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Children with intellectual and developmental disabilities (IDD) are likely to receive high-risk prescribing practices, such as polypharmacy, long-term use of psychotropic medications, and overuse of antipsychotics. Behavioural interventions, such as applied behavioural analysis, are evidence-based practices for children with IDD and should be the first-line treatment. Short-term use of psychotropic medications may be helpful in reducing the severity and frequency of challenging behaviours while evidence-based behavioural interventions are pursued. In this essay, we offer practical guidelines for better care. [ABSTRACT FROM AUTHOR]

BackgroundThe development of neurocognitive deficits in people infected with HIV is a significant public health problem. Previous cross-sectional studies have shown that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist for confirmation. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV-positive and HIV-negative individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction. ObjectiveThe goal of the project was to determine if CATs can track the trajectory of cognitive function over time in people diagnosed with HIV. MethodsTests of peripheral and central auditory function as well as cognitive performance were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of auditory temporal processing (gap detection) and speech perception in noise (Hearing in Noise Test and Triple Digit Test). Cognitive tests included the Montreal Cognitive Assessment (MoCA), Test of Variables of Attention (TOVA), and subtests from the Cogstate battery. HIV-positive subjects were divided into groups based on their CAT results at their final visit (bottom 20%, top 20%, middle 60%). Primary analyses focused on the comparison between HIV-positive individuals that performed worse on CATs (bottom 20%) and the overall HIV-positive group (middle 60%). Data were analyzed using linear mixed-effect models with time as the main fixed effect. ResultsThe group with the worst (bottom 20%) CAT performance showed a difference in trajectory for the MoCA (P=.003), TOVA (P

We investigate the superconducting pairing instabilities of eight-band models for the iron arsenides. Using a functional renormalization group treatment, we determine how the critical energy scale for superconductivity depends on the electronic band structure. Most importantly, if we vary the parameters from values corresponding to LaFeAsO to SmFe AsO, the pairing scale is strongly enhanced, in accordance with the experimental observation. We analyze the reasons for this trend and compare the results of the eight-band approach to those found using five-band models. [ABSTRACT FROM AUTHOR]

Dyschondrosteosis is a mesomelic form of short stature which occurs in conjunction with a characteristic wrist deformity. Madelung's deformity. A family with dyschondrosteosis had an affected father and two daughters. The affected females had dyschondrosteosis and Madelung's deformity, while the affected males had dyschondrosteosis, but no Madelung's deformity. All affected members had arthralgias. The occurrence of male to male transmission confirms an autosomal dominant inheritance pattern for this disorder. [ABSTRACT FROM PUBLISHER]

We investigate the quantum many-body instabilities for electrons on the honeycomb lattice at half filling with extended interactions, motivated by a description of graphene and related materials. We employ a recently developed fermionic functional renormalization group scheme, which allows for highly resolved calculations of wave-vector dependences in the low-energy effective interactions. We encounter the expected anti-ferromagnetic spin density wave for a dominant on-site repulsion between electrons, and charge order with different modulations for dominant pure nth nearest-neighbor repulsive interactions. Novel instabilities towards incommensurate charge density waves take place when nonlocal density interactions among several bond distances are included simultaneously. Moreover, for more realistic Coulomb potentials in graphene including enough nonlocal terms there is a suppression of charge order due to competition effects between the different charge ordering tendencies, and if the on-site term fails to dominate, the semimetallic state is rendered stable. The possibility of a topological Mott insulator being the favored tendency for dominating second-nearest-neighbor interactions is not realized in our results with high momentum resolution. [ABSTRACT FROM AUTHOR]

Objective: Although reported to be effective as a performance validity test (PVT) in TBI and ADHD, little is known about the ability of the CPT-II to model performance validity in psychiatric patients. Also, while repeat CPT-II administrations have been shown to enhance its diagnostic accuracy in ADHD evaluations, the effect of such strategic redundancy on validity assessment is largely unknown. Method: CPT-II subtests previously identified as embedded PVTs (ePVTs) were systematically tested in a sample of 30 patients with a variety of psychiatric conditions but without credible evidence of neuropsychological impairment. Neurocognitive profiles were classified as valid (n = 18) and invalid (n = 12) using a composite measure based on 20 independent PVTs. The CPT-II was administered twice, at the beginning and at the end of the testing session. Results: Significant improvement in signal detection properties was observed from Time 1 to Time 2 for Commission T ≥ 60, Perseveration T ≥ 70, Variability T ≥ 60 and the combination of Commission T ≥ 60 and Variability T ≥ 60. No difference was found for Omission T ≥ 80 and Hit RT T ≥ 60. Negligible loss in sensitivity was noted on Hit RT SE T ≥ 90. Conclusion(s): Results suggest that the ePVTs in the CPT-II developed in TBI and ADHD samples generalize to other clinical populations. Furthermore, invalid neuropsychological profiles are common in psychiatric patients (40% of the current sample). Finally, repeating the CPT-II or administering it later during the day tends to improve its signal detection properties as a PVT. [ABSTRACT FROM AUTHOR]

Introduction: Although Omega-3 is thought to have anticoagulative properties, the potential untoward effects of Omega-3 during pregnancy have not been investigated. No previous studies have been made to specifically assess its effect on postpartum hemorrhage (PPH). Our aim was to determine if an association exists between Omega-3 intake during pregnancy and profuse PPH or massive PPH., Material and Methods: Data on all deliveries that occurred at Karolinska University Hospital during the years 2007-2011 (n = 41 139) was collected from the medical record of Obstetrix, maternal health and delivery chart system. Women with reported Omega-3 use in early pregnancy were considered exposed and all other as unexposed. Bivariate and adjusted multivariate analysis was performed on main outcomes., Results: Omega-3 use was associated with 25% increased odds of PPH (adjusted odds ratio (aOR) 1.25, 95% confidence interval [CI] (1.06-1.47)) and a more than doubled odds of massive PPH (aOR 2.36, 95% CI 1.26-4.44). In addition, there was a minor increase in the amount of blood loss. Although few, women on low-dose discontinued terminated at 36th week showed no significant association to blood loss measurements., Conclusions: Our observational findings showed 25% higher odds of PPH and two times higher odds of massive PPH in women who reported using Omega-3 in early pregnancy. Our findings give some support to advocate discontinued use of Omega-3 in late pregnancy., (© 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

Objective: Central nervous system (CNS) damage from HIV infection or treatment can lead to developmental delays and poor educational outcomes in children living with HIV (CLWH). Early markers of central nervous system dysfunction are needed to target interventions and prevent life-long disability. The frequency following response (FFR) is an auditory electrophysiology test that can reflect the health of the central nervous system. In this study, we explore whether the FFR reveals auditory central nervous system dysfunction in CLWH., Study Design: Cross-sectional analysis of an ongoing cohort study. Data were from the child's first visit in the study., Setting: The infectious disease center in Dar es Salaam, Tanzania., Methods: We collected the FFR from 151 CLWH and 151 HIV-negative children. To evoke the FFR, three speech syllabi (/da/, /ba/, /ga/) were played monaurally to the child's right ear. Response measures included neural timing (peak latencies), strength of frequency encoding (fundamental frequency and first formant amplitude), encoding consistency (inter-response consistency), and encoding precision (stimulus-to-response correlation)., Results: CLWH showed smaller first formant amplitudes ( P  < 0.0001), weaker inter-response consistencies ( P  < 0.0001) and smaller stimulus to response correlations ( P  < 0.0001) than FFRs from HIV-negative children. These findings generalized across the three speech stimuli with moderately strong effect sizes (partial η2 ranged from 0.061 to 0.094)., Conclusion: The FFR shows auditory central nervous system dysfunction in CLWH. Neural encoding of auditory stimuli was less robust, more variable, and less accurate. As the FFR is a passive and objective test, it may offer an effective way to assess and detect central nervous system function in CLWH., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Tests of the brain's ability to process complex sounds (central auditory tests) correlate with overall measures of neurocognitive performance. In the low- middle-income countries where resources to conduct detailed cognitive testing is limited, tests that assess the central auditory system may provide a novel and useful way to track neurocognitive performance. This could be particularly useful for children living with HIV (CLWH). To evaluate this, we administered central auditory tests to CLWH and children living without HIV and examined whether central auditory tests given early in a child's life could predict later neurocognitive performance. We used a machine learning technique to incorporate factors known to affect performance on neurocognitive tests, such as education. The results show that central auditory tests are useful predictors of neurocognitive performance and perform as well or in some cases better than factors such as education. Central auditory tests may offer an objective way to track neurocognitive performance in CLWH., (© 2024. The Author(s).)

Objective: Researchers employed two recruitment strategies in a school-based comparative effectiveness trial for students with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) or autism. This study assessed the: 1) effectiveness of school-based referrals for identifying students meeting diagnostic criteria and 2) impact of eliminating requirements for existing diagnoses on recruitment, sample characteristics, and intervention response., Method: Autistic students and students with ADHD in schools serving underresourced communities were recruited for an executive functioning (EF) intervention trial over 2 years. In Year 1, school staff nominated students with previous diagnoses. In Year 2, school staff nominated students demonstrating EF challenges associated with ADHD or autism; previous diagnosis was not required. Study staff then confirmed diagnoses., Results: More students were included in Year 2 ( N  = 106) than Year 1 ( N  = 37). In Year 2, 96% of students referred by school staff met diagnostic criteria for ADHD or autism, 53% of whom were not previously diagnosed. Newly identified students were less likely than previously diagnosed students to be receiving services and, for those with ADHD, were more likely to speak primarily Spanish at home. Previously diagnosed and newly identified students did not differ on other demographic variables or intervention response. Caregivers of previously diagnosed students reported more symptoms than caregivers of newly identified students for both diagnostic groups. Previously diagnosed students with ADHD had more researcher-rated symptoms than newly identified students., Conclusions: Recruitment for an intervention study using behavior-based referrals from school staff enhanced enrollment without compromising the sample's diagnostic integrity and engaged children who otherwise would have been excluded.

Hispanic/Latinx parents of children with developmental delays/disabilities (DD) face disparities in service access and research participation. In the present study, 60 Spanish-speaking caregivers of young children with DD participated in randomly assigned stress reduction interventions (psychoeducation/support groups or Mindfulness-Based Stress Reduction [MBSR]), followed by behavioral parent training (BPT). Caregiver attendance and satisfaction ratings were measured, and focus groups gathered additional information on caregivers' takeaways from the interventions. Caregivers demonstrated high satisfaction across interventions, with slightly greater preference for psychoeducation/support groups, and qualitative data indicated that the relevance of the information and style of delivery may be responsible. Researchers and clinicians may attain greater engagement with this population by focusing on intervention services that include psychoeducation and peer support elements., (©AAIDD.)

Objectives: To (1) describe the prevalence of work- or school-related distress among patients with cancer and (2) compare overall distress among those impacted at work or school to overall distress among those not impacted at work or school., Design: Retrospective chart review., Participants: All patients visiting the study site March 2016-December 2020 who completed the NCCN Distress Thermometer and Problem List., Methods: Descriptive statistics examined work- or school-related distress across patient characteristics and compared mean Distress Thermometer scores between patients with and without work- or school-related distress., Findings: Among 1,760 unique patients, 7.5% reported work- or school-related distress at one or more visits. Rates were highest among patients seen for neurological (14.1%), skin (10.6%), and gastrointestinal (9.2%) cancers. Those reporting work- or school-related distress had higher overall distress scores (mean = 4.76; SD = 2.52) than others (mean = 3.37; SD = 2.92) (g=-0.482; t=-5.327, p < 0.001)., Conclusions: Although the prevalence of work- or school-related distress was low in this sample, the magnitude of this distress emphasizes the importance of having effective resources available for patients with cancer who experience work- or school-related problems., Implications: More research is needed to understand how well distress screening processes identify and support patients with work- or school-related problems.

Families of children with autism spectrum disorder (ASD) often utilize a variety of services. Relatively few studies have examined the relationship between family empowerment and service utilization for this population. The present study investigated the relationship between family empowerment and service utilization in families of children with ASD from the Pacific Northwest. Family empowerment did not predict the use of behavioral services or established related services. However, higher family empowerment was reported for families who reported use of complementary and alternative medicine. Implications for future research and clinical practice are discussed., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)