Metasynthesis of Youth Suicidal Behaviours: Perspectives of Youth,Parents, and Health Care Professionals

BackgroundYouth suicide is a major public health issue throughout the world. Numerous theoretical models have been proposed to improve our understanding of suicidal behaviours, but medical science has struggled to integrate all the complex aspects of this question. The aim of this review is to synthesise the views of suicidal adolescents and young adults, their parents, and their healthcare professionals on the topics of suicidal behaviour and management of those who have attempted suicide, in order to propose new pathways of care, closer to the issues and expectations of each group.ConclusionThe violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences.     

How Consistently are Good Parents Good Parents? Repeatability of Parental Care in the House Sparrow,Passer domesticus

In many avian species, substantial individual variation occurs in parental food‐provisioning levels, which often is assumed to reflect variation in parental quality. Parental quality also has often been invoked as a key element in mate choice among biparental species, and many sexually‐selected traits have been investigated as potential predictors of parental quality. In recent studies of house sparrow (Passer domesticus) parents, we found that individuals behaved remarkably consistently across time, regardless of temporary manipulations of the nestling provisioning of their partners. This suggests that variation in parental competence may be attributable to quality differences among individuals. One prediction of the ‘parental quality differences’ hypothesis is that individuals also should show consistency in their provisioning behavior across broods. To test this, we compared the parental delivery rates of individual house sparrows across broods. Parents of both sexes reduced their per‐chick delivery rates as the season progressed; parents of both sexes were also responsive to changes in their brood sizes. Despite these sources of environmental variation in provisioning rates, the parental care of individual males was highly repeatable across broods. By contrast, female parental care showed extremely low repeatability, and standardized measures of among‐individual variation in parental behavior revealed females to be much less variable than males. These results indicate that females in this multi‐brooded species have much to gain from mate‐choice decisions predicated on male parental quality or accurate indicators of such, whereas males are less likely to profit from being highly selective about the ‘parental quality’ of their partners.     

Intersecting Cultures in Deaf Mental Health: An Ethnographic Study of NHS Professionals Diagnosing Autism in D/deaf Children

Autism assessments for children who are deaf are particularly complex for a number of reasons, including overlapping cultural and clinical factors. We capture this in an ethnographic study of National Health Service child and adolescent mental health services in the United Kingdom, drawing on theoretical perspectives from transcultural psychiatry, which help to understand these services as a cultural system. Our objective was to analyse how mental health services interact with Deaf culture, as a source of cultural-linguistic identity. We ground the study in the practices and perceptions of 16 professionals, who have conducted autism assessments for deaf children aged 0–18. We adopt a framework of intersectionality to capture the multiple, mutually enforcing factors involved in this diagnostic process. We observed that professionals working in specialist Deaf services, or with experience working with the Deaf community, had intersectional understandings of assessments: the ways in which cultural, linguistic, sensory, and social factors work together to produce diagnoses. Working with a diagnostic system that focuses heavily on ‘norms’ based on populations from a hearing culture was a key source of frustration for professionals. We conclude that recognising the intersectionality of mental health and Deaf culture helps professionals provide sensitive diagnoses that acknowledge the multiplicity of D/deaf experiences.     

Sex Differences in Mental Rotation and How They Add to the Understanding of Autism

The most consistent cognitive sex differences have been found in the visuo-spatial domain, using Mental Rotation (MR) tasks. Such sex differences have been suggested to bear implications on our understanding of autism spectrum disorders (ASD). However, it is still debated how the sex difference in MR performance relates to differences between individuals with ASD compared to typically developed control persons (TD). To provide a detailed exploration of sex differences in MR performance, we studied rotational (indicated by slopes) and non-rotational aspects (indicated by intercepts) of the MR task in TD individuals (total N = 50). Second-to-fourth digit length ratios (2D:4D) were measured to investigate the associations between prenatal testosterone and performance on MR tasks. Handedness was assessed by the use of the Edinburgh Handedness Inventory in order to examine the relation between handedness and MR performance. In addition, we investigated the relation of spatial to systemising abilities, both of which have been associated with sex differences and with ASD, employing the Intuitive Physics Test (IPT). Results showed a male advantage in rotational aspects of the MR task, which correlated with IPT results. These findings are in contrast to the MR performance of individuals with ASD who have been shown to outperform TD persons in the non-rotational aspects of the MR task. These results suggest that the differences in MR performance due to ASD are different from sex-related differences in TD persons, in other words, ASD is not a simple and continuous extension of the male cognitive profile into the psychopathological range as the extreme male brain hypothesis (EMB) of ASD would suggest.     

Opinions of Youngsters with Congenital Below-Elbow Deficiency,and Those of Their Parents and Professionals Concerning Prosthetic Use and Rehabilitation Treatment

Background

Youngsters with unilateral congenital below-elbow deficiency (UCBED) seem to function well with or without a prosthesis. Reasons for rejecting prostheses have been reported earlier, but unfortunately not those of the children themselves. Furthermore, reasons for acceptance are underexplored in the literature.

Objectives

To investigate opinions of children and early and late adolescents with UCBED, and those of their parents and healthcare professionals, concerning (1) reasons to wear or not to wear prostheses and (2) about rehabilitation care.

Methods

During one week of online focus group interviews, 42 children of 8–12 y/o, early and late adolescents of 13–16 and 17–20 y/o, 17 parents, and 19 healthcare professionals provided their opinions on various topics. This study addresses prosthetic use or non-use of prosthetics and rehabilitation care. Data were analyzed using the framework approach.

Results

Cosmesis was considered to be the prime factor for choosing and wearing a prosthesis, since this was deemed especially useful in avoiding stares from others. Although participants functioned well without prostheses, they agreed that it was an adjuvant in daily-life activities and sports. Weight and limited functionality constituted rejection reasons for a prosthesis. Children and adolescents who had accepted that they were different no longer needed the prosthesis to avoid being stared at. The majority of participants highly valued the peer-to-peer contact provided by the healthcare professionals.

Conclusions

For children and adolescents with UCBED, prostheses appeared particularly important for social integration, but much less so for functionality. Peer-to-peer contact seemed to provide support during the process of achieving social integration and should be embedded in the healthcare process.     

Mechanisms Underlying Microbial-Mediated Changes in Social Behavior in Mouse Models of Autism Spectrum Disorder

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Information following a Diagnosis of Congenital Heart Defect: Experiences among Parents to Prenatally Diagnosed Children

BackgroundPrenatal screening of pregnant women in Sweden has improved the detection of major congenital heart defects (CHD). The aim was to explore parental experiences and need for information following a prenatal diagnosis of CHD.MethodsSemi-structured interviews conducted with six fathers and five mothers to seven prenatally diagnosed children. Data were analyzed through content analysis.ResultsThree themes and 9 categories emerged. Theme 1, Grasping the facts today while reflecting on the future, containing five categories: Difficulties sorting out information when in emotional chaos; Respectful information regarding termination of pregnancy; Early information is crucial; Understanding the facts regarding the anomaly; Preparing for the future. Theme 2, Personal contact with medical specialists who give honest and trustworthy information is valued, containing two categories: Trust in information received from medical specialists and Truth and honesty is valued. Theme 3, An overwhelming amount of information on the Internet, containing two categories: Difficulties in finding relevant information and Easy to focus on cases with a poor outcome when searching the Internet.ConclusionEarly and honest information in line with individual preferences is crucial to support the decisional process regarding whether to continue or terminate the pregnancy. The use of illustrations is recommended, as a complement to oral information, as it increases comprehension and satisfaction with obtained information. Furthermore, the overwhelming amount of information on the Internet calls for compilation of easily accessible and reliable information sources via the Internet.     

Developing the Autism Model of Implementation for Autism spectrum disorder community providers: study protocol

ABSTRACT: BACKGROUND: Currently, 1 out of 88 children are diagnosed with an autism spectrum disorder (ASD), and the estimated cost for treatment services is $126 billion annually. Typically, ASD community providers (ASD-CPs) provide services to children with any severity of ASD symptoms using a combination of various treatment paradigms, some with an evidence-base and some without. When evidence-based practices (EBPs) are successfully implemented by ASD-CPs, they can result in positive outcomes. Despite this promise, EBPs are often implemented unsuccessfully and other treatments used by ASD-CPs lack supportive evidence, especially for school-age children with ASD. While it is not well understood why ASD-CPs are not implementing EBPs, organizational and individual characteristics likely play a role. As a response to this need and to improve the lives of children with ASD and their families, this study aims to develop and test the feasibility and acceptability of the Autism Model of Implementation (AMI) to support the implementation of EBPs by ASD-CPs. Methods/design An academic-community collaboration developed to partner with ASD-CPs will facilitate the development of the AMI, a process specifically for use by ASD community-based agencies. Using a mixed methods approach, the project will assess agency and individual factors likely to facilitate or hinder implementing EBPs in this context; develop the AMI to address identified barriers and facilitators; and pilot test the AMI to examine its feasibility and acceptability using a specific EBP to treat anxiety disorders in school-age children with ASD. DISCUSSION: The AMI will represent a data-informed approach to facilitate implementation of EBPs by ASD-CPs by providing an implementation model specifically developed for this context. This study is designed to address the real-world implications of EBP implementation in ASD community-based agencies. In doing so, the AMI will help to provide children with ASD the best and most effective services in their own community. Moreover, the proposed study will positively impact the field of implementation science by providing an empirically supported and tested model of implementation to facilitate the identification, adoption, and use of EBPs.     

How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

Background

According to the Chagas congenital transmission guides, the diagnosis of infants, born to Trypanosoma cruzi infected mothers, relies on the detection of parasites by INP micromethod, and/or the persistence of T. cruzi specific antibody titers at 10–12 months of age.

Methodology and Principal Findings

Parasitemia levels were quantified by PCR in T. cruzi-infected children, grouped according to the results of one-year follow-up diagnosis: A) Neonates that were diagnosed in the first month after delivery by microscopic blood examination (INP micromethod) (n = 19) had a median parasitemia of 1,700 Pe/mL (equivalent amounts of parasite DNA per mL); B) Infants that required a second parasitological diagnosis at six months of age (n = 10) showed a median parasitemia of around 20 Pe/mL and 500 Pe/mL at 1 and 6 months old, respectively, and C) babies with undetectable parasitemia by three blood microscopic observations but diagnosed by specific anti - T. cruzi serology at around 1 year old, (n = 22), exhibited a parasitemia of around 5 Pe/mL, 800 Pe/mL and 20 Pe/mL 1, 6 and 12 month after delivery, respectively. T. cruzi parasites were isolated by hemoculture from 19 congenitally infected children, 18 of which were genotypified as DTU TcV, (former lineage TcIId) and only one as TcI.

Significance

This report is the first to quantify parasitemia levels in more than 50 children congenitally infected with T. cruzi, at three different diagnostic controls during one-year follow-up after delivery. Our results show that the parasite burden in some children (22 out of 51) is below the detection limit of the INP micromethod. As the current trypanocidal treatment proved to be very effective to cure T. cruzi - infected children, more sensitive parasitological methods should be developed to assure an early T. cruzi congenital diagnosis.     

How Subdiffusion Changes the Kinetics of Binding to a Surface

Under molecular crowding conditions, biopolymers have been reported to subdiffuse, ?r²(t)? ? t^α, with 0 < α < 1. Here we study the exchange dynamics of such a subdiffusing particle with a reactive boundary using a continuous time random walk approach. We derive the generalized boundary condition and consider the unbinding from the boundary. An ensuing weak ergodicity breaking has profound consequences for material exchange between the boundary and bulk. We discuss the effects in biological contexts such as gene regulation or membrane-bulk exchange processes. We also suggest various methods to experimentally probe the subdiffusive behavior.