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Ko Yen,1,* Chen-Chung Liu,1– 3,* Yi-Ting Lin,1,2 Yi-Ling Chien,1,2 Ming H Hsieh,1,2 Chih-Min Liu,1,2 Tzung-Jeng Hwang,1,2 Wei-Hsiang Liao,1,2 Hai-Gwo Hwu1,2 1Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; 2Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan*These authors contributed equally to this workCorrespondence: Chen-Chung Liu Department of Psychiatry, National Taiwan University Hospital, No. 7 Chung Shan South Road, Taipei, 10002, Taiwan Tel +886-2-23123456 ext. 66130 Email chchliu@ntu.edu.twBackground: Patients in remission after first-episode psychosis are inclined to discontinue antipsychotic treatment, which may lead to higher risk of relapse and unfavorable outcomes. Paradoxically, also there are evidences suggesting that certain patients may stay well in drug-free condition. Psychiatrists’ views towards this dilemma might affect their approaches to these patients, and discrepant attitudes are noted between Western and Asian clinicians. This study aimed to examine psychiatrists’ attitudes about discontinuing antipsychotic medications after remission from first-episode psychosis.Methods: Psychiatrists were recruited for this study using convenience sampling. A cross-sectional survey was conducted using a set of questionnaires comprising nine items for attitudes toward medication discontinuation, six vignettes for probing psychiatrists’ practice in designated clinical scenarios, and a list of criteria that may affect their responses.Results: Responses were provided by 118 psychiatrists, two-thirds men, mean age 39.8 ± 10.1 years and mean experience 12.7 ± 9.7 years. Half of the participants endorsed that fewer than 20% of the remitted patients should stop medication completely; the majority advised that an observation period of 1 year or longer is necessary while discontinuing medication. The majority would not initiate discussion with patients about discontinuing medication. Responding to two case vignettes, those who endorsed that more patients could stop antipsychotics were also more inclined to discuss it with patients, but not consistently in response to the other four case vignettes. Taiwan psychiatrists expressed a wide range of decision-making considerations for discontinuing antipsychotics.Conclusion: The majority of Taiwan psychiatrists thought it was not feasible to stop medications completely but were willing to consider this option. Once being presented with actual clinical scenarios, many participants hesitated to discontinue antipsychotic medications for various reasons. The proactive attitude of psychiatrists towards conducting clinical trials to test the feasibility of medication discontinuation may help to provide better reference for this clinical dilemma.Keywords: antipsychotics, attitude, discontinuation, first-episode psychosis, remission, questionnaire

This study investigated the effects of L2 pronunciation instruction on speech intelligibility and fluency, the relationship between intelligibility and fluency, and the extent to which utterance fluency can predict perceived fluency. Participants were 30 beginning adult EFL learners who received either segmental or suprasegmental instruction. Oral data included monologues recorded at the beginning and end of an 8-week course. Speech segments were transcribed for intelligibility and rated on a 1000-point scale for fluency by 11 native speakers. They were also coded and analyzed for transcription errors and utterance fluency measures. Quantitative analyses did not reveal significant changes in intelligibility or perceived fluency as the result of instruction. However, the suprasegmental group seemed to show an upward trend in speech rate, which was found to strongly predict perceived fluency. The findings further our understanding.

Young women with disabilities face multiple barriers that limit their career pathways. Little research has been conducted to examine how cognitive constructs of career self-efficacy and outcome expectations contribute to their future aspirations. This study examined direct relationships between career self-efficacy and outcome expectations on future aspirations, mediating effects of autonomy and self-realization on these relationships, and moderating effects of mental health on these links for young women with disabilities. Although existing research on social cognitive career theory has focused on career self-efficacy, results from this study indicated that outcome expectations might have an even stronger influence on future aspirations. Mental health barriers negatively impact future aspirations of the study's sample. Limitations and implications for research and practice were discussed.

Mechanical disuse will bias bone marrow stromal cells towards adipogenesis, ultimately compromising the regenerative capacity of the stem cell pool and impeding the rapid and full recovery of bone morphology. Here, it was tested whether brief daily exposure to high-frequency, low-magnitude vibrations can preserve the marrow environment during disuse and enhance the initiation of tissue recovery upon reambulation. Male C57BL/6J mice were subjected to hindlimb unloading (HU, n = 24), HU interrupted by weight-bearing for 15 min/d (HU+SHAM, n = 24), HU interrupted by low-level whole body vibrations (0.2 g, 90 Hz) for 15 min/d (HU+VIB, n = 24), or served as age-matched controls (AC, n = 24). Following 3 w of disuse, half of the mice in each group were released for 3 w of reambulation (RA), while the others were sacrificed. RA+VIB mice continued to receive vibrations for 15 min/d while RA+SHAM continued to receive sham loading. After disuse, HU+VIB mice had a 30% greater osteogenic marrow stromal cell population, 30% smaller osteoclast surface, 76% greater osteoblast surface but similar trabecular bone volume fraction compared to HU. After 3 w of reambulation, trabecular bone of RA+VIB mice had a 30% greater bone volume fraction, 51% greater marrow osteoprogenitor population, 83% greater osteoblast surfaces, 59% greater bone formation rates, and a 235% greater ratio of bone lining osteoblasts to marrow adipocytes than RA mice. A subsequent experiment indicated that receiving the mechanical intervention only during disuse, rather than only during reambulation, was more effective in altering trabecular morphology. These data indicate that the osteogenic potential of bone marrow cells is retained by low-magnitude vibrations during disuse, an attribute which may have contributed to an enhanced recovery of bone morphology during reambulation.

Teacher-student relationships have been studied with increasing intensity during the past three decades, but the majority of this study has focused on young children and has relied on teacher perceptions of these relationships. The current study was designed to add to this growing body of research by exploring the factor structure, reliability, and validity of an instrument designed to measure adolescents' perceptions of their own relationships with teachers. Participants included 687 high school students, half of whom were students with diagnosed disabilities and the other half were students considered at risk of academic failure due to placement in dropout retrieval programs. All youth completed a self-report instrument of teacher-student relationships along with multidimensional measures of school engagement. Findings from a confirmatory factor analysis of the Inventory of Teacher-Student Relationships indicated that the three hypothesized factors (i.e., Communication, Trust, and Alienation) had robust factor loadings, adequate internal consistency, and were associated with multiple measures of school engagement. These findings align with previous research linking teacher-student relationships with school engagement and support the need for continued research on the importance of teacher-student relationships among adolescents who are at-risk of experiencing difficulties in school.

Parent engagement has been extensively studied, but more information is needed on how teacher-parent relationships vary for adolescents with different disabilities, varying socioeconomic backgrounds, and racial/ethnic backgrounds. This study investigates associations between teacher-parent relationships, teacher-student relationships, student's disability, socioeconomic status, racial/ethnic backgrounds, and school performance among 228 high school students. Cross-sectional data were gathered through student and teacher reports. Findings from correlational analyses reveal associations between (a) teacher-student and teacher-parent relationships, (b) teacher-parent relationships and students' disability type and socioeconomic status, and (c) teacher-parent relationships and students' grades, behavior, and engagement in school. Implications for research and practice are discussed.

An internal locus of control has benefits to individuals across multiple life domains, but little is known about associations between "career" locus of control (CLOC) and adjustment outcomes for adolescents with disabilities or at risk of academic failure. This exploratory study used data from 252 high school students to examine associations between CLOC and indicators of school- and career-related adjustment for high-need youth. Findings indicated that an internal CLOC contributed significantly to explaining variances in school bonding, engagement, career self-efficacy, and outcome expectations. Results also showed that adolescent girls with disabilities scored higher on external CLOC compared to boys with disabilities and boys and girls without disabilities. However, there were no moderation effects of ability status or gender on the strengths of CLOC and adjustment associations. Implications for research and practice were discussed in the context of study limitations.

Introduction: Social support is important for many youth but may be particularly important for English learners (ELs) with disabilities, a population that has historically faced barriers accessing resources to meet their educational needs. The current study investigates social support from parents, peers, teachers, and schools in a nationally representative sample of adolescents. Method: Data from the National Longitudinal Transition Study 2012 was used to evaluate potential group differences in social support among participants that included ELs with (n = 440) and without disabilities (n = 100) and non‐ELs with (n = 4890) and without disabilities (n = 1090). A multivariate analysis of covariance was conducted to evaluate potential between‐group variations in social support among these student groups after controlling for variations in background demographic characteristics. Results and Conclusions: Results showed between group differences in parental support and peer connectedness but not in teacher or school support. Parents of students with disabilities reported the highest levels of support, whereas parents of ELs without disabilities reported the lowest levels of support. Students with disabilities reported the lowest levels of peer connectedness among the four groups. Overall, levels of teacher and school supports were high across all four groups of students. These patterns contribute to our understanding of the social support network of ELs with disabilities in comparison to other students. Further investigation is needed to examine the mechanisms that contribute to these differences. [ABSTRACT FROM AUTHOR]

In facilitating prosocial identity formation and preventing recidivism among adjudicated youth upon reentry to school and community, one key issue to address is the confidentiality of juvenile records. Educators can support young offenders by teaching youth to problem-solve the disclosure of past juvenile involvements. This article discusses two lessons that aim to help adjudicated youth take responsibility for past mistakes, use discretion when discussing their history, and communicate future goals to potential employers.

BackgroundThe aim of this study was to compare the reproducibility, agreement, and sensitivity of pulsed-wave Doppler tissue imaging (DTI) versus spectral Doppler assessment of right ventricular (RV) myocardial performance index (MPI) in midgestation fetuses in both a normal and a disease state.MethodsRV MPI was calculated using pulsed-wave DTI and spectral Doppler in normal pregnancies (n = 69) and in women with pregestational diabetes (n = 51). Intraobserver and interobserver variability and agreement were evaluated using Bland-Altman analysis. Student's t tests were used for comparisons of differences.ResultsIn normal fetuses, RV MPI derived by the two methods showed no statistical difference, were interchangeable (DTI, 0.51 ± 0.10; spectral Doppler, 0.50 ± 0.12; P = .686), and were in agreement by Bland-Altman analysis. However, in fetuses of mothers with diabetes, the two methods produced different RV MPI measurements (DTI, 0.56 ± 0.10; spectral Doppler, 0.51 ± 0.12; P < .001). Intraobserver and interobserver bias was lower for DTI.ConclusionsThe DTI method of measuring fetal RV MPI is more sensitive, has less variability and more precision, and is better able to demonstrate subtle abnormalities in cardiac function than the spectral Doppler method in diabetic versus normal pregnancies.

This exploratory study investigated linkages between parent, peer, teacher, and mentor relationships and adjustment among adolescents with disabilities. The sample included 228 high school students with disabilities (65% male, 50% White) across four states. Overall findings indicate that students' social relationships were significantly associated with life satisfaction, problem behaviors, and school bonding and that teacher-student relationships contributed significant unique variance to these outcomes over and above influences of parents and peers. An analysis of specific dimensions of relationships indicated that trust and alienation in teacher-student relationships were particularly strong predictors of adjustment. Mentors also contributed significantly to the life satisfaction of youth. Collectively, our findings indicate that nonfamilial adults significantly contributed to the overall well-being of youth with disabilities.

Author(s): Olga A Guryanova [1]; Kaitlyn Shank [1]; Barbara Spitzer [2]; Luisa Luciani [3]; Richard P Koche [4, 5]; Francine E Garrett-Bakelman [6]; Chezi Ganzel [7]; Benjamin H Durham [1]; [...]

This study used multilevel modeling to examine the extent to which secondary special educators promoted nonacademic behaviors that were positively linked to postschool outcomes for students with disabilities, including self-advocacy, goal setting and attainment, disability awareness, employment, and utilization of supports. Respondents were 248 special educators in 20 states. Results showed that between-state factors accounted for significant variance in transition practices and that teachers reported teaching skills related to disability awareness, self-advocacy, goal setting and attainment, and utilization of supports more frequently than those related to employment. Limitations of the study, suggestions for future research, and implications for practice are discussed.