Parenting is related to the development of callous-unemotional (CU) traits (i.e. low empathy and restricted guilt), making it an important target of interventions for childhood conduct problems (CPs). However, the relative importance of different parenting features in relation to the development of CU traits remains unclear. This study used machine learning to examine multiple parenting features assessed across infancy and early childhood as predictors of CU traits and CPs in early adolescence.

Data were from the Family Life Project (N = 1,292; 49% female, 41% Black, and 28% below the poverty line). Seventy-four parenting predictors were assessed at eight time points between children aged 6–90 months using parent-reported questionnaires and observer ratings of videotaped interactions and home visits. CU traits and CPs were assessed via parent-reported questionnaires in preadolescence (12–14 years).

Parenting features explained 8.2% of CU traits variability in preadolescence, with top predictors including early sensitive parenting and later behavior management and scaffolding practices. Prediction of CPs was weaker, with parenting explaining 4.5% of the variability.

Results highlight that disruption in close and sensitive early parent–child relationships is relevant to the development of CU traits. Results from the prediction of CPs indicate a more heterogeneous etiology. Findings support targeting parental sensitivity and behavior management within preventative interventions for CU traits and CPs.

This study aimed to examine the experiences of self-identification, diagnosis, and support for adults with tic disorders (including Tourette Syndrome) in the United Kingdom (UK).

Traditionally viewed as a neurological disorder of childhood-onset, tic disorders have been observed to remit or persist, often in a milder form, into adulthood. However, the reappearance of problematic symptoms after periods of asymptomatic latency might be more common than previously recognized. The medical exposure and standardization of clinical practice for primary adult-onset or non-typical adult-presenting cases of tic disorders is currently limited and poses barriers to diagnosis.

An online survey of 42 adults with self-identified tic symptomology explored their tic recognition and journey of attaining a confirmed diagnosis and/or self-identifying after the age of 18 in the UK.

No significant differences were found between adult and childhood-onset cases. Elevated scores on the Acceptance and Action Tic Specific Questionnaire (AAQ-T) correlated with higher overall frequency, intensity, and severity of motor tics from the Adult Tic Questionnaire (ATQ). The AAQ-T was also shown to negatively correlate with increasing age. Nearly all adults expressed dissatisfaction with the diagnostic process, especially regarding information provided and lack of post-diagnostic support. Those who self-identified quoted fear of dismissal, long waiting lists and lack of understanding from clinicians as reasons for not seeking a formal diagnosis. Overall, the results emphasize the importance for a standardized improved comprehension of tic conditions in healthcare including how to best support adults seeking recognition later in life.

To evaluate the safety and efficacy of two-stage arterial switch operation using bidirectional Glenn anastomosis combined with pulmonary artery banding in late-diagnosed dextro-transposition of the great arteries with intact ventricular septum.

This single-centre retrospective study included 24 children with late-diagnosed dextro-transposition of the great arteries with intact ventricular septum treated between 2020 and 2025, all with left ventricular mass index <35 g/m2 and banana-shaped geometry. Demographics, interventions, imaging, postoperative course, and follow-up data were collected. Haemodynamics, left ventricular retraining, complications, and survival were evaluated.

The cohort included 9 boys (37.5%) and 15 girls (62.5%), with a median age at first-stage surgery of 5 months (4–9.75). Patent ductus arteriosus was more common in patients without prior interventions (61.54% vs. 0%, p = 0.002). Additional surgical interventions performed concurrently with the first-stage BDG + pulmonary artery banding differed by prior-intervention status (p = 0.016). One mortality (4.17%) occurred due to sepsis in the no-prior group. Twenty-three patients proceeded to second-stage arterial switch (median interval 15 months, median age 22 months). In the prior-intervention group, post-second-stage ICU stay (median 5 vs. 4 days, p = 0.007) and inotrope use (median 4 vs. 3 days, p = 0.027) were longer. Two patients (8.7%) required ECMO (both prior group, resolved). At follow-up (1–4 years), all survivors were NYHA class I, with mild neo-aortic insufficiency in 52.17% and mild neo-pulmonary insufficiency in 13.04%.

Bidirectional Glenn anastomosis combined with pulmonary artery banding is a safe and effective strategy for gradual left ventricular retraining in late-diagnosed dextro-transposition of the great arteries with intact ventricular septum. It reduces perioperative morbidity and provides good survival and functional outcomes, which is valuable in resource-limited settings.

Children with attention-deficit/hyperactivity disorder (ADHD) frequently exhibit impairing emotional dysregulation along with inattention and hyperactivity. We aim to parse the heterogeneity of behavioral and emotional dysregulation in ADHD using latent brain factors based on cortical thickness (CT), and examine associated differences in intrinsic functional connectivity (iFC).

Data were collected from 123 children (39 ADHD, 47 ADHD with impairing emotional outbursts [ADHD + IEO], 37 neurotypical controls [NT], 5–9.9 years old). First, exploratory factor analysis revealed latent behavioral factors. Using Latent Dirichlet allocation, we decomposed heterogeneous CT patterns into parsimonious latent brain factors. We further investigated the functional relevance of brain regions showing structural differences in the ADHD + IEO group and examined associations between brain and behavioral latent factors.

Among the four behavioral factors identified (Externalizing, Emotion Dysregulation, Internalizing, and Surgency/Impulsivity), the dominant factor – Externalizing behavior – significantly differentiated the ADHD + IEO from the ADHD and NT groups. A conjunction analysis of the three brain factors revealed significantly thicker CT in the dorsolateral prefrontal cortex for ADHD + IEO compared to NT. Using this region as a seed, we found reduced functional connectivity primarily in the default mode network, which differentiated ADHD + IEO and ADHD groups. Structural brain and iFC measures showed significant associations with the Externalizing behavior factor.

Parsing the neurobiology underlying the heterogeneous presentation of ADHD requires integrating multiple modalities and analytical methods. This study demonstrates that combining behavioral, structural, and functional data reveals unique neural features associated with behavioral and emotional dysregulation.

Given the high prevalence of mental health challenges, the field of paediatric cardiology has increasingly recognised the need for integrated and embedded psychosocial programming in cardiology care. In response to this, the University of Michigan Congenital Heart Centre Psychosocial and Educational (M-COPE) Program was established in January 2020. This paper aims to describe the development, current structure, preliminary outcomes, and future directions of the M-COPE Program to inform similar programme development efforts.

Informed by a comprehensive needs assessment (group/individual interviews, patient surveys), the M-COPE Program mission centres on expanding (1) psychosocial clinical services, (2) psychosocial research, (3) mental health training for all learners, and (4) advocacy for improved psychosocial care for paediatric cardiology patients and families.

In its first five years, the M-COPE Program has expanded access to mental health care by increasing the number of psychosocial clinicians, embedding psychology/perinatal psychiatry in select cardiology clinics, and developing novel modes of service delivery through collaborative efforts across our multidisciplinary teams. Training initiatives have included the development of cardiac psychology fellowships and a mental health curriculum for cardiology physician fellows. Research is foundational to the programme, ranging from federally funded research to centre-specific quality improvement projects.

The M-COPE Program has become foundational to our heart centre. Future directions include enhancing psychosocial care at home for patients/caregivers, integration of a perinatal psychiatrist, and wider-scale launch of novel patient-focused initiatives. Continued study of programme impact will be ongoing with key metrics including referral patterns and patient/family outcomes.

To report on a volunteer-led program supporting local healthcare providers (L-HCPs) and disaster responders after the 2024 Noto Peninsula Earthquake, focusing on its implementation and immediate outcomes.

A volunteer-led initiative established by university alumni deployed medical teams to a local hospital on weekends following the earthquake, providing onsite support to relieve L-HCPs from prolonged strain. The program integrated information and communication technology (ICT) platforms to enable remote support, communication, and structured debriefing sessions for volunteers, facilitating assistance from a wider network.

The project effectively sustained the local health care institution’s capacity by managing diverse patient needs, including a surge in internal medical conditions. It provided essential respite, allowing local physicians crucial personal time, for which they expressed profound gratitude. Volunteer doctors reported effective stress management through the onsite and ICT-based support structure, and the initiative concluded safely without injury.

The project demonstrated that combining onsite medical assistance with strategically implemented ICT effectively mitigates burnout among L-HCPs, providing essential psychological support for deployed volunteers. The findings highlight the significance of sustained recovery-phase support, professional networks, and ICT in disaster response. These experiences highlight the need for comprehensive, system-wide support strategies for all frontline personnel in future disasters.

To monitor the influence of international trade and investment agreements on the food environment and population nutrition in Canada.

Implementation of a revised version of the INFORMAS trade and investment monitoring protocol to guide descriptive analysis of quantitative trade and investment data over the period 1994 to 2020 as well as qualitative review of policy documents related to nutrition regulations and trade concerns.

Canada, which has 15 trade and investment agreements in force with 51 countries as of 2024.

Extensive tariff reductions occurred in 1995 with the introduction of the World Trade Organization, with minimal tariff reductions since that time. Tariff rates were generally highest on ultra-processed focus foods, though many countries gained tariff-free access over the study period. There were large surges in imports of dairy, meats, sugars, and soft drinks after joining the WTO, while exports of grains, dairy, sugars, processed meats, ready-meals, and sauces saw substantial growth. FDI into Canada’s food manufacturing sector increased consistently, reaching $32.6 billion in 2020-2022. Canada has raised several specific trade concerns at the WTO over other countries’ nutrition labelling policies and some of the challenged policies have subsequently been abandoned, modified, or delayed.

Increased trade and investment openness in Canada appears linked to changes in food imports, exports, and foreign investment that may impact the nutritional quality of food environments. Monitoring how trade agreements shape national food supplies is critical to developing trade policies that improve nutrition in alignment with public health goals at home and abroad.

The intersection between the Assisted Decision-making (Capacity) Act 2022 (ADMCA) and the Mental Health Act, 2001 (MHA) has prompted considerable debate. Although not alone in its differential treatment of mental health and physical health advance healthcare directives (AHDs), Ireland is unique in affording legally binding status to mental health AHDs for some but not all inpatient service users detained under mental health legislation. As such, in this study we aim to compare groups of service users for which AHDs would be binding or not at point of detention and to track changes in binding status over the course of admission.

This is a retrospective observational study examining involuntary admissions to a 36 bedded acute psychiatric unit in Dublin from 2021 to 2023. Admissions were grouped into those initially detained on grounds of risk or on the treatment criterion alone, as this would determine binding status of a mental health AHD. We also examined changes to binding status over the course of admission to calculate median bed days when a service user would be entitled to a binding AHD. Descriptive statistics and inferential testing (Chi-squared and Mann–Whitney U) were used to analyse the data.

Of 287 admissions of 212 service users, 73.9% admissions were under the treatment criterion alone and would therefore qualify for a binding AHD. We found that diagnosis, mode of detention, and service division were significantly associated with AHD binding status. Service users would qualify for binding AHDs on 83.6% of involuntary bed days and, of those admissions affirmed by the first tribunal, 89.9% would qualify for binding AHDs in the days afterward.

Most involuntary service users would qualify for a legally binding AHD under the ADMCA for at least part of their admission. Should AHDs become common practice, binding AHDs will play a significant role in inpatient psychiatric care.