matos (2006).
Finally, it should be stated that none validated tools to measure emphatic communication in clinical contexts have been employed in this study. Although the works of Wissow et al. (2005), Nicolai et al., (2007), Makoul et al., (2008), Vatne et al. (2010a, b) and also Howells et al. (2010) provided these tools, none of them have been adapted, translated and validated for the language and country in which this study took place, which explains the impossibility of using these scales.
Even with these limitations, this study presents contributions regarding associations between the clinical and sociodemographic data of children and caregivers, and communication patterns established by physicians. This should be taken into account when considering professional training during graduate courses, in order to provide tailored skills that may suit individual communicative patterns, since the literature highlights the lack of appropriate professional training (Rider et al. 2008). It is also relevant to point out the need of psychosocial interventions that may contribute to include children of very early ages, considering that the patients should not be excluded from pediatric interaction (Taylor et al. 2010; Vaknin and Zisk-Rony 2010; Washington et al. 2012). The data showed in the present study may be useful in planning educational interventions in health settings, focused on the staff as well as parents and children, and it may be relevant to highlight the need of more academic discussions regarding the pediatric communication process.
Future research should study other sociodemographic variables that may influence interaction during medical consultations, including the characteristics of the pediatricians and the variables related to the organization of the healthcare services, with a larger sample size and other clinical and sociodemographic variables of children and caregivers, in order to contribute towards a better quality of care in pediatric settings.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Dehydration Can Cause Mood Swings in Women
Foodie Friday Link Time: Feeling Moody? Could Be Dehydration
- Drink up! Dehydration can put you in a bad mood — HuffPost Healthy Living
- Quick and easy breakfasts that will literally make your day — Real Simple
- Low-cal onion dip perfect for your Super Bowl party — Prevention
- Skip the mayo! Balsamic tuna with celery will do just fine — Shape
- Foods to fuel your next sweat session — Blisstree
- Do you live in a Girl Scout Cookie capital? — The Daily Beast
- Fire up your Crock-Pot for an easy black bean soup — Eating Bird Food
- Low-carb wraps? Easy! Just use some greens — Vegetarian Times
- A new weapon in the fight against E. coli: manganese — Newser
Image Source: Thinkstock

subset: commoncrawl


text:
Today in Black History: Voting rights activist Fannie Lou Hamer was born in 1917 in Ruleville, in Sunflower County, Mississippi.
The New York Times
Editorial: How Long Until We Debate Real Gun Laws?
Brooks: Guns and the Soul of America
Comparing the Las Vegas Attack With Gun Deaths in U.S. Cities
From Single Shots to Automatics: How Firearms Work
For G.O.P. Leaders, the Headaches Just Keep Mounting
Trump Nominates a Coal Lobbyist to Be No. 2 at E.P.A.
Bill for Mnuchin's Use of Military Jets Totals $800,000
Transgender Is Not Protected Category, Justice Dept. Says
Courts Thwart Administration's Effort to Rescind Obama-Era Environmental Regulations
De Blasio Expands Affordable Housing, but Results Aren't Always Visible
De Blasio Holds Huge Lead in Mayoral Race, Poll Finds
Firm Behind 'Fearless Girl' Statue Underpaid Women, U.S. Says
Suit: A federal jail in Philly is stopping kids from seeing their dads
Reading, writing, arithmetic and now coding for youngest learners
Calling out Trump, sprinting around Pa., Josh Shapiro seeks to make a name as AG
Gun safety groups now o[ppose Pat Toomey's landmark background check bill, urge stronger measure
Pa. attorney general sues the largest US student loan servicer
The Detroit Free Press
Flint water crisis case against state health director resumes in Flint
Detroit roads, parking would get $125M improvement under plan
Detroit schools count 48,511 students on Wednesday, above budget projections
Kwame Kilpatrick's pal Jeffrey Beasley loses final appeal; stuck in prison for hurting pensioners
The Cleveland Plain Dealer
Racist fliers target Ohio business, say blacks unwelcome
Ohio man posts Facebook Live video of him holding gun in hospital, gets arrested
CWRU gets federal money to establish new Minority Health and Health Disparities Center of Excellence
Boy, 9, investigated on possible sexual assault at Ohio elementary school
The Star-Ledger
A detailed look at how the NRA spends millions to push its gun agenda in Washington
Trauma is real for Newark residents and police | Carter
Why won't Christie's AG step up for the wrongfully convicted? | Editorial
15-year-old had loaded gun at school, police say
My mail-in ballot was already filled in with votes for Dems, GOP leader claims
The Chicago Tribune
Unions, progressive groups put on Democratic governor forum Sunday
After shooting, suburban school forfeits football game at West Side field
Contractor paid thousands in kickbacks to suburban mayor, complaint states
Nonprofit puts workers on track for higher earnings, job retention, report shows
Chicago student is 'shocked' rapper Nicki Minaj helped pay his tuition
The Los Angeles Times
Lazarus: Guns, like cigarettes, are legal products that kill people. That's not OK
USC medical school dean out amid revelations of sexual harassment claim, $135,000 settlement with researcher
Gov. Brown visits L.A. to lobby for the $17-billion delta water project
The Washington Post
As ACA enrollment nears, administration keeps cutting federal support of the law
Trump administration could sharply limit ACA's contraception mandate
Georgia sheriff, deputies indicted after body searches of 900 high school students
Arizona congressman repeats bogus claim that Charlottesville violence was left-wing plot
The firm that brought us 'Fearless Girl' was underpaying women, U.S. government says
Trump administration plans to scrap Obama's key effort to combat climate change
Treasury secretary's military flights totaling $811,000 were legal but poorly justified, watchdog says
Judge lets former Louisiana congressman William Jefferson out of prison
Her disability check was gone, and now the only option left was also one of the worst.
Fewer poor students deemed ready for college and career due to test error
Negotiations stall over vanished African-American cemetery in Bethesda
D. C. will not appeal concealed carry gun ruling to Supreme Court
D.C. police chief responds to change in city's gun control law
USA Today
Milwaukee alderman bounced from leadership post after questioning grant money spending
Rick Pitino raked in 98% of the cash from University of Louisville's current Adidas deal
Some clips might require your registering for the paper's website. Sites like The Chicago Tribune are free while The New York Times and others have a pay wall that will allow you to see a specific number of articles per month for free and require a paid subscription for further reading.


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July 23, 2015
This week TheBodyPRO.com attended the 8th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015), in Vancouver, Canada. Here are our research highlights so far. Stay tuned for continuing coverage! To beat HIV, you have to follow the science!
An 18-year-old female has been able to maintain an undetectable viral load for more than 12 years after interrupting early antiretroviral therapy, according to a study presented at IAS 2015.
Final results revealed a 93% reduction in the rate of sexual HIV transmission in serodiscordant couples when the individual with HIV was taking antiretroviral therapy.
"Medical evidence is clear: All people living with HIV must have access to antiretroviral treatment upon diagnosis. Barriers to access in law, policy, and bias must be confronted and dismantled," declares the Vancouver Consensus, a consensus statement unveiled on the opening night of IAS 2015.
Earlier this year, we learned that the START study had found overwhelming evidence that beginning HIV antiretroviral therapy at any CD4 count was better than waiting. At IAS 2015, we got our first detailed look at the data.
The science is a little over my head at this point, but the preliminary results for this new approach are very promising. Using a method of gene editing known as CRISPR/Cas9, the researchers were able to cut out the proviral DNA fragment in latently infected T cells, which led to inactivation of HIV gene expression and replication -- meaning eradication.
Is there a development this week in HIV research that you think we missed? Send us a tip!
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
Copyright © 2015 Remedy Health Media, LLC. All rights reserved.
No comments have been made.
The content on this page is free of advertiser influence and was produced by our editorial team. See our content and advertising policies.


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Old Times Final v5.0
Old Times v5.0 Final
So, now it runs correctly .
Installation: Simply replace the old OLD_TIMES_IV.zip file with the new version.
Load Places of cars newly placed . Ie : your land vehicles not on the roof, but the dealer and on the farm.
- The fields can now be grubbed .
Invisible - away collisions
- The entrance to the dealer is now slightly wider .
- The markers at points of sale were adjusted
- The crops are now visible even from afar
_The Meadow north of Box No. 2 was something geebne so that there are placeable building place.
And there are a few minor blemishes were still eliminated
- You may draw your old saves from version 4.0 use
The terrain is largely remained the old , but the court, the cow pasture , the village , the harbor, the vegetation, etc. have been completely revised . And of course there is now a sheep pasture.
Where originally was the sugar factory , now is the weaving where you can sell your wool . The harbor was scaled so that it better fits into the overall landscape. You can , of course, there continue to sell your crop.
Now located at the former potato collection is a windmill. This will be displayed to you as a " country store " in the PDA . - There can be sold alongside cereals and potatoes and sugar beets. The water mill ( mill) has remained at its old location .
The Old Brewery has given a decent half-timbered building , and is now an inn , where their corn , potatoes and sugar beet can sell .
The milk you have to bring yourself back to the dairy . See PDA. You need a suitable trailer to transport milk . Fits to the map there is for example Can the milk of HatzFan car .
The feeders for the cows are in the barn (where you can also sprinkle straw ) and the pasture.
Right next to the barn is the storage of milk . Can there you can load your car. ( With the "R" button.) Directly behind the milk storage is the manure pile and a small manure pit . The corner building next to the barn , the barn in which their example Store straw bales can.
On the old farm a lot has changed . So now is example the corn , potatoes and beets stored in barns . The trailers are emptied prior to the corresponding gates . Loaded you can get your followers to both the blowers, which are located at the barns , or by hand with a shovel. This has reinforced the Deutz front loader bucket of Steve007 .
details :
- No Missions
- All fields are yours and need not be purchased separately
Fruit varieties : standard
Standard Start Vehicles
- Best for the free add-on " Classics of Agriculture" suitable .
Off - road
Multiplayer : Yes
- Decay : from
It is not allowed to upload the map or parts of it again !
The map may be found in forums , etc , using the original download links !
Keep the original download link !
And now, have fun !
2013-11-24 17:22
2013-11-24 17:22
Garage - ziolek6
Fachwerkscheune - RAUSCHEBART
Alter Zaun - martinbigM500
Barn - ziolek6
Kuhstall - ziolek6
Kuhstall2 - Cayman
Stodola - Kosa
Steinbrücke - LU-herzberg
Gebäude Magazin - marjas31
Altes Landhaus - spider100
Bierzeltpack (Sidor) - charly_99
Old models - thecsfun
Farm Silotriggers - pisty
Hafenmauer - MThis
Grastextur - Marc85
Milchannahme - GE-Mapping
Milchsammelstelle - firststep
Vanilleeis - Lowpoly-Bäume
Eifok Landhandel - cyber11
Alte Windmühle - spider100
Alter Klinkerstall - Kolbenfresser
Heuhaufen - unbekannt
Misthaufenset - M-S_Buschi
Bauer und seine Frau - spider100


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TCS Graduate News
We knew when Elisa Kendall graduated from Texas Christian High School last year, she would do great things! Elisa is a freshmen at East Texas Baptist University where she received a scholarship for tennis. Well, ETBU is not regretting their decision. Elisa is an undefeated freshmen playing against juniors and seniors and has been named Player of the Week for 3 weeks in a row now. Elisa we could not be more proud of your hard work and determination. Super job Tiger!!! Read more at http://www.etbusports.com/wtennis/news/2016-17/2923/award-kendall-is-the-asc-player-of-the-week/


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TeamQuest Revenue Up 25 Percent in 2011
Clear Lake, Iowa, Feb. 14, 2012
TeamQuest Corporation continues to defy the slumping economy as the company announced its 21st consecutive year of profitability, with a 25% increase in revenues in 2011.
"Our success is based on our customers' success," said TeamQuest President and CEO Jerred Ruble. "Everything we do is about helping IT and its customers achieve great things."
One company, Verizon Wireless, explained how TeamQuest Performance Software is one of the few tools that is universally recognized throughout Verizon Wireless IT. The company used TeamQuest software to prepare for its inaugural iPhone launch which accomplished a record number of sales without any performance issues or outages.
Communications, along with Financial, Tech and Business, and Government were the top industries, in terms of revenue, for TeamQuest in 2011. TeamQuest received a slight boost to its net revenues from the company's November 2011 acquisition of Performance Surveyor.
"Our acquisition provides our customers with automated performance and capacity analysis that spans all technology and business silos and seamlessly integrates with existing investments in configuration management, help desk, asset management and other management processes and tools," said Ruble. "Customers appreciate the flexibility and simplicity of implementing and using our capacity management solutions."
The need for capacity management software and services are important to the health of the business. With dynamic environments like virtualization and cloud, capacity management creates a more agile IT because it understands current and future resource needs. Budgeting is more disciplined and costs are controlled.
"That means meeting your service level agreements without over-provisioning, supporting business unit goals with minimum risk, and a greater responsiveness to market dynamics with a higher return on existing IT investments," said Ruble.
TeamQuest is the global leader in IT Service Optimization, delivering automated, comprehensive and real-time performance analysis covering everything from apps to servers to storage. TeamQuest software enables organizations to accurately analyze, predict, manage and measure the performance of highly dynamic, multi-vendor environments. Enterprises around the world trust TeamQuest solutions to proactively improve latency, mitigate financial risk, and reduce cost.


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Mark your calendars, Windows Phone fans. Nokia and Microsoft have revealed that they'll be coming together to host an event on September 5 and, as you can see in the invitation we received, Windows Phone will be the focus. The event is taking place in New York City and the doors to the big shindig will be opening up at 9:30 a.m. Unsurprisingly, the invitation doesn't specifically mention what Nokia and Microsoft have up their sleeves for the gathering.
So what will the two companies have in store? Judging by the small live tiles on the invitation and the fact that Windows Phone 8 is due this fall, some new Windows Phone 8-powered Lumia hardware seems like a reasonable guess. It's also worth noting that Nokia World will be kicking off in Finland on the same date, so September 5 will be a big day for Nokia and its fans. As usual, you can bet that we'll be bringing you all the news from this Nokia-Microsoft event as it happens. What are you hoping to see the two companies introduce on September 5?


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LONDON, Sept. 2, 2014 (GLOBE NEWSWIRE) -- Imagination Technologies (IMG.L) announces the highly-efficient MIPS I-class I6400 CPU family, the first IP cores to combine a 64-bit architecture and hardware virtualization with scalable performance through multi-threading, multi-core and multi-cluster coherent processing. Its extraordinary feature set and performance/power/area leadership place the I6400 far ahead of the competition, enabling customers to implement a smaller core at the same performance, or a faster core in the same area.
MIPS Warrior I-class processor cores set a new standard for mainstream 64-bit processing in applications including embedded, mobile, digital consumer, advanced communications, networking and storage—the broadest set of applications ever addressed by a single MIPS core family.
Says Tony King-Smith, EVP marketing, Imagination: "This is the MIPS Warrior core that many have been waiting for. As the industry moves toward instruction set neutrality, customers can now choose a CPU based on its technical superiority. The I6400 is more efficient, flexible and scalable than the competition, and its feature set clearly lends itself to the needs of a wide range of next-generation applications including smartphones and tablets. We know that unique features like multi-threading provide significant advantages for many applications, and customers already using this technology agree. Unsurprisingly, we've already secured licensees for the I6400 across multiple markets."
Says Jim McGregor, founder and principal analyst, Tirias Research: "To address the ongoing evolution in applications from IoT to mobile to networking and storage, companies need to select scalable platforms that can future-proof their designs. With 64-bit, multi-threading, and multicore/multi-cluster support, the I6400 is designed to be a phenomenally flexible, low-power processor architecture capable of scaling across a wide range of applications. Imagination now has MIPS IP cores for everything from microcontrollers to 64-bit servers, delivering choice across the range and changing the competitive dynamic in the industry."
Inside the I6400 family of cores
- Highly efficient, scalable 64-bit performance: The I6400 will enable customers to set new price/performance points across markets. It achieves over 50% higher CoreMark performance and 30% higher DMIPS compared to leading competitors in its class*. The I6400 can be implemented across a very wide range of performance, power and area operating points and achieves high frequencies in aggressive implementations.
- Hardware multi-threading: The I6400 features hardware multi-threading technology that supports up to four hardware threads per core. Imagination's proven MIPS multi-threading technology leads to higher utilization and CPU efficiency. The simultaneous multi-threading (SMT) technology in the I6400, which builds on the decades of combined multi-threading expertise in the MIPS and Imagination engineering teams, enables execution of multiple instructions from multiple threads every clock cycle. Preliminary benchmarking shows that adding a second thread leads to performance increases of 40-50% on popular industry benchmarks including SPECint and EEMBC's CoreMark, with less than a 10% cluster area increase. Real-world applications such as browsers can also take significant advantage of multi-threading.
- Hardware virtualization: The I6400 joins the entire range of MIPS Warrior cores in incorporating hardware virtualization technology, providing increased security and reliability, and enabling a unified security and virtualization strategy throughout the system and across the entire SoC. As implemented in the I6400, this includes support for up to 15 secure/non-secure guests.
- Next-generation security: As part of Imagination's unified security strategy, designed to address the privacy and security needs of evolving and emerging connected applications, the I6400 core is optimized to support multiple independent security contexts and multiple independent execution domains. This much enhanced security capability leverages technology from Imagination and its ecosystem partners and can encompass other critical components of an SoC. The solution scales to support secure content delivery, secure payments, identity protection and more across multiple applications and content sources.
- Advanced power management: With PowerGearing™ for MIPS, the I6400 features advanced power management capabilities. This includes the ability to provide a dedicated clock and voltage level to each core in a heterogeneous cluster, while maintaining coherency across CPUs so that sleeping cores only need to wake when needed.
- Efficient FPU: The proven hardware Floating Point Unit (FPU) in the I6400 supports both single and double precision capabilities relevant to general computing as well as improved control systems processing.
- 128-bit SIMD: The I6400 features 128-bit SIMD support, delivering high performance and high throughput for a wide range of tasks that can exploit the efficiencies of SIMD execution in data-parallel applications. It is built on the MIPS SIMD architecture which adheres to true RISC philosophy, with instructions defined to be easily supported within high-level languages such as C or OpenCL for fast and simple development of new code, as well as leverage of existing code. The SIMD in the I6400 supports a wide variety of integer (8, 16, 32 and 64-bit) and floating point (32, 64-bit) data types, making it highly efficient for many applications across audio, video, vision, and other computationally-intensive use cases.
Next-generation multicore coherency
The I6400 features the latest generation of the MIPS Coherency Manager fabric based on a new multicore coherent interconnect architecture. It supports multicore configurations of up to six cores per cluster where multiple cores on a single cluster can have different synthesis targets, and operate at different clock frequencies and voltages. The Coherency Manager fabric implements numerous high-performance features including hardware pre-fetching as well as wider buses and lower latencies compared to previous generations.
Scalable, multi-cluster coherency
I6400 cores are designed to be delivered in diverse combinations of threads, cores and clusters, supporting multi-cluster fabric configurations up to 64 clusters. The cores are also designed to operate in heterogeneous clusters in future SoC implementations leveraging CPUs, GPUs and other processing elements.
MIPS: the ultimate 64/32-bit architecture
Broad ecosystem of support
I6400 customers benefit from the broad ecosystem that already exists around MIPS, including software, tools and applications and the new prpl open source foundation. With founders Broadcom, Cavium, Ikanos, Ineda Systems, Ingenic Semiconductor, Lantiq, PMC, Qualcomm Incorporated and others, prpl is delivering exciting open source software for MIPS I-class and other Warrior cores with a focus on markets from IoT to datacenter.
Tools and software
A broad range of development tools and software is already available or in development for the I6400 cores, from Imagination and numerous companies across the MIPS ecosystem. In addition, the I6400 is optimized for the latest 64-bit and 32-bit mobile operating systems. The forthcoming 'L' release of Android includes support for 64-bit MIPS, building on long-time existing support for the 32-bit MIPS architecture. Hypervisors in development for the I-class cores will enable customers to take full advantage of hardware virtualization and enhanced multi-context security capabilities.
Getting started with the I6400 core
One of the first projects completed through the prpl open source foundation is support for the MIPS64 r6 architecture in the QEMU open source emulator, currently available at http://github.com/prplfoundation. With QEMU, developers can get started on developing applications and software for the 64-bit I6400. More information on the QEMU working group in prpl can be found at http://wiki.prplfoundation.org/wiki/QEMU.
Imagination is already engaged with multiple lead I6400 licensing partners, with general availability scheduled for December 2014. Contact email@example.com for more information.
Editor's Note:
* Imagination benchmark results are preliminary; competitive results are based publicly available information.
About MIPS Processors
Imagination's family of MIPS CPU IP cores are ideal for products where ultra-low power, compact silicon area and high levels of integration are required. The comprehensive portfolio of MIPS processor IP cores range from the smallest cores for 32-bit MCUs to high-performance 32-bit and 64-bit multi-core solutions. Based on a heritage of continuous innovations over more than three decades, including full support for 64-bit for more than 20 years, Imagination's MIPS architecture is the industry's most mature and efficient RISC architecture, delivering the highest performance and lowest power consumption in a given silicon area.
About prpl
prpl (pronounced "Purple") is an open-source, community-driven, collaborative, non-profit foundation targeting and supporting the MIPS architecture—and open to others—with a focus on enabling next-generation datacenter-to-device portable software and virtualized architectures. prpl represents leaders in the technology industry investing in innovation in efficiency, portability and compatibility for the good of a broad community of developers, businesses and consumers. Initial domains targeted by prpl include datacenter, networking & storage, connected consumer and embedded/IoT. See: www.prplfoundation.org.
About Imagination Technologies
Imagination is a global technology leader whose products touch the lives of billions of people across the globe. The company's broad range of silicon IP (intellectual property) includes the key processing blocks needed to create the SoCs (Systems on Chips) that power all mobile, consumer and embedded electronics. Its unique software IP, infrastructure technologies and system solutions enable its customers get to market quickly with complete and highly differentiated SoC platforms. Imagination's licensees include many of the world's leading semiconductor manufacturers, network operators and OEMs/ODMs who are creating some of the world's most iconic products. See: www.imgtec.com.
Follow Imagination on Twitter, YouTube, LinkedIn, RSS, Facebook and Blog.
Imagination Technologies and the Imagination Technologies logo are trademarks of Imagination Technologies Limited and/or its affiliated group companies in the United Kingdom and/or other countries. All other logos, products, trademarks and registered trademarks are the property of their respective owners.
CONTACT: Imagination Technologies' Press Contacts: UK: David Harold firstname.lastname@example.com +44 (0)1923 260 511 USA: Jen Bernier-Santarini firstname.lastname@example.com +1 408-530-5178
Source:Imagination Technologies


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Hyannis Transportation Center Information
Quick Links:
Bus Passenger Waiting Area
- Address/Directions
- Hours of operation: 5:00 a.m. - 8:30 p.m. year round
- Intercity Bus ticket booth open
- Vending machines available for snacks, coffee, drinks and ice cream
- Wi-Fi service available
- Newspapers for sale
- Daily and monthly Parking passes for sale
- CCRTA Transit passes for sale
- Information booth 7:00am - 5:00pm
- Gateway to downtown Hyannis
Long term overnight parking for 160 automobiles
Parking Rates at the Hyannis Transportation Center:
|Parking Duration
|Dec 15th - Mar 31st
|Apr 1st - Jun 14th
|Jun 15th - Sep 14th
|Sep 15th - Dec 14th
CCRTA Local Year Round Service
- Service from Hyannis to Mashpee, Falmouth, and Woods Hole
- Service from Hyannis to Yarmouth, Dennis, Harwich, Chatham, and Orleans
- Service from Hyannis to Rte 132 Malls, Cape Cod Community College, Barnstable County Complex in Barnstable Village
- Service six days per week off-season, seven days in season
Taxi Service
- Taxi service is available year round
Intercity Bus Service:
- Service from Hyannis to Sagamore, Plymouth, Kingston, Rockland, Boston - South Station and Logan Airport
- Service from Hyannis to Harwich, Orleans, Eastham, Wellfleet, Truro and Provincetown
- Service 7 days per week year round
- Service from Hyannis to Barnstable, Sagamore, New Bedford, Fall River, Boston, South Station, Logan Airport, Providence, RI and New York City
CCRTA Seasonal Service (Summer Only)
- Service from HTC to Main St., South Street and Hyannis Harbor.
CapeFlyer Seasonal Rail Service (Summer Only)
- Service from South Station, Boston to the Hyannis Transportation Center.
Steamship Authority Ferry Connections (Seasonal)
- The Steamship Authority will send over a shuttle bus to pick up passengers on demand. A direct phone line is available at the HTC.
Cape Cod Central Railroad (Seasonal)
- Cape Cod Central Railroad offers scenic train rides to the Cape Cod Canal daily in season and dinner train rides in the evening in season.
- The Cape Cod Central Railroad ticket office is located in a red building at the intersection of Main Street and Center Street next to the rail line.
Cape Cod Regional Transit Authority
- The Cape Cod Regional Transit Authority Administrative Offices are located on the second floor of the HTC.
Hours of operation are 8:30 a.m. to 4:30 p.m Monday - Friday.


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Evolution of optimizare web site notion inside the planet of World-wide-web Advertising and marketing
Net is hugely recognised as the upcoming of human race. The digital worldwide is rising with this sort of a rate that it are unable to be expected inside any tactics. The range of subscribers of the net is quickly escalating and in accordance in direction of on-line surveys, the variety will double by means of 2012. The range of web support expert services contains as well discovered improvement within rate with the people. Firms, no make a difference how large or very low they are, are preventing demanding toward incorporate a reduce of percentage within this company marketplace.
The digital earth is starting to be nearer in the direction of starting to be a fact with the announcement of internet-based mostly doing the job procedure (Chrome OS) and cloud computing primarily based info handle solutions (Google Purposes) as a result of Google. The market place is getting to be fiercer working day through working day, and sector biggies including Google and Microsoft are battling it out encounter-toward-encounter. This fierceness can move upon right up until the jobs run by way of current market biggies turn out to be a truth or could be till 2020.
Web Advertising and marketing is a thought which grew to become notable with Google rising as the dominant chief within just the glance market place. Inside of 1998, Google was set up by means of Larry Web site and Sergey Brin Although the 2 have been attending Stanford Faculty as Ph.D. applicants. Then the genuine video game commenced. Net Marketing and advertising was dubbed in the direction of be the process of advertising and marketing web-sites more than the web or on the internet medium toward inspiration targeted visitors towards the world wide web or office, and hence making potential customers for the place of work.
The first manner of on-line internet marketing in advance of the times of Google was rather basic and consisted of confined approaches toward be adopted. Yet, the moment the introduction of the Google generation, elements altered. Those commenced toward consider otherwise and fresh strategies of electronic advertising arrived into lifestyle as and Though the appear engines, primarily Google, started out toward remodel them selves as the blue h2o navies of the mighty ocean known as the World wide web or the Digital Environment. Opportunity brain-upon collisions triggered by way of the evolution of seem engines have been dealt with by means of the advent of substitute world-wide-web internet marketing secrets and techniques. optimizare web page is just one between them.
optimizare web page (optimizare internet site) solution was invented any time the strategy of glimpse engines was initial launched in direction of the individuals of digital world-wide through the 1990's via appear presents such as Inquire Jeeves, Lycos, and so on. optimizare web-site includes advanced speedily mainly because then.
For the duration of the 1st times of optimizare internet site, the key terms or principal text would be filled into the internet profusely inside the terms product and the Meta Key phrases tag, and the internet would rank within just look engines for comparable keywords and phrases. Still, throughout the later on amounts, as appear engines advanced, the thought of back links (digital voting course of action) arrived into lifestyle and it grew to become a purely amount sport. Internet websites with a lot of key terms crammed into them and with even more hyperlinks than their competitiveness would rank high inside of look motor listings. This path of uncomplicated moving optimizare website procedures was shattered with the emergence of Google.
Google entered the appear current market with a bang and altered the guidelines of the video game totally. It started off with the arrival of Google Bot (Google's Appear Motor Algorithm) and Google PageRank. Google unveiled a fresh idea named good quality into the marketplace and sites with high-quality back links versus excellent internet websites or authoritative internet websites which include .gov, .edu, .mil, and media web sites, and with high-quality web site product commenced in the direction of rank high inside of Google's look end result for their respective search phrases.
For the duration of this evolving generation of glimpse engines, site owners applied towards assemble within just undisclosed on line regional boards and go over the techniques and secrets of optimizare web page. A Googler inside conceal would support them and give insights of the Google appear motor upgrades. Yet, this is no added adopted unless for the Black-Hat tricks, which are unethical strategies of undertaking optimizare web page, and in opposition to the webmaster regulations available via the seem engines. The Googler inside of hide contains emerged into the outer world wide with the temperament and track record Matt Cutts, the thoughts of Google's anti-spam staff members.
Inside of these days's environment, optimizare internet site is no further more an uncomplicated participate in. It contains advanced towards the key phrase stuffing and amount of money times toward a complete fresh generation of top quality and perfection. Several workplace property owners nonetheless think that all people getting a simple expertise upon optimizare web site and world-wide-web or accurately as a result of reading identical content articles and looking at analysis product can get the job done optimizare web site assignments. Still, this fantasy is no additional alive and glance motor optimisation are unable to be completed as it was remaining taken care of in the course of the 1990's. Considering that look engines comprise developed and include arrive a extended course in just their sophistication, look motor optimisation can basically be taken care of by way of an consultant or an World-wide-web Internet marketing Enterprise within India. Nowadays's optimizare internet site expects accuracy inside of mathematical calculations and makes use of huge amount of money of information, such as analytics.
Consequently it can be naturally talked about that seem motor optimisation is total of good quality information and facts accumulating, analytics and accuracy accomplished with calculations. As it is a extremely aggressive globe that requirements every month info investigate and functionality checking of web-sites for equivalent keyword phrases upon seem achievements, it is improved for enterprise householders towards depart all the complexities and head aches in direction of specialists, sit back again and unwind, and count on some optimistic accomplishment.


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Silky synthetic bristles are angled to fit the contours of your face for precise medium-to-full coverage of bareMinerals READY® SPF 20 Foundation.
Tap brush on foundation until bristles are lightly coated. Buff gently onto skin with long, graceful strokes for buildable coverage.
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Keep up to date on Montgomery Sisam projects and news through our blog. We'll post photos of ongoing projects and share our thoughts as well.
"Designed to create a well integrated and unified ' Campus of Care'. "
The new addition to St. Joseph's Hospital for Mental Health Services is comprised of three 38 bed in-patients units, ambulatory out-patient services, clinics and a teaching facility.
The addition will integrate the Mental Health programs with the existing hospital to maximize efficiencies and synergies. The front façade of the mental health building aligns with the entrance wall of the existing hospital creating a well integrated and unified 'Campus of Care'.
The building has been designed to provide the best possible access to daylight and views. Existing Healing Gardens will be rejuvenated and re-located to a semi-enclosed court that will provide a therapeutic setting for patients, as well as a welcoming entry court for people entering the Mental Health facility.
The facility is designed to achieve LEED Gold certification.
Joint venture with Kuch Stephenson Gibson Malo Architects and Engineer.
Completion Date: In Progress
Project Type: Healthcare
Building Size: 55,000 sq. ft.
LEED Status: Targeting LEED Gold


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At the kind invitation of the Chairman of the Tenents and Residents of Muirhouse and Friends of West Pilton, candidates are invited to write an open letter to voters of the neighbourhoods.
Here is my letter.
My name is Martin Veart and I am standing on behalf of the Scottish Liberal Democrats in our constituency of Edinburgh Northern and Leith.
The Liberal Democrats have been taking a bit of a battering of late. I have stuck with the party because out of all the political parties, it is the only one that believes that government should serve people. That is the core of liberalism. Liberals understand we that know our own local communities best of all: knowing both the problems but also the opportunities to improve. The Liberal Democrats want to return power to the most local level possible, to tackle the challenges that we face right now.
At this point I will do something that may surprise you. I will praise the SNP. Alone of all the parties, they engaged and got stuck into the grassroots of civil Scotland: the residents' associations, the voluntary groups and respected community individuals. They have raised hopes that have been long absent from the political scene.
It is the job though of politicians to deliver results and that is where the SNP have failed. Edinburgh is undergoing continuing rounds of cuts: to the council (2,000 jobs), to the health and social services (wards being closed, Liberton Hospital due to shut and staff frightened into silence) and our educational facilities suffering from cuts to places and staff, resulting in overflowing class sizes.
It is little wonder that the only party that have consistently supported the SNP budgets over the years are the Conservatives.
During the post-Referendum talks, Liberal Democrats took a full and constructive part in the Smith Commission negotiations. We helped bring back new powers to Scotland and we now want to use those powers to improve people's lives. Not is some distant future, after a new referendum, but starting right now.
Our main policy to achieve this new start is a rise in income tax of 1p in the £. The extra £450 million raised would be used this to invest in education: from pre-nursery to adult life-long learning. Through the Pupil Premium, a policy Liberal Democrats have already delivered in England, the pupils who are most disadvantaged gain the most benefit. For Scotland that means £1400 for each disadvantaged primary school child and £900 for each young person at secondary school. The funding follows the pupil so if the family moves, the child does not lose out on resources.
The extra money will increase a child's chance of going on to further education and even to university. In some neighbours in Scotland, a young person has more chance of ending up in a young offenders unit rather than at their local university. That cannot be allowed to continue.
The 1p in the £ will see funding returned to pre-2008 levels, returning our education levels to where it used to be: among the finest in the world.
It is all very well providing our young people with a good start in life if, when they are looking for a home there is nowhere they can afford to live. Edinburgh is in the mist of a housing crisis. I want to see the plans for Leith and the Western Harbour reactivated. The city needs more social housing. We also need better planning in the city. I have been listening to residents in Muirhouse and I understand it is not good enough building new homes if there are not the services for people to use. People need nearby places to shop and shouldn't have to travel miles to find health facilities like GPs, pharmacists and dentists. As your MSP, I will work closely with Edinburgh Council to ensure the services that people need are delivered and that new homes are built.
When it comes to health services, the Liberal Democrats want to see better treatment and availability for mental health problems. Only one-in-four young people in Scotland suffering from mental health issues have their first appointment within the 18 week target. There are over 50 children in Scotland who are waiting over a year for their first consultation. For too long mental health treatment has been the Cinderella service of the NHS and that needs to change. We will be listening carefully to Scottish health professionals how we can improve matters here, as well as drawing on the Liberal Democrat experience in England, where we have already delivered real improvements.
Liberal Democrats also want to see the end of criminalisation of drug use in Scotland. Supply of illegal drugs would remain a criminal offence, with suppliers facing long prison sentences, but users are suffering from health and social problems and are not criminals for being addicts. This approach have led to good results in Portugal, which, after fifteen years of following the policy, has seen a decline in drug use among the young.
Liberal Democrats value evidence-led policies and that is what we will deliver for the people of Scotland. For more details, visit our website: http://www.scotlibdems.org.uk
I will just like to end upon a further word or two about myself. With my family, I live at Newhaven Harbour. Previously I worked in oil and gas but, like many in the industry nowadays, I am now looking for new opportunities.
If one looks at the leaflets of any political party, each of them promise to supply a strong voice for the constituency. Very good, but what does a strong voice actually mean? Meekly following the party leadership, despite private doubts? Not rocking the boat in case that means being overlooked for a ministerial post in the future?
My pledge to you would be to use my best judgement on every occasion: to listen carefully, to consider the issues and work for the best outcome possible for the people here. I am a liberal to the core and as such I am not afraid to speak out on the issues: even to be point of disagreeing with the leadership, openly if need be.
In voting for me, Martin Veart, you will be voting for a person, not just a party. In using your second vote for the Scottish Liberal Democrats, you will be voting for the party with wants use power to serve you, your family and the community.
You can contact me on email@example.com and my personal blog is at http://martinveart.blogspot.co.uk/


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Getting your first DSLR is a big deal—it really feels like you've entered a new world of photographic possibilities. If you want to open up even more options, though, you'll want to consider investing in a few accessories. Some are inexpensive and essential, like cleaning products, while others could cost you quite a bit more and will change your entire photography experience, like a telephoto lens.
Check out these 9 accessories for beginning photographers, and share the accessories you can't live without in the comments below!
Camera Bag
This is absolutely essential—if you're going to be bringing your camera with you on hikes, trips, or outings, you want it to be easy to carry, and you want to be able to bring some small accessories with you. Camera bags range widely in size, and you'll want to give some thought to which size will work best for you. I have a shoulder bag, like this Lowepro Adventura 170:
For the most part, a bag of this size serves me very well—but sometimes I wish I had more space. For example, if I'm going on a hike, I have to choose to either bring the camera bag and a backpack, or put my camera and any accessories that I'm carrying in my hiking backpack, which is less preferable. A larger backpack-style camera bag, like this one from Case Logic, might be a better option for hikers:
Or, if you're looking for something in in the middle, a messenger bag might be the best option. Many messenger bags include inserts for storing cameras and lenses that can be taken out, giving you the option to use it for non-camera hauling, as well. This bag from Evecase is a great example:
Cleaning Kit
The picture quality that you get from your camera is partially a reflection of the quality of the glass used in the lenses, and keeping your lenses clean will help make sure that your photos are as clear as they can possibly be. A cleaning kit will run you between $10 and $20, and it's absolutely worth the small investment.
This cleaning kit from Altura Photo includes everything you need to keep your camera clean, from microfiber cloths and cleaning spray to an air blower cleaner and lens-cleaning tissue paper. And it's only $15.
One part of your camera that you probably shouldn't clean is the sensor. While it's important to keep the sensor clean, it's an extremely sensitive piece of equipment, and should only be cleaned by professionals. Every couple years, take your camera into a shop that offers sensor cleaning and pay them to do it for you. You can do it by yourself, but the risk probably isn't worth it.
Extra Battery
An extra battery for your camera seems like a simple enough accessory, but it can be an absolute game changer for your photography. Out on an all-day expedition taking hundreds of photos? You might run your battery down and miss the best shot of the day at sunset. Not with an extra battery! Just get out to where you're going, pull your camera out, and get a low battery warning? Not to worry! You have an extra. It's great.
Buying an extra battery for your camera is simple: just search for "[model of your camera] battery" on Amazon. You should be able to find one for $10 or $15.
Eye-Fi Card
Your camera probably came with an SD card, and if it didn't, you almost certainly already have one that you can use. But keeping an extra around is great for the same reason as having an extra battery—so you don't have to worry about filling one up and manually deleting all the photos until you have enough space for new ones. When you buy an extra SD card, though, I recommend considering the Eye-Fi card.
Eye-Fi is an SD card with built-in wifi, so you can download your photos to your computer without having to take the card out of your camera (which is especially useful for people who have a tendency to forget that they took it out). Just open up the Eye-Fi app, connect the card to your wireless network, and you're set to go. At $100 for a 32GB card, $55 for 16GB, or $30 for 8GB, it's more expensive than a regular card, but it's worth it.
A tripod is an oft-overlooked accessory for beginning photographers, many times because they don't quite understand how useful it can be. When you start to learn about adjusting aperture and shutter speed to properly expose your photos, a tripod can really come in handy—if you're using a shutter speed of 1/60 or less, having a stable base for your camera makes sure you don't capture camera shake.
This is especially useful in night-time photography, where longer exposures are required. But it can also be useful if you're trying out landscape photography or if you want to use the timer on your camera to capture a picture of a group of people (including you). A basic tripod, like the AmazonBasics 60″ tripod pictured below, will be sufficient for most beginning photographers.
The AmazonBasics option will only run you $23, but if you want a more durable tripod that will last a long time, you'll want to consider something like this MeFOTO Roadtrip tripod / monopod, which will set you back $200:
Remote Shutter Release
When a camera is on a tripod, you may want to use the timer function so that your hands don't bump the body and cause shake in the picture. Another option is to use a remote shutter release, which allows you to take a picture with the press of a button—it's great for landscape and night-time photography, as well as if you want to take a family picture that you're in.
To find a remote for your camera, just search for "[your camera] remote" on Amazon, and you should find something. There's a wide range of prices, but you shouldn't have to pay more than $15 or $20 for this useful piece of equipment.
Polarizing Filter
Without a polarizing filter, some of your pictures will include a lot of glare—this is especially true when you're photographing things that reflect well, like glass or water. And while changing the angle of your camera might help eliminate that glare, a polarizing filter will make the job much easier.
A polarizing filter is like polarized sunglasses for your camera—it only allows specific waves of light through. And by properly aligning it, you'll get better, truer colors in your pictures. Fortunately, simple polarizing filters are quite inexpensive, like this circular polarizer from Goja, which only costs $10:
There are more expensive options that include higher-quality glass, but for beginning photographers, an inexpensive one will work perfectly. Make sure to find the diameter of your lens before ordering a polarizer! The image below, from Goja, shows you were to find it.
Telephoto Lens
When you're ready to make the jump from photography beginner to photography enthusiast, a telephoto lens is a great investment. It's not cheap—you can plan on spending at least $300—but being able to fill the frame with distant subjects will help take your photos to the next level.
Most telephoto lenses for enthusiasts have a maximum focal length of 200–300mm. Beyond that, you'll be getting into very expensive equipment that only specialists need. By searching for your camera brand and "telephoto lens" on Amazon, you'll see a huge range of options that can be overwhelming. However, if you're not taking professional-quality pictures, a lens in the middle of the price range will give you suitably crisp images.
For example, I have the Nikon NIKKOR 50–300mm lens, above, and while it doesn't pack the same quality glass as a more expensive Sigma or Tamron lens might, its pictures are perfectly crisp for my purposes. At $400, it's not cheap, but it's also not a bank-breaker.
Again, you'll need to run a search for your camera brand and "telephoto lens," and you'll see plenty of options. Don't worry about picking the exact right lens; go with one in your price range, and it will be perfectly fine.
Camera Strap
While the other items on this list are very functional, replacing the camera strap on your camera is a more aesthetic choice. The camera straps that are included with beginner-level DSLRs work well, but they don't really look very exciting, and having a fun-looking camera can help motivate you to keep practicing your photography skills and bring your camera with you when you go places.
A quick-release shoulder strap like this one from Altura does make it easier to get your camera into place to fire off a shot, but not all of them will change how you use your camera.
Most people will be interested in getting a strap that's fun and unique, like these from Orota:
(My personal favorite is the pink strap with skulls on it.) As I'm sure you can imagine, a quick Amazon search will give you dozens of options for getting a new strap on your camera, with most of them costing less than $20.
SEE ALSO: 7 Things You Should Consider While Buying A New Camera
Upgrade Your Photography
As a beginner photographer, the best thing you can do is to practice your photography skills in a lot of different conditions. The second best thing you can do, however, is to outfit yourself with the accessories you need to step up your game. These 9 are perfect for beginners, and most of them are quite inexpensive, as well.
Which DSLR accessories do you find to be the most useful? Share in the comments below!


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REPROWORMProject ID: 637530
Funded under:
Safeguarding Cell Identities: Mechanisms Counteracting Cell Fate Reprogramming
Project details
Total cost:EUR 1 457 938
EU contribution:EUR 1 457 938
Coordinated in:Germany
Topic(s):ERC-StG-2014 - ERC Starting Grant
Call for proposal:ERC-2014-STGSee other projects for this call
Funding scheme:ERC-STG - Starting Grant
Regenerating tissues by reprogramming cells has the potential to become a therapeutic approach for replacing lost tissues in patients suffering from injury or degenerative diseases such as Alzheimer's or Muscular Dystrophy. Strategies to generate required tissues using embryonic stem cells or induced pluripotent stem cells (iPSCs) are associated with either ethical or medical safety issues. An alternative strategy is to directly reprogram cells to the required tissue type by forced expression of cell fate-inducing transcription factors (TFs). Direct reprogramming (DR) has the potential to circumvent unsafe proliferative pluripotent cell stages and it allows in vivo procedures. However to date, DR is successful in only a few cell types and it is not well understood why most cells are refractory to DR. Recently, we provided evidence that inhibitory mechanisms play an important role in restricting cell fate conversion. We identified factors inhibiting direct conversion of germ cells into specific neurons or muscle cells. Additionally, preliminary studies in our group revealed other factors that inhibit ectopic cell fate induction in somatic cells.
The objective of this proposal is to further understand mechanisms that restrict DR. We aim to identify and characterize factors involved in safeguarding differentiated cells and thereby counteract induction of ectopic fates in different cells. We use C. elegans as an in vivo model and apply large-scale forward and reverse genetic screenings with high-throughput. Next generation sequencing, tissue-specific biochemistry (ChIP-seq, SILAC) and 4D imaging will be used to elucidate the molecular function of identified DR-regulating factors. Finally, we will test the ability to convert cells in aged animals and assess the effects of ageing on the ability to induce ectopic cell fates. Our research has the potential to facilitate the generation of specific tissues from different cellular contexts for future biomedical approaches.
Host Institution
EU contribution: EUR 1 457 938
See on map
EU contribution: EUR 1 457 938
See on map


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Winter has settled in for the long haul in eastern Washington. This time of year I drive my car to work and park about a quarter mile away from the front door to my office. The office is right downtown, so it's all two hour parking. All of us office dwellers park in one of several parking lots outside the main downtown. Lately, I've been thinking it might be worth the cost to skip the walk and park in front of the building. The bone chilling walk is starting to make me wonder how many parking tickets I can fit into the budget. It's also got me thinking about a trip I took to Florida recently. A few weeks ago I had the privilege of speaking on a panel with James Patterson and Jerry Spinelli. Super guys, and I got to wear a t-shirt. And shorts. Because, you know, it was Florida. To see some pictures of the event, check out this photo gallery.
In other news, I saw Avatar with Jeffrey (the studio director of development) and Squire (the illustrator for all the interior art on Atherton) and we all thought it was pretty good. I think Peter Jackson can spend a couple hundred million a little more effectively, but still, Avatar is worth ten bucks and three hours for sure. Giovanni Ribisi, I think, steels the show as a really bad dude.
1 Comment
You look like Dr. Oz in the last pic!
New Comments
your books are wonderful !!! ...
Evelyn Crabtree
I love Skelton creek please make a movie ...
i am doing a report on skeloton creak and you ...


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As you've no doubt learned from your little shadow, tiny tykes love to imitate the grown-ups in their lives. Once they hit toddlerhood, kids want to eat, clean, and yes, even relax just like their parents do, so a toddler chair is a surefire hit (especially if your wee one loves playing house). From basic wooden and plastic seats to mini recliners and plush club chairs with matching ottomans, it's easy to find a chill-out spot for your tot that's practically identical to your own chair of choice. And if your little one is sitting pretty in her pint-sized perch, she'll be more likely to spend time there, happily entertaining herself. These tips will put you in the driver's seat as you search out the perfect toddler chair:
- The right size. Not every toddler chair is the perfect height for your small fry, so it's best to bring your little lounger to the store to give a couple of chairs a try before you invest in this piece of toddler gear. Her feet should touch the floor when she's seated, though it's not necessary that they rest flat against it. The goal is for your toddler to be able to sit down and get out of the chair on her own, and if her feet hit the ground when she's sitting, she should have no trouble making those moves all by herself.
- A sturdy make. Safety shouldn't take a backseat to style. For children's safety, a toddler chair should be able to hold up to 120 pounds (and most are manufacturer-tested to do just that). Why? Well, your toddler's not going to pack on that many pounds before preschool, but she'll probably run into her chair, try knocking it over, and even stand on it. The high weight limit means it can withstand that kind of rough play.
- The right age range. Most chairs for toddlers are designed for children between the ages of 18 months and four years old, but it's still worth checking the age recommendations on the packaging before you buy one, in case the chair is intended for bigger kids.
- The best material for the intended use. Basic plastic or wood chairs are great if your tot and her playmates will be using them at tiny tables for children, while an upholstered chair works well next to your critter's book collection. Crazy about coordinating? You'll be able to find a toddler chair to match practically every material on the grown-up versions scattered around your house.