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This project surveyed Veterans’ COVID-19 vaccination beliefs and status. 1,080 (30.8%) Veterans responded. Factors associated with being unvaccinated, identified using binomial logistic regression, included negative feelings about vaccines (OR = 3.88, 95%CI = 1.52, 9.90) and logistical difficulties such as finding transportation (OR = 1.95, 95%CI = 1.01, 3.45). This highlights the need for education about and access to vaccination.
Exposure to maternal hyperglycemia in utero has been associated with adverse metabolic outcomes in offspring. However, few studies have investigated the relationship between maternal hyperglycemia and offspring cortisol levels. We assessed associations of gestational diabetes mellitus (GDM) with cortisol biomarkers in two longitudinal prebirth cohorts: Project Viva included 928 mother–child pairs and Gen3G included 313 mother–child pairs. In Project Viva, GDM was diagnosed in N = 48 (5.2%) women using a two-step procedure (50 g glucose challenge test, if abnormal followed by 100 g oral glucose tolerance test [OGTT]), and in N = 29 (9.3%) women participating in Gen3G using one-step 75 g OGTT. In Project Viva, we measured cord blood glucocorticoids and child hair cortisol levels during mid-childhood (mean (SD) age: 7.8 (0.8) years) and early adolescence (mean (SD) age: 13.2 (0.9) years). In Gen3G, we measured hair cortisol at 5.4 (0.3) years. We used multivariable linear regression to examine associations of GDM with offspring cortisol, adjusting for child age and sex, maternal prepregnancy body mass index, education, and socioeconomic status. We additionally adjusted for child race/ethnicity in the cord blood analyses. In both Project Viva and Gen3G, we observed null associations of GDM and maternal glucose markers in pregnancy with cortisol biomarkers in cord blood at birth (β = 16.6 nmol/L, 95% CI −60.7, 94.0 in Project Viva) and in hair samples during childhood (β = −0.56 pg/mg, 95% CI −1.16, 0.04 in Project Viva; β = 0.09 pg/mg, 95% CI −0.38, 0.57 in Gen3G). Our findings do not support the hypothesis that maternal hyperglycemia is related to hypothalamic–pituitary–adrenal axis activity.
The use of online platforms for pediatric healthcare research is timely, given the current pandemic. These platforms facilitate trial efficiency integration including electronic consent, randomization, collection of patient/family survey data, delivery of an intervention, and basic data analysis.
Methods:
We created an online digital platform for a multicenter study that delivered an intervention for sleep disorders to parents of children with autism spectrum disorder (ASD). An advisory parent group provided input. Participants were randomized to receive either a sleep education pamphlet only or the sleep education pamphlet plus three quick-tips sheets and two videos that reinforced the material in the pamphlet (multimedia materials). Three measures – Family Inventory of Sleep Habits (FISH), Children’s Sleep Habits Questionnaire modified for ASD (CSHQ-ASD), and Parenting Sense of Competence (PSOC) – were completed before and after 12 weeks of sleep education.
Results:
Enrollment exceeded recruitment goals. Trial efficiency was improved, especially in data entry and automatic notification of participants related to survey completion. Most families commented favorably on the study. While study measures did not improve with treatment in either group (pamphlet or multimedia materials), parents reporting an improvement of ≥3 points in the FISH score showed a significantly improved change in the total CSHQ (P = 0.038).
Conclusion:
Our study demonstrates the feasibility of using online research delivery platforms to support studies in ASD, and more broadly, pediatric clinical and translational research. Online platforms may increase participant inclusion in enrollment and increase convenience and safety for participants and study personnel.
There is evidence that Cognitive Behaviour Therapy for Psychosis (CBTp) is an effective intervention for reducing psychotic symptoms. The recently updated Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines (RANZCP CPG) recommend CBTp for the therapeutic management of schizophrenia and related disorders. Translational research is required to examine how well CBTp can be applied into public mental health services. This feasibility study aimed to provide preliminary evidence on how acceptable, implementable, and adaptable individual or group CBTp may be within a public mental health service in Australia. Twenty-seven participants initially agreed to participate in the study with 16 participants being randomised to either group or individual therapy, 11 starting therapy and 7 completing therapy. The intervention involved approximately 20 h of manualised CBTp. Attendance was higher in the individual therapy. Subjective reports indicated that the therapy was acceptable to all completers. Participants who engaged in individual or group CBTp experienced a similar level of reduction in the severity of hallucinations and delusions. Individual CBTp may be a feasible, acceptable, and effective intervention to include in Australian public mental health services. A pilot trial is now required to provide further evidence for and guidance of how best to translate CBTp protocols to Australian mental health services.
Several research teams have previously traced patterns of emerging conduct problems (CP) from early or middle childhood. The current study expands on this previous literature by using a genetically-informed, experimental, and long-term longitudinal design to examine trajectories of early-emerging conduct problems and early childhood discriminators of such patterns from the toddler period to adolescence. The sample represents a cohort of 731 toddlers and diverse families recruited based on socioeconomic, child, and family risk, varying in urbanicity and assessed on nine occasions between ages 2 and 14. In addition to examining child, family, and community level discriminators of patterns of emerging conduct problems, we were able to account for genetic susceptibility using polygenic scores and the study's experimental design to determine whether random assignment to the Family Check-Up (FCU) discriminated trajectory groups. In addition, in accord with differential susceptibility theory, we tested whether the effects of the FCU were stronger for those children with higher genetic susceptibility. Results augmented previous findings documenting the influence of child (inhibitory control [IC], gender) and family (harsh parenting, parental depression, and educational attainment) risk. In addition, children in the FCU were overrepresented in the persistent low versus persistent high CP group, but such direct effects were qualified by an interaction between the intervention and genetic susceptibility that was consistent with differential susceptibility. Implications are discussed for early identification and specifically, prevention efforts addressing early child and family risk.
Schmidt-hammer exposure-age dating (SHD) was applied at 15 sites with glacially-transported granite boulders in parts of northern and western Ireland and southwest Scotland that had been exposed by retreat of the last British-Irish Ice Sheet (BIIS) or Younger Dryas (YD) ice masses. Seven of these surfaces had previously been dated using terrestrial cosmogenic nuclide (TCN) exposure-age dating. Application of the granite calibration equation of Tomkins et al. (2018c) indicated a close correspondence between the SHD ages and the TCN ages (within 1σ or 2σ uncertainties). These findings demonstrate that SHD ages can be of comparable accuracy, precision, and reliability to TCN ages and are a strong argument for the more extensive use of SHD in some Quaternary dating projects. However, surface ages obtained by both SHD and TCN dating should not be accepted uncritically; they must be assessed in relation to the wider geological, geomorphological, and geochronological evidence. Evaluation of eight SHD ages, for which corresponding TCN ages are not available, indicate that most are consistent with current theory and field evidence, but some anomalous age estimates occur.
Little is known about olfactory identification (OI) function in early-onset Alzheimer’s disease (EOAD) and early-onset mild cognitive impairment (eoMCI) with age of onset <65 years. We aimed to study OI in EOAD compared with eoMCI and age-matched healthy controls (HC). Nineteen EOAD subjects with mild to moderate dementia, 17 with eoMCI, and 21 HC recruited as a convenience sample from memory services were assessed for cognition, behavioral symptoms, and activities for daily living. The OI was tested using the University of Pennsylvania smell identification test (UPSIT). EOAD participants performed worse compared with eoMCI and HC on cognitive tests and OI (p < 0.001). Although eoMCI had poorer cognitive scores compared to HC, they were similar in their OI function. OI correlated with attention (r = 0.494, p = 0.031), executive functions (r = 0.508, p = 0.026), and praxis (r = 0.455, p = 0.05) within the EOAD group. OI impairment was significantly associated with the diagnosis of EOAD versus eoMCI, but not with eoMCI when compared with HC. OI could potentially be useful in differentiating EOAD from eoMCI. Studies with late-life MCI patients showing OI impairment relative to HC may be attributed to a different disease process. Independent replication in a larger sample is needed to validate these findings.
Several studies suggest that neighborhood deprivation is a unique risk factor in child and adolescent development of problem behavior. We sought to examine whether previously established intervention effects of the Family Check-Up (FCU) on child conduct problems at age 7.5 would persist through age 9.5, and whether neighborhood deprivation would moderate these effects. In addition, we examined whether improvements in parent–child interaction during early childhood associated with the FCU would be related to later reductions in child aggression among families living in the highest risk neighborhoods. Using a multisite cohort of at-risk children identified on the basis of family, child, and socioeconomic risk and randomly assigned to the FCU, intervention effects were found to be moderated by neighborhood deprivation, such that they were only directly present for those living at moderate versus extreme levels of neighborhood deprivation. In addition, improvements in child aggression were evident for children living in extreme neighborhood deprivation when parents improved the quality of their parent–child interaction during the toddler period (i.e., moderated mediation). Implications of the findings are discussed in relation to the possibilities and possible limitations in prevention of early problem behavior for those children living in extreme and moderate levels of poverty.
Languages differ in how they encode events. Some languages (e.g., English) encode manner of motion (e.g., hop) in verbs while others (e.g., Spanish) encode the path of motion (e.g., descender-descend) (Talmy, 1985). This study examines verb construal in Japanese bilingual adults (L1-Japanese, L2-English). Maguire, Hirsh-Pasek, Golinkoff, Imai, Haryu, Vanegas, Okada, Pulverman and Sanchez-Davis (2010) suggest that although Japanese is traditionally considered a path language, manner plays an important role in Japanese verbs. Bilinguals completed two verb construal tasks (one in English; one in Japanese). Results showed that the Japanese bilinguals construed a novel verb as encoding manner for English and chose path for Japanese. This differs from Maguire et al. (2010) who found that Japanese monolinguals construed a novel verb as encoding manner. Bilinguals may find it useful to highlight differences between Japanese and English to keep the two languages distinct. Bilingual verb construal may be influenced by the linguistic typology of bilinguals’ L1 and L2.
Information-processing speed and cue reactivity were evaluated in women with bulimia nervosa and controls in response to neutral, mood, and food cues in isolation, and mood and food cues in combination. Significant differences were consistently observed between women with bulimia nervosa and control women on information-processing speed for food/body-related words, but not for words unrelated to food/body concerns. As expected, women with bulimia nervosa demonstrated slower processing of information related to food/body concerns. In addition, the presentation of mood and food cues affected speed of information processing. Especially for women with bulimia nervosa, information processing was slowest when either mood or food cues were presented in isolation. Significant cue reactivity was also observed, again especially for women with bulimia nervosa. In conclusion, both transient and more enduring subject characteristics affected information-processing speed. Moreover, the way transient factors were presented significantly affected speed of information processing. This suggests a more complex relationship between cue presentation and information processing than was anticipated.
Studies examining the musical mood induction procedure (MMIP) currently typically involve the experimenter preselecting a piece of music for use with all subjects. This assumes that the same piece of music will be equally effective at eliciting low mood for all subjects. The validity of this assumption was evaluated among 12 bulimic and 12 control women. Subjects listened to seven preselected pieces of music and rated them according to how likely it would be that the piece of music would help them to lower their mood / feel sad. Analysis showed that subjects were highly individual in their responses, and that it could not be assumed that the same piece of music would be equally effective at eliciting low mood across subjects.
This study examined dimensions of callous behaviors in early childhood and the role of these behaviors in the development of conduct problems, as well as responsiveness to a family-centered preventative intervention. Caregiver reports of callous behaviors were examined using exploratory and confirmatory factor analysis. Problem behavior was examined using within- and cross-informant reports of these behaviors. Parenting was measured using observational methods within the context of a randomized control trial of the Family Check-Up with a sample of 731 ethnically diverse boys and girls (followed from ages 2 to 4) at high risk for later conduct problems. Results demonstrated that a measure of deceitful–callous (DC) behaviors had acceptable factor loadings and internal consistency at ages 3 and 4. DC behaviors at age 3 predicted problem behavior concurrently and longitudinally within and across informant. However, DC behaviors did not reduce the effectiveness of the family preventative intervention. These findings have implications for our understanding of behaviors that may precede later callous–unemotional traits and for our understanding of the development and prevention of early starting conduct problems.
The objective of this study was to evaluate associations between adverse outcomes in twin pregnancies and preterm prelabour rupture of membranes (PPROM). A chart review of 246 consecutive twin pregnancies with confirmed PPROM was conducted. Regression analysis (β [natural log of the odds ratio] and odds ratio [OR]) was performed to identify independent predictors. Two hundred and forty-six twin pregnancies, 492 liveborns, and 20 neonatal deaths. Mean (SD) PPROM gestational age (GA): 31.3 (3.8) wk; delivery GA: 32.0 (3.3) wk. PPROM < 30wk was associated with increased parity (OR: 2.66), and log (admission leukocyte count) (OR: 9.99). Shortened latency was associated with PPROM GA (β = −0.17) and chorioamnionitis (β = 0.95). Neonatal sepsis was predicted by lower delivery GA (OR: 2.04). Adverse perinatal outcomes were protected against by older GA at PPROM (OR 0.53) and shortened latency (OR 0.73). It was concluded that increased leukocytosis and parity implies an infectious aetiology in earlier PPROM. Increased risk for neonatal sepsis at earlier delivery GA is consistent with gestation-dependent fetal immunocompetence. Early PPROM and long latencies were associated with increased adverse perinatal outcomes.
Maternal depression has been consistently linked to the development of child problem behavior, particularly in early childhood, but few studies have examined whether reductions in maternal depression serve as a mediator in relation to changes associated with a family-based intervention. The current study addressed this issue with a sample of 731 families receiving services from a national food supplement and nutrition program. Families with toddlers between ages 2 and 3 were screened and then randomized to a brief family intervention, the Family Check-Up, which included linked interventions that were tailored and adapted to the families needs. Follow-up intervention services were provided at age 3 and follow-up of child outcomes occurred at ages 3 and 4. Latent growth models revealed intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. The results are discussed with respect to targeting maternal depression in future intervention studies aimed at improving early child problem behavior.