Search

Bipolar disorder (BD) largely begins in adolescence, but diagnosis lags for years, causing significant morbidity and mortality, and demonstrating the need for better diagnostic tools. Suggesting an association between BD and immune activity, elevated levels of peripheral inflammatory markers, including C-reactive protein (CRP), have been found in adults with BD. As similar data are extremely limited in adolescents, this study examined CRP levels in adolescents with BD (n = 37) compared to those with anxiety disorders (ADs, n = 157) and healthy controls with no psychiatric diagnoses (HCs, n = 2760). CRP blood levels for patients aged 12–17 years were retrieved from a nationwide repository of deidentified clinical data. After excluding patients with inflammatory conditions, differences in CRP were examined using multivariate and weighted regressions (covariates: demographics and BMI). Mean CRP levels were significantly elevated in adolescents with BD relative to those with ADs and HCs. Mean CRP levels were lower in the ADs cohort versus HCs. Although CRP levels were significantly higher in males and younger patients, the significant between-cohort differences in CRP remained after controlling for multiple confounders. To our knowledge, our study is the first to compare CRP levels between adolescent BD, ADs, and HCs, comprising a novel and essential contribution. Our results suggest the presence of a unique immune process in adolescents with BD and indicate that CRP may represent a biomarker with a crucial role in the diagnostic assessment of adolescent BD. • CRP levels were higher in adolescents with bipolar disorder vs. healthy controls. • CRP levels were higher in adolescents with bipolar disorder vs. anxiety disorders. • Differences in CRP levels were not driven by demographic variables or BMI. • CRP may be a candidate biomarker for adolescent bipolar disorder. [ABSTRACT FROM AUTHOR]

Objective: There is concern whether established parenting programs for children's conduct problems meet the needs of families with severe and complex mental health problems. For example, many children with conduct problems show comorbid attention-deficit/hyperactivity disorder (ADHD) or emotional problems, or have parents who are depressed, but families with such complex mental health problems typically seen in real life are often underrepresented in evaluation trials. We tested whether children with more severe conduct problems, and those with more complex mental health problems, benefit less from the Incredible Years parenting program, using individual participant data meta-analysis of randomized trials in Europe.Method: In 1,696 families from 13 children aged (child age 2-11 years; 37% girls; 58% low income; 30% ethnic minority; 98% mothers), we used moderator analysis within a multilevel model to test whether initial conduct problem severity, comorbid ADHD or emotional problems, and maternal depression would diminish intervention effects for children's conduct problems.Results: The Incredible Years program reduced children's conduct problems overall (Cohen's d = -0.35), but more so in children with more severe conduct problems. There was no evidence that children's comorbid ADHD and emotional problems changed the intervention benefits. Children of mothers with more depressive symptoms benefited more.Conclusion: Children with more severe conduct problems derive greater, rather than lesser, benefits from a high-quality group parenting program, and comorbid ADHD and emotional problems do not reduce effects; maternal depression, rather than being linked to less child change, was associated with greater reductions in children's conduct problems. [ABSTRACT FROM AUTHOR]

Depression is a prevalent and impairing problem affecting both women and offspring during the perinatal (pregnancy and the postpartum) period. Despite this, few studies have examined treatments for perinatal adolescents with depressive symptoms. The present study examined the feasibility and preliminary outcomes of a dialectical behavioral therapy (DBT) informed skills group among depressed adolescent perinatal women ( N = 25) recruited from both a public health parent education program and an adolescent obstetric clinic. A brief composite case example is included to illustrate how DBT skills were taught, practiced, and applied. Findings suggest the intervention was credible, acceptable, and associated with improvement in depression. Challenges with feasibility of enrolling and retaining adolescent perinatal women were evident, as approximately half of the enrolled participants did not complete the study. This study provides preliminary evidence that a DBT-informed skills group may be a promising intervention for depressed adolescent perinatal women and points to important directions for clinical practice and research, including treatment engagement and retention. [ABSTRACT FROM AUTHOR]

Study Objective A rare cause of adolescent abdominal pain includes isolated tubal torsion (ITT). Presentation is nonspecific and few studies have investigated ITT in adolescents. Our study objective was to describe the presentation and management of ITT in a large case series. Design Retrospective observational case series. Setting Tertiary care children's hospital. Participants Participants were female and aged 3-21 years, presenting to Children's Hospital Colorado and diagnosed with ITT between January 2004 and August 2015. Interventions and Main Outcome Measures Clinical presentation, physical exam, laboratory findings, surgical diagnosis, and treatment provided. Results A total of 19 cases were included. Average age was 13.3 (range, 11-18) years. In patients with unilateral abdominal pain (n = 16), there was 100% correlation with side of adnexal pathology. Ultrasound examination in 14 of 18 cases (78%) noted abnormal findings ipsilateral to the ITT. Most cases were managed with laparoscopy (84%; n = 16 of 19) and detorsion with or without cystectomy (74%; n = 14 of 19). Salpingectomy was more common with prolonged pain greater than 24 hours (relative risk 5.6, 95% confidence interval, 0.7-39.0). The most common intraoperative finding was a paratubal cyst (74%; n = 14 of 19). When Doppler flow was performed, it was present in 88% (n = 16 of 18) of the affected adnexa. ITT was more common on the left side (68%; n = 13 of 19). Conclusion The high occurrence of paratubal cysts might suggest pathologic predisposition for ITT. Providers should maintain a high index of suspicion for ITT, particularly if associated with a paratubal cyst. Classic examination findings of surgical abdomen, leukocytosis, fever, and absence of Doppler flow are infrequently present. Laparoscopy and detorsion are appropriate treatments for managing ITT. [ABSTRACT FROM AUTHOR]

The Canadian federal government has introduced carbon dioxide emission intensity limits of no greater than 420 kg/MWh net for new coal plants and existing coal plants more than 50 years of age. Many operating coal plants in Canada will be impacted by this legislation in the near future, requiring operators to plan a compliance strategy. The Canadian Clean Power Coalition (CCPC) investigated the performance and economics of a number of options for existing plants that could deliver compliant solutions. These options included strategies in which natural gas is available and some in which only coal firing is feasible due to cost or logistical issues. Repowering and post-combustion capture (PCC) options were studied using an eastern Canadian power plant firing bituminous coal. The base-case (BC) option was a new combined-cycle gas turbine (CCGT) plant, against which all other options were compared. The following cases were investigated: 1. PCC using: a. Monoethanolamine MEA solvent with crossover steam regeneration b. Commercial advanced solvent with crossover steam regeneration c. Commercial advanced solvent with a small gas turbine (GT) and a low-pressure steam generator d. Commercial advanced solvent with a GT, triple-pressure heat recovery steam generator (HRSG) and a back pressure steam turbine e. Commercial advanced solvent with a natural gas boiler and a back pressure steam turbine 2. Repowering of existing steam turbines with new a GT and HRSG 3. Repowering of existing steam turbines with fuel cells a. New solid oxide fuel cell (SOFC) topping unit b. New molten carbonate fuel cell (MCFC) topping unit 4. Expanded PCC approach with: a. Third unit with full LP steam turbine bypass supplying steam to PCC b. Circulating fluidized bed (CFB) boiler and back pressure steam turbine One of the issues with incorporating PCC in an existing facility is delivering the thermal regeneration energy to the PCC reboilers in an efficient and cost-effective manner. This can involve significant integration with the low-pressure stages of the steam turbine, a duty for which the turbine was not designed. Because turbine modifications (to deliver partially expanded steam to the PCC plant) can be costly and would require significant down time, alternative strategies were investigated in which the PCC facility would effectively be a “standalone” facility, with the main plant interfaces being the flue gas to be treated and some shared services. The costing analysis was carried out on the following basis: 30-year plant design life (with life-extension costs included for existing plant), 90% capacity factor for the first year cost of electricity (COE), and a coal cost of $4.73/GJ and a natural gas cost of $10.00/GJ (based on 2013 forecasted costs). Case 2 (repowering existing steam turbines with new natural gas combined-cycle plant) without any additional CO 2 abatement, delivered both the lowest capital costs and cost of electricity. If the existing coal boiler plant remains operational, the lowest costs were achieved by installing a molten carbonate fuel cell (Case 3b) followed closely with an advanced solvent PCC unit with solvent regeneration thermal energy being delivered by an efficient, small, dedicated gas turbine with a triple pressure HRSG (Case 1d). Where there is no existing infrastructure to deliver natural gas, the traditional methodology of extracting crossover steam from the unit for PCC solvent regeneration proved to be the lowest-cost option. [ABSTRACT FROM AUTHOR]

Humans are adept at performing an extraordinary breadth of voluntary motor actions that allow us to rapidly move around and interact with the environment. While voluntary motor actions necessarily include top-down intention to generate a motor act, a key to voluntary control is the selective use of bottom-up sensory feedback to select and guide motor actions. This review classifies the many ways in which sensory feedback is used by the motor system and highlights regularities in the timing of each class of motor responses to sensory stimuli, revealing a functional hierarchical organization of motor control. The highly automatic way in which feedback is typically used in goal-directed action blurs the distinction between reflexes and voluntary control. [ABSTRACT FROM AUTHOR]

The application of molten carbonate fuel cell (MCFC) technology for carbon capture at a thermal in situ oil sands facility has been studied. A steam assisted gravity drainage (SAGD) facility with once-through steam generator (OTSG) was used as a base case. Engineering modelling was conducted to compare the base case with no carbon capture, and with carbon capture from an OTSG facility using MCFC or amine-based carbon capture. The results indicate that MCFC has the potential to significantly reduce the carbon capture cost at a SAGD facility and to export low GHG intensity electric power. For a 33,000 barrels of oil per day (or 99,000 barrels of steam per day) production facility, a 76 MW sized MCFC would be required to capture 90% of CO 2 from the OTSG. Of the 76 MW power from MCFC, approximately 48 MW can be exported. If reliably produced, excess power generation may provide CO 2 credits by offsetting Alberta grid electricity, possibly leading to a negative carbon footprint in bitumen production. Excess power would also provide a revenue stream to cover some of the cost of capture. The carbon capture cost of MCFC would be about 30% of that for amine-based chemical solvent process. [ABSTRACT FROM AUTHOR]

Humans possess an impressive ability to generate goal-oriented motor actions to move and interact with the environment. The planning and initiation of these body movements is supported by highly distributed cortical and subcortical circuits. Recent studies, inspired by advanced control theory, highlight similar sophistication when we make online corrections to counter small disturbances of the limb or altered visual feedback. Such goal-directed feedback is likely generated by the same neural circuits associated with motor planning and initiation. These common neural substrates afford a highly responsive system to maintain goal-directed control and rapidly select new motor actions as required to deftly move and interact in a complex world. [ABSTRACT FROM AUTHOR]

Hair tourniquets are a rare phenomenon effecting potentially any appendage. Male genitalia and digits are the most common locations with female genitalia classified as an "other" site, occurring in less than 6% of reported reviews. The most recent review of female genital hair tourniquets identified 34 patients from 32 reports or series. Pain was reported as a presenting symptom in 30 cases, while the remaining four cases did not comment on pain. We present a case of an asymptomatic labial hair tourniquet presenting as a vulvar mass. The patient is a 5-year 7-month female born at 24 weeks gestation with intraventricular hemorrhage and subsequent cerebral palsy (CP) and lower extremity contractures. The patient was referred by her PCP for possible biopsy due to a recurrent vulvar mass that waxed and waned in size and purple discoloration over two months. The patient was scheduled for exam under anesthesia and noted to have an edematous left labia minora (Fig 1) with tightly wound hair and cotton threads at the base leaving an erosion with an indentation flap in its mid portion (Fig 2). The fibers were released, a 'V" excision was created removing the mid portion (Fig3), and the inferior and superior areas of the labia were approximated restoring symmetry. (Figs 4) The patient's postoperative course was uncomplicated and at 20 months post procedure her parents report normal anatomy without new incidents of labia edema. This case report demonstrates a presentation of chronic painless swelling due to a labia hair tourniquet, which has not yet been described in the literature. Absence of pain may have led to a delay in referral for definitive diagnosis and treatment. It is possible that sensory disruptions in the lower extremities from CP contributed to the lack pain perception by the patient. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is highly heterogeneous, and can be difficult to assess and diagnose particularly when unusual symptoms are present. This case study (n=9) describes an under-reported presentation of OCD in youth, whereby the patient experiences an obsessional fear of a sibling. Clinical characteristics of this presentation are discussed and comparisons with sibling rivalry disorder are examined. Seven of the participants engaged in a standard treatment protocol for OCD (comprising cognitive-behaviour therapy with or without an SSRI medication); five achieved remission. This presentation of sibling obsessions should be recognised as OCD, and be treated with evidence-based interventions for OCD. [ABSTRACT FROM AUTHOR]

Optimal feedback control (OFC) provides a powerful tool to interpret voluntary motor control, highlighting the importance of sensory feedback in the control and planning of movement. Recent studies in the context of OFC have increasingly used mechanical perturbations and visual shifts to probe voluntary control processes. These studies reveal the surprising sophistication of corrective responses, which are goal-directed and exhibit knowledge of the physical properties of the limb and the environment. These complex feedback processes appear to be generated through transcortical feedback pathways. The research reviewed here opens and enhances several lines of discovery, including testing whether feedback corrections share all of the attributes associated with voluntary control, identifying how prediction influences optimal state estimation, and importantly, how these voluntary control processes are generated by the highly distributed circuitry within the brain. [ABSTRACT FROM AUTHOR]

Abstract: It is well-known that heavy particles in homogeneous isotropic turbulence tend to collect in certain regions of the flow, leading to preferential accumulation. In this study, we investigate different measures of preferential accumulation, some of which show a dependence on Reynolds number. All the measures used in this study confirm that this phenomenon is most pronounced for a Stokes number, St ∼ 1, based on the Kolmogorov time-scale. The variation with Stokes number has been studied over a wider range for all the measures than in previous studies. Though the effect of changing St, for a particular Re, has been well understood, the scaling with Re is not so obvious. The measures used in this study seem to suggest a structure to the particle concentration field which scales with Re. To investigate this structure, we introduce a concentration distribution length scale which shows a dependence on Re, especially at higher St. The results in the present work agree with several previous computational and experimental works and provide a more unified picture of the dependence of preferential accumulation on St and Re. [Copyright &y& Elsevier]

Abstract: Parenting programmes are one of the best researched treatments for childhood psychiatric problems. As well as being proven effective for symptoms of conduct disorders in over 200 trials, there have now also been more than 60 trials, proving their effectiveness for insecure attachment patterns in infants. Their mechanism of action is now being confirmed, with both a reduction in harsh parenting and an increase in positive parenting appearing necessary to reduce conduct symptoms, and an increase in sensitive responding being necessary to promote secure attachment in infants. However, the less good news is that in ‘real-life’ everyday clinical conditions, as opposed to trials run in university clinics, the effects are often more modest. This is partly due to therapists having less well-developed skills, and partly due to cases being more difficult, with more comorbid conditions. The challenge now is to disseminate training in high-quality programmes and to develop these so that they are tailored to individual parenting needs, rather than offered as ‘one size fits all’. [Copyright &y& Elsevier]

Abstract: Background: Obesity is linked to the development of postmenopausal breast cancer, and some studies indicate obesity predicts a worse prognosis for premenopausal women who develop the disease. It was our hypothesis that proteins associated with breast cancer would be associated with body mass index (BMI). Methods: We searched our database of women enrolled in breast health translational research trials for information on BMI and markers predictive of breast cancer (basic fibroblast growth factor (bFGF), prostate-specific antigen (PSA), human kallikrein (hK)2, and urinary plasminogen activator (uPA). Information on BMI and one or more nipple aspirate fluid (NAF) or serum biomarkers was available from 382 women. Results: In this data set, NAF and serum levels of PSA (nPSA and sPSA), and NAF levels hK2, bFGF and uPA were each associated with pre- and/or postmenopausal breast cancer. sPSA was inversely associated with BMI in both pre- (r =−.56, p =.001) and postmenopausal women (r =−.62, p =.0035) without breast cancer. This association was lost when controlling for plasma volume. In women without breast cancer, NAF bFGF (p =.07, premenopausal subjects) and NAF hK2 (p =.09, postmenopausal subjects) were borderline associated with BMI. In women with breast cancer, nPSA was inversely (r =−.53, p =.049) associated with BMI in premenopausal women and directly associated with BMI in postmenopausal women (r =.37, p =.017). nPSA trended higher in hormone sensitive cancers, especially those that expressed progesterone receptor (p =.059). Conclusions: sPSA was inversely associated with BMI in all pre- and postmenopausal women and specifically in pre- and postmenopausal women without breast cancer. NAF PSA was associated with BMI in pre- and postmenopausal women with breast cancer. Evaluating the change in PSA with changes in weight may provide clues regarding a subject''s breast cancer risk. [Copyright &y& Elsevier]

Abstract: Purpose: Mucopurulent cervicitis is neither a sensitive nor a specific indicator of antibiotic sensitive infection. This analysis examines the positive and negative ramifications of treating cervicitis empirically as a Chlamydial (CT) infection. It begins where prior analyses leave off, with the number of cases of pelvic inflammatory disease (PID) prevented. Methods: Three treatments were compared: 1) treat empirically/refer partner; 2) test, treat, and base partner treatment on results; 3) test, base treatment on results. The outcomes were the physical sequelae of PID and the psychological sequelae of being diagnosed with CT in a hypothetical cohort of 500 teenagers with cervicitis, among whom the prevalence of CT averaged 33%, but ranged between 10% and 70%. Results: At a CT prevalence of 33%, Treatments 1 and 2 prevented three times as many cases of PID-related physical sequelae (n = 14) as Treatment 3 (n = 5). However, to prevent these 14 cases of physical sequelae, with Treatment 1, 163 teens needlessly suffer the psychological sequelae of a false CT diagnosis and with Treatment 2, 101 do so. The ratio of physical sequelae prevented to psychological sequelae caused, changed in relationship to the prevalence of CT, but was always numerically most favorable with Treatment 3. Moreover, it was the only therapeutic approach for which overall morbidity never exceeded the PID-related physical morbidity incurred in the absence of treatment. Conclusions: By including the effects of over diagnosing and treating CT, we have demonstrated how the risks and benefits of empiric and nonempiric cervicitis therapy vary in relationship to CT prevalence. Failure to consider both the physical and the psychological aspects of patient well-being may mean that well-intentioned policies to reduce physical morbidity do not result in an overall improvement in health of teenagers. [Copyright &y& Elsevier]

Abstract: Purpose: To create a data management system that: (1) standardizes antecedent, program, and outcome variables relevant to the shared goals of adolescent-oriented maternity programs while allowing users to add variables pertaining to unique aspects of their work; (2) cues providers to physiologic and psychosocial characteristics that predispose teenagers to adverse pregnancy and parenting outcomes, (3) standardizes patient care by guiding providers through adolescent-oriented prenatal, postpartum, and well baby visits, and (4) establishes the infrastructure to collect data from a nationally representative sample of pregnant and parenting teens. Method: We adapted a powerful, state-of-the-art relational database framework (Microsoft Access 2000®) to create an easy-to-use data management system—The Electronic Report on Adolescent Pregnancy (ERAP)—that requires minimal training to use on a personal computer. Results: ERAP is designed to meet the administrative and analytic needs of adolescent-oriented maternity programs. It consists of six linked core data tables (teen, pregnancy, prenatal visits, child, interconception interval, and interconception interval visits), that allow users to analyze data from these multiple views while preserving the family structure. In addition, the database standardizes methods for collecting and storing the information and automatically computing the variables needed to monitor and evaluate an adolescent-oriented maternity program. Since by adding variables and appending supplementary tables, users can modify the core database to accommodate unique aspects of their programs and/or research, ERAP is also an ideal conduit for translating research findings into clinical practice. Similarly, because ERAP actually structures the care patients receive, the database provides the infrastructure needed to develop and implement best practice guidelines for treating teen-headed families. Finally, the confidentiality of all subject data is assured because ERAP is password-protected and automatically prepares files for batched external analyses by removing personal identifiers. Conclusions: ERAP provides the infrastructure needed to create a teen-pregnancy databank at the national level and an efficient patient monitoring system at the program level. By standardizing variable definitions and data collection techniques, serving as a repository for data collected at multiple sites, and tracking the multidisciplinary aspects of the care patients receive, ERAP has the potential to facilitate collaboration between adolescent-oriented maternity programs, increase the scientific rigor of teen pregnancy research, and improve the quality of care individual teen-headed families receive by prompting compliance with best practice guidelines. [Copyright &y& Elsevier]

Neurophysiological studies on non-human primates have provided a large body of information on the response patterns of neurons in primary motor cortex during volitional motor tasks. Rather than finding a single simple pattern of activity in primary motor cortex neurons, these studies illustrate that neural activity in this area reflects many different types of information, including spatial goals, hand motion, joint motion, force output and electromyographic activity. This richness in the response characteristics of neurons makes estimates of any single variable on motor performance from population signals imprecise and prone to errors. It initially seems puzzling that so many different types of information are represented in primary motor cortex. However, such richness in neural responses reflects its important role in converting high-level behavioral goals generated in other cortical regions into complex spatiotemporal patterns to control not only α-motoneuron activity but also other features of spinal processing. [Copyright &y& Elsevier]

The ability to sequence a bacterial genome in less than 1 day represents a step change for clinical microbiology. Genomic data can be used to investigate suspected outbreaks and rapidly to identify multidrug-resistant organisms. We held an open public debate to explore public understanding and perceptions of bacterial whole-genome sequencing (WGS), which we describe here. [ABSTRACT FROM AUTHOR]

Abstract: Background: Advances in radiation therapy have led to long term survival in young patients with Hodgkin''s disease. Oophoropexy may reduce ovarian damage and preserve hormonal production and future fertility. When ovarian ligaments are shortened, incising the serosa parallel to the infundibulopelvic ligaments at laparoscopy permits the completion of a medial oophoropexy. Case: An adolescent female underwent a laparoscopic medial oophoropexy prior to radiation therapy for Stage IIIB Hodgkin''s disease. Due to shortened ovarian ligaments the ovaries could not be placed behind the uterus without excessive tension. The infundibulopelvic ligaments were sharply dissected off of the lateral pelvic sidewalls eliminating tension on the ligaments and allowing completion of the medial oophoropexy. Twenty-two months after completion of her radiation therapy the patient was normally menstruating and conceived spontaneously. Conclusion: Laparoscopic dissection of the infundibulopelvic ligaments allowed for a medial oophoropexy to be performed in an adolescent patient and was associated with return of ovarian function after radiation therapy. [Copyright &y& Elsevier]

Abstract: Parent training programmes are a very well replicated, effective treatment for conduct problems. The most effective include a strong element of practising skills, combined with understanding the parents'' predicament and helping them alter this. However, they don''t always improve behaviour in the school setting, which is an important predictor of poor outcomes. The focus therefore is now on also adding effective teacher training programmes so that the child is effectively treated across both contexts. [Copyright &y& Elsevier]

Abstract: Bacterial vaginitis is commonly seen in the pediatric population. Severe or recurrent cases may be associated with ulcerative lesions. We report a case of vaginal biopsies of ulcerative lesions in a 9-year-old which led to severe vaginal adhesions, stenosis, and hematocolpos. A vaginoscopy and resection from below were not successful and an exploratory laparotomy with uterine perforation and sounding into the upper vagina were required to reopen the lower vaginal canal. We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required. [Copyright &y& Elsevier]

Parenting programs are the most widely used strategy to prevent and reduce children's disruptive behavior,1 and yet we know very little about what exact changes in parenting behavior underlie program effects on disruptive child behavior. In fact, most studies have been unable to identify any mediators of parenting program effects.2 This is likely because, at least in part, individual trials tend to be underpowered to detect mediation effects,3 and are unable to take the known heterogeneity in program effects4 into account. [ABSTRACT FROM AUTHOR]

Parenting interventions reduce antisocial behavior (ASB) in some children with conduct problems (CPs), but not others. Understanding the neural basis for this disparity is important because persistent ASB is associated with lifelong morbidity and places a huge burden on our health and criminal justice systems. One of the most highly replicated neural correlates of ASB is amygdala hypoactivity to another person's fear. We aimed to assess whether amygdala hypoactivity to fear in children with CPs is remediated following reduction in ASB after successful treatment and/or if it is a marker for persistent ASB. We conducted a prospective, case-control study of boys with CPs and typically developing (TD) boys. Both groups (ages 5–10 years) completed 2 magnetic resonance imaging sessions (18 ± 5.8 weeks apart) with ASB assessed at each visit. Participants included boys with CPs following referral to a parenting intervention group and TD boys recruited from the same schools and geographical regions. Final functional magnetic resonance imaging data were available for 36 TD boys and 57 boys with CPs. Boys with CPs were divided into those whose ASB improved (n = 27) or persisted (n = 30) following the intervention. Functional magnetic resonance imaging data assessing fear reactivity were then analyzed using a longitudinal group (TD/improving CPs/persistent CPs) × time point (pre/post) design. Amygdala hypoactivity to fear was observed only in boys with CPs who had persistent ASB and was absent in those whose ASB improved following intervention. Our findings suggest that amygdala hypoactivity to fear is a marker for ASB that is resistant to change following a parenting intervention and a putative target for future treatments. [ABSTRACT FROM AUTHOR]

Balance tests have clinical utility in identifying balance deficits and supporting recommendations for appropriate treatments. Motion capture technology can be used to measure whole-body kinematics during balance tasks, but to date the high technical and financial costs have limited uptake of traditional marker-based motion capture systems for clinical applications. Markerless motion capture technology using standard video cameras has the potential to provide whole-body kinematic assessments with clinically accessible technology. Our aim was to quantify poses and movement strategies during static balance tasks (tandem stance, single limb stance, standing hip abduction, and quiet standing on foam with eyes closed) using video-based markerless motion capture software (Theia3D) and principal component analysis to examine the associations with age, body mass index (BMI) and sex. In 30 healthy adults, the mean poses for all balance tasks had at least one principal component (PC) that differed significantly by sex. Age was significantly associated with the PC describing leg height for the hip abduction task and erect posture for the quiet standing task. BMI was significantly associated with the PC capturing knee flexion in the single leg stance task. The movement strategies used to maintain balance showed significant differences by sex for the tandem stance pose. BMI was correlated with PCs for movement strategies for hip abduction and quiet standing tasks. Results from this study demonstrate how markerless motion capture technology could be used to augment analyses of balance both in the clinic and in the field. [ABSTRACT FROM AUTHOR]

A majority of teens pregnancies are unplanned and 80% of teen mothers will be single parents within 12 months of childbirth. Conflict generally precedes dissolution of relationships. There is limited understanding of how adolescent parents engage in conflict resolution. Adolescent mothers and fathers under the age of 22 were recruited from the Colorado Adolescent Maternity Program to complete a mixed methods study including an IRB approved semi-structured interview. Demographic characteristics were collected along with perspectives on co-parenting, conflict, and methods of conflict resolution. Grounded theory analysis was utilized to develop themes surrounding aspects of conflict resolution until thematic saturation was achieved. A working construct for styles of conflict resolution among co-parenting adolescents was established. Between July-December 2016, 14 adolescent women and men between the ages of 18 and 22 years were recruited to participate in interviews. Four subjects declined participation. After 10 interviews of five males and five females, thematic saturation was obtained. Median age was 20 years (19–21), and median age of the child was 1.5 years (1-4). Race included Black (50%), Hispanic (30%), and White (20%). Eighty percent were no longer in a relationship with the co-parent of their child. Six major themes were identified. Two motivating factors to continue co-parenting from a child-focused approach were 1) a common desire for the child's well-being and 2) recognition of the counterpart's parenting strengths. Four styles of conflict resolution were identified. Three styles: Confrontation, Avoidance, and Acquiescence, were described at early points in the relationship. Collaborative styles were more often cited later in the co-parenting phase. Styles of conflict resolution among adolescents vary. Dependent relationships that generally remain intact after conflicts use Acquiescence with parents and Confrontation with siblings. Preservation of non-dependent relationships is influenced by the relationship's perceived importance. Less important relationships end with Avoidance while important relationships are preserved with Collaboration. Teen parents use Confrontation earlier in a co-parenting relationship when it is perceived as permanent. Relationships that change from couple to co-parent utilize Avoidance initially but became Collaborative over time. Future interventions should assist teens in developing Collaborative styles of conflict resolution earlier in their co-parenting relationship. [ABSTRACT FROM AUTHOR]

Most young autistic children display emotional and behavioral problems (EBPs). There is evidence that behavioral parenting interventions (BPIs) reduce these. The COVID-19 pandemic and associated lockdowns can be seen as a natural experiment to test the longer-term effect of BPIs under conditions of increased uncertainty. Opportunistic follow-up (n = 49) of a pilot randomized controlled trial (RCT) cohort (n = 62 autistic children aged 6-11 years; originally randomized to a 12-week group BPI [Predictive Parenting; n = 31] or an attention control [Psychoeducation; n = 31]) was conducted during COVID-19−related lockdowns. Measures of parent-reported child irritability and parenting stress were collected at 3 time points (baseline: mean age = 6.7 years; primary endpoint: mean age = 7.1 years, ∼5 months after randomization; and COVID-19 follow-up: mean age = 8.8 years, ∼2 years after randomization). We tested the magnitude of intervention effects using point estimates of differences in child irritability and parenting stress between arms at primary endpoint and COVID-19 follow-up, covarying for baseline scores. We used area under the curve (AUC) analyses to obtain overall estimates of the average intervention effect across all 3 timepoints. Semi-structured qualitative interviews were conducted with a subsample of parents (n = 18). A small but significant intervention effect was found from baseline to COVID-19 follow-up in favor of Predictive Parenting on parent-reported child irritability (d = −0.33, 95% CI = −0.65, −0.01) and parenting stress (d = −0.31, 95% CI = −0.59, −0.03). No overall mean intervention effect for these measures as estimated by the AUC analyses (which takes into account the nonsignificant effect at primary endpoint) was found. Interview feedback on the both interventions was positive, and parents reported using strategies from Predictive Parenting during COVID-19−related restrictions. This opportunistic follow-up study at a time of stress indicates the need for careful consideration of how and when to measure the effects of BPIs in autistic child populations. Future trials should consider both the most appropriate endpoint and in what context effects may be more likely to be seen. Autism Spectrum Treatment and Resilience (ASTAR); https://www.isrctn.com ; 91411078. [ABSTRACT FROM AUTHOR]