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An attentional bias toward threat has been theorized to be a normative aspect of infants' threat and safety learning, and an indicator of risk for internalizing psychopathology in older populations. To date, only four studies have examined this bias using the dot-probe task in infancy and the findings are mixed. We extended the literature by examining patterns of attention to threat in a culturally and linguistically diverse sample of infants aged 5-11 months old (N = 151) using all measures previously employed in the infant dot-probe literature. Given that an attentional bias toward threat is associated with higher risk of developing anxiety disorders later in life, we also examined how negative affect-an early correlate of later anxiety disorders-is related to attentional bias toward threat in infancy. This study was the first to use a consistent measure of negative affect across the whole sample. An eye-tracking dot-probe task was used to examine attentional bias toward threat (i.e., angry faces) relative to positive (i.e., happy faces) stimuli. Results showed that an attention bias to threat was not characteristic of infants at this age, and negative affect did not moderate the putative relationship between attention and emotional faces (angry, happy). These findings therefore suggest that attention biases to socio-emotional threat may not have emerged by 11 months old.

Objective In contrast to adult cohorts, neocortical changes in epileptic children with hippocampal damage are not well characterized. Here, we mapped multimodal neocortical markers of epilepsy‐related structural compromise in a pediatric cohort of temporal lobe epilepsy and explored how they relate to clinical factors. Methods We measured cortical thickness, gray–white matter intensity contrast and intracortical FLAIR intensity in 22 patients with hippocampal sclerosis (HS) and 30 controls. Surface‐based linear models assessed between‐group differences in morphological and MR signal intensity markers. Structural integrity of the hippocampus was measured by quantifying atrophy and FLAIR patterns. Linear models were used to evaluate the relationships between hippocampal and neocortical MRI markers and clinical factors. Results In the hippocampus, patients demonstrated ipsilateral atrophy and bilateral FLAIR hyperintensity. In the neocortex, patients showed FLAIR signal hyperintensities and gray–white matter boundary blurring in the ipsilesional mesial and lateral temporal neocortex. In contrast, cortical thinning was minimal and restricted to a small area of the ipsilesional temporal pole. Furthermore, patients with a history of febrile convulsions demonstrated more pronounced FLAIR hyperintensity in the ipsilesional temporal neocortex. Interpretation Pediatric HS patients do not yet demonstrate the widespread cortical thinning present in adult cohorts, which may reflect consequences of a protracted disease process. However, pronounced temporal neocortical FLAIR hyperintensity and blurring of the gray–white matter boundary are already detectable, suggesting that alterations in MR signal intensities may reflect a different underlying pathophysiology that is detectable earlier in the disease and more pervasive in patients with a history of febrile convulsions.

OBJECTIVE: Impairment of speech repetition following injury to the dorsal language stream is feature of conduction aphasia - a well-described 'disconnection syndrome' in adults. The impact of similar lesions sustained in infancy has not been established. METHODS: We compared language outcomes in term-born individuals with confirmed neonatal stroke (n=30; age: 7-18 years, left-sided lesions in 21 cases) to matched controls (n=40). Injury to the dorsal and/or ventral language streams was assessed using T1- and T2-weighted MRI and diffusion tractography. Language lateralization was determined using functional MRI. RESULTS: At the group level, left dorsal language stream injury was associated with selective speech repetition impairment for non-words (p=0.021) and sentences (p

Objective Impairment of speech repetition following injury to the dorsal language stream is a feature of conduction aphasia, a well-described “disconnection syndrome” in adults. The impact of similar lesions sustained in infancy has not been established. Methods We compared language outcomes in term-born individuals with confirmed neonatal stroke (n = 30, age = 7–18 years, left-sided lesions in 21 cases) to matched controls (n = 40). Injury to the dorsal and/or ventral language streams was assessed using T1- and T2-weighted magnetic resonance imaging (MRI) and diffusion tractography. Language lateralization was determined using functional MRI. Results At the group level, left dorsal language stream injury was associated with selective speech repetition impairment for nonwords (p = 0.021) and sentences (p

Very preterm (VP) survivors are at increased risk of autism spectrum disorder (ASD) compared with term-born children. This study explored whether neonatal magnetic resonance (MR) brain features differed in VP children with and without ASD at 7 years. One hundred and seventy-two VP children (

Background Parents are increasingly recognized as important partners in children's health care. Despite their involvement in care, parental experiences of their child's hospitalization have received little research attention. In this study we explored parents' perceptions of what they found difficult, what they would like to be different and what they found to be helpful during their infant's hospitalization and surgery for the treatment of congenital heart disease. Methods Structured interviews were conducted with 154 parents (91 mothers, 63 fathers) whose infant underwent cardiac surgery (at

Parental responses to children's emotions influence children's emotion-related abilities. Tuning in to Toddlers (TOTS) is a new emotion-focused parenting program for parents of toddlers aged 18 to 36 months. It is based on the empirically tested Tuning in to Kids program that teaches parents how to emotion coach their children. In the current pilot study, an intervention-only sample of parents of typically developing toddlers attended a 6-session group program. At preprogram and postprogram, parents’ emotion-coaching and emotion-dismissing behaviors were assessed using self-report questionnaires and observation measures. Results showed significant increases in self-reported and observed emotion coaching behaviors and use of emotion talk after intervention. There was also a significant decrease in self-reported and observed emotion dismissing behaviors, and toddler externalizing behavior problems. Overall, findings provide preliminary support for TOTS and suggest its potential as a valuable intervention for supporting parents in their efforts to emotion coach their toddlers.

Little is known about the immediate impact of neonatal cardiac surgery on emotional and behavioral functioning in infancy. This exploratory, qualitative study investigated if infants who underwent cardiac surgery in the first 3 months of life exhibited emotional and behavioral dysregulation or traumatic stress responses. Ninety-one infants and their mothers were recruited while inpatients. Mothers were interviewed about their perceptionof the impact of illness, surgery, and the hospitalizationon on their infant 4 weeks after discharge. Responses were analyzed by two coders using thematic analysis. Eighty-three of the mothers interviewed described impacts on the infant, which emcompassed five themes: infant behavior (n = 44, 48%), emotions (n = 43, 47%), physical health (n = 31, 34%), relationship and social interaction (n = 27, 30%), and development (n = 18, 20%). Our expectation that there would be impacts in the period soon after neonatal cardiac surgery consistent with a pediatric medical traumatic stress response model was supported. Maternal report of infant well-being following neonatal cardiac surgery delineated three groups of infants: those who appear unscathed; those who appear generally happy, but demonstrate specific alarm and avoidance responses in the presence of medical trauma; and those with significant problems in emotional regulation, behavioral regulation, or both.

Diabet. Med. 28, 1109–1112 (2011) Abstract Aims This study investigated whether continuous subcutaneous insulin infusion is associated with sustained improvement in behaviour and metabolic control. Methods Children with Type 1 diabetes mellitus (n = 27, 8–18 years old) who had been assessed previously prior to commencing continuous subcutaneous insulin infusion, and 6–8 weeks later, were re-evaluated 2 years after commencing insulin pump therapy. Behaviour was reassessed using the Behavioral Assessment System for Children—2nd edition (BASC-2) and current HbA1c levels were recorded. Results Two years after commencing continuous subcutaneous insulin infusion, parent-reported internalizing and externalizing symptoms were significantly lower than pre-insulin pump therapy commencement levels. Self reports of internalizing and externalizing problems did not differ significantly across the three assessment points. There was no significant difference between pre-insulin pump therapy HbA1c and HbA1c after 2 years on continuous subcutaneous insulin infusion, despite an initial improvement 6–8 weeks after commencing the therapy. Conclusions Children with Type 1 diabetes mellitus showed sustained improvements in parent-reported behaviour, but not in self reports of behaviour or in metabolic control 2 years after commencement of continuous subcutaneous insulin infusion.

Diabet. Med. 27, 1084–1087 (2010) Abstract Aims Studies of siblings of children with Type 1 diabetes (Type 1 DM) have shown either increased levels of maladjustment or, alternatively, increased levels of pro-social behaviour according to whether the sibling or parent was interviewed. The purpose of this study was to examine the psychological adjustment of Type 1 DM siblings using both parent and sibling report and to assess the concordance between child and parent reports. Methods Ninety-nine siblings aged 11–17 years and parents of children with Type 1 DM treated at the Royal Children’s Hospital, Melbourne were recruited sequentially. The Strengths and Difficulties Questionnaire (SDQ) was used to assess well siblings’ emotional and behavioural functioning using data collected within a semi-structured interview. SDQ data between the sibling cohort and normative data sample were compared using independent-samples t-tests. Sibling reports and parent reports were compared using a series of paired-sample t-tests and correlation analyses. Results Type 1 DM siblings did not report greater emotional or behavioural maladjustment or more pro-social behaviour than norms. Parents rated siblings’ pro-social behaviour as being comparable with that of youth from the general community; however, parents rated healthy siblings as having lower levels of maladjustment; specifically, significantly fewer conduct problems, hyperactive behaviour and peer-related problems (all P

We describe the first use from space of the Bundle Protocol for Delay-Tolerant Networking (DTN) and lessons learned from experiments made and experience gained with this protocol. The Disaster Monitoring Constellation (DMC), constructed by Surrey Satellite Technology Ltd (SSTL), is a multiple-satellite Earth-imaging low-Earth-orbit sensor network in which recorded image swaths are stored onboard each satellite and later downloaded from the satellite payloads to a ground station. Store-and-forward of images with capture and later download gives each satellite the characteristics of a node in a disruption-tolerant network. Originally developed for the Interplanetary Internet, DTNs are now under investigation in an Internet Research Task Force (IRTF) DTN research group (RG), which has developed a bundle architecture and protocol. The DMC is technically advanced in its adoption of the Internet Protocol (IP) for its imaging payloads and for satellite command and control, based around reuse of commercial networking and link protocols. These satellites use of IP has enabled earlier experiments with the Cisco router in Low Earth Orbit (CLEO) onboard the constellation s UK-DMC satellite. Earth images are downloaded from the satellites using a custom IP-based high-speed transfer protocol developed by SSTL, Saratoga, which tolerates unusual link environments. Saratoga has been documented in the Internet Engineering Task Force (IETF) for wider adoption. We experiment with the use of DTNRG bundle concepts onboard the UK-DMC satellite, by examining how Saratoga can be used as a DTN convergence layer to carry the DTNRG Bundle Protocol, so that sensor images can be delivered to ground stations and beyond as bundles. Our practical experience with the first successful use of the DTNRG Bundle Protocol in a space environment gives us insights into the design of the Bundle Protocol and enables us to identify issues that must be addressed before wider deployment of the Bundle Protocol. Published in 2010 by John Wiley & Sons, Ltd. KEY WORDS: Internet; UK-DMC; satellite; Delay-Tolerant Networking (DTN); Bundle Protocol

Age is an important predictor of neuromuscular recovery after peripheral nerve injury. Insulin-like growth factor 1 (IGF-1) is a potent neurotrophic factor that is known to decline with increasing age. The purpose of this study was to determine if locally delivered IGF-1 would improve nerve regeneration and neuromuscular recovery in aged animals. Young and aged rats underwent nerve transection and repair with either saline or IGF-1 continuously delivered to the site of the nerve repair. After 3 months, nerve regeneration and neuromuscular junction morphology were assessed. In both young and aged animals, IGF-1 significantly improved axon number, diameter, and density. IGF-1 also significantly increased myelination and Schwann cell activity and preserved the morphology of the postsynaptic neuromuscular junction (NMJ). These results show that aged regenerating nerve is sensitive to IGF-1 treatment.

Chronic illness is common in childhood and is associated with an increased risk of psychological difficulties in the child. Current research is focused on the identification of specific risk and protective factors that may predict psychological and health outcomes. The challenges faced by physicians caring for a child with chronic illness are described and contrasted with the medical role in treating acute illness. The child's adaptation to illness is discussed in a developmental framework and positive and maladaptive family responses are identified. It is suggested that chronic illness and/or its treatment may compromise intellectual development and academic progress.

The incidence of Type 1 diabetes is increasing worldwide, imposing enormous public health costs, as well as profoundly affecting individual quality of life. There is evidence that psychological problems are increased in children with diabetes and this morbidity is often associated with poor metabolic control. Specific risk factors for this dual morbidity are emerging from empirical studies. The next challenge is to identify effective interventions for use with children at risk for adverse mental and physical health outcomes. The intervention literature is reviewed. It is noted that most studies have used diabetes-specific, unstandardized interventions in groups of adolescents, with few interventions trialled with younger children. No study has targeted a specific psychological disorder such as behaviour problems or depression, both of which are known to be increased in children with diabetes and for which effective standardized interventions are available. Attention is drawn to methodological limitations in many of the studies conducted to date and suggestions made to reduce these in future interventions attempting to reduce the burden of illness in children with diabetes.

AIMS: To describe psychiatric status and relationship to metabolic control in adolescents with Type 1 diabetes studied prospectively from diagnosis. METHODS: Adolescents (n = 41) completed a self-report measure of psychiatric status 10 years after disease onset. Metabolic control information was recorded prospectively from diagnosis. The rate and type of psychiatric disorder were determined and the relationship between mental health status and metabolic control history examined. RESULTS: Thirty-seven per cent of the adolescents met criteria for a DSM-IV psychiatric disorder, two to three times higher than community levels of psychiatric morbidity. Females were significantly more likely to receive a diagnoses (chi2 = 4.98, P < 0.05). Two thirds of participants had experienced at least one serious hypoglycaemic episode and one third had a history of chronic poor metabolic control. DSM-IV diagnoses were present in half of those with a history of chronic poor control, one third of the hypoglycaemia group and one quarter of well controlled participants. Adolescents with a current Mood (t = -2.83, P < 0. 01), Anxiety (t = -3.77, P = 0.001) or Behaviour (t = 2.56, P < 0.05) disorder and those with a history of poorly controlled diabetes (F (2,29) = 5.4, P = 0.01) had higher externalizing behaviour problem scores at diagnosis than those without current disorder. CONCLUSIONS: Adolescents with Type 1 diabetes are at high risk for psychiatric disorder. Poorly controlled diabetes over the first 10 years of illness was associated with pre-existing behaviour problems at diagnosis and there was a trend for an association with current psychiatric status.

Objective.—To compare the efficacy of a single over-the-counter dose (7.5 mg/kg, p.o.) of children's ibuprofen suspension vs. placebo for the acute treatment of pediatric migraine. Background.—Migraine occurs in 4% of young children. There is a paucity of controlled clinical research in the treatment of childhood migraine and there are currently no approved drugs in the USA for treatment of migraine in children 12 years of age. The purpose of this study is to assess the efficacy and tolerability of a single OTC dose of ibuprofen suspension for the acute treatment of childhood migraine. Methods.—Prospective, double-blind, placebo-controlled, parallel group, randomized study of children 6-12 yrs with migraine (I.H.S.-R1997) treating 1 attack with a 7.5 mg/kg liq. ibuprofen vs matching placebo. Efficacy measures: (1) Headache severity based upon a 4 pt scale (severe, mod., mild, no headache) at 30, 60, 90, 120, 180 and 240 minutes post dose, and (2) nausea, vomiting, and photo/phonophobia at 120 min. The 1° endpoint was cumulative % of responders (severe or mod. headache reduced to mild or none) by 120 minutes. Secondary endpoints were headache recurrence within 4-24 hours and need for rescue medicines within 4 hours. Results.—138 enrolled; 84 treated/completed diary. 45 active agent, 39 placebo. The 2 groups were comparable (active: placebo) - Ages: 9: 9.1, gender boy/girl - 1.25: 1.6, and diagnosis: migraine w/o aura - 86%: 79%. Concomitant use of prophylactic Rx: 24%: 10% (Table 3). Table 3. Endpoint Ibuprofen (N=45) Placebo (N=39) P-value Cum. % responders, 2 hr (1° endpoint) 76% 53% 0.006 2 pt. improvement in severity, 2 hr 27 (62%) 11 (28%) 0.004 Median pain score at 2 hr 2 3

Many of the properties of carbon-carbon make it an ideal material for reciprocating materials of intermittent combustion (IC) engines. Recent diesel engine tests, shown herein, indicate that the thermal and mechanical properties of carbon-carbon are adequate for piston applications, However, reducing the manufacturing costs and providing long term oxidation protection are still issues that need to be addressed.