Search

To be a desirable social partner and develop healthy relationships with peers, a child must be able to engage with peers across a variety of contexts. Understanding the factors supporting high levels of social engagement with peers is thereby essential, requiring the development of nuanced and ecologically valid indices of social engagement. Building on recent adult work, the current study explores conversational response time as a novel index of children's social engagement with peers in a dyadic context. This study further explores relationship between conversational response time and children's shyness. Fifty‐six 9‐ to 11‐year‐old children interacted with an unfamiliar peer in an unstructured setting and completed a self‐report measure of shyness. Children's behaviour was coded for their conversational RTs and overall social engagement. Faster conversational RTs were significantly related to children's own social engagement and marginally related to their partners' engagement. Moreover, higher shyness in children's partners predicted faster conversational RTs in children themselves. New directions for using conversational RT as an index of children's social engagement and implications for accounts children's social development are discussed. [ABSTRACT FROM AUTHOR]

Background: Among ambulatory people with incomplete spinal cord injury (iSCI), balance deficits are a primary factor limiting participation in walking activities. There is broad recognition that effective interventions are needed to enhance walking balance following iSCI. Interventions that amplify self-generated movements (e.g., error augmentation) can accelerate motor learning by intensifying sensorimotor feedback and facilitating exploration of motor control strategies. These features may be beneficial for retraining walking balance after iSCI. We have developed a cable-driven robot that creates a movement amplification environment during treadmill walking. The robot applies a continuous, laterally-directed, force to the pelvis that is proportional in magnitude to real-time lateral velocity. Our purpose is to investigate the effects of locomotor training in this movement amplification environment on walking balance. We hypothesize that for ambulatory people with iSCI, locomotor training in a movement amplification environment will be more effective for improving walking balance and participation in walking activities than locomotor training in a natural environment (no applied external forces). Methods: We are conducting a two-arm parallel-assignment intervention. We will enroll 36 ambulatory participants with chronic iSCI. Participants will be randomized into either a control or experimental group. Each group will receive 20 locomotor training sessions. Training will be performed in either a traditional treadmill environment (control) or in a movement amplification environment (experimental). We will assess changes using measures that span the International Classification of Functioning, Disability and Health (ICF) framework including 1) clinical outcome measures of gait, balance, and quality of life, 2) biomechanical assessments of walking balance, and 3) participation in walking activities quantified by number of steps taken per day. Discussion: Training walking balance in people with iSCI by amplifying the individual's own movement during walking is a radical departure from current practice and may result in new strategies for addressing balance impairments. Knowledge gained from this study will expand our understanding of how people with iSCI improve walking balance and how an intervention targeting walking balance affects participation in walking activities. Successful outcomes could motivate development of clinically feasible tools to replicate the movement amplification environment within clinical settings. Trial registration: NCT04340063. [ABSTRACT FROM AUTHOR]

Temperament, parenting, and executive functioning (EF) are individual and contextual factors that have been identified to play a role in the development of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. Specifically, exuberant temperament in toddlerhood has been associated with both adaptive and maladaptive outcomes, including ADHD symptoms. Therefore, it is important to understand factors that predict which exuberant children experience increased ADHD symptoms and the specific mechanisms through which early exuberant temperament impacts later ADHD symptoms. Using a multi-method, prospective longitudinal design, this study examined a moderated mediation model wherein the interactive effects of observed exuberance and parenting at age 3 predicted the development of parent-reported ADHD symptoms from childhood through adolescence (age 5, 7, 9, 12, and 15) via child EF (i.e., inhibitory control) at age 4. Parent–child dyads (n = 291) from a longitudinal study on child temperament were included. A piecewise model of ADHD symptom growth demonstrated stability in ADHD symptoms from age 5–9 and a decrease from age 9–15. Results support a moderated mediation model wherein an increase in ADHD symptoms throughout childhood was predicted from early childhood exuberant temperament by way of EF, but only for children whose parents displayed less directive parenting. Findings suggest identifiable early markers of risk, including temperament, parenting, and EF- pointing to possible targets for early intervention/prevention. [ABSTRACT FROM AUTHOR]

Background In the USA, nirmatrelvir/ritonavir is authorized for the treatment of mild-to-moderate COVID-19 in patients at least 12 years of age, at high risk for progression to severe COVID-19. Objectives To estimate the impact of outpatient nirmatrelvir/ritonavir on COVID-19 hospitalization risk in a US healthcare system. Methods We conducted a cohort study using electronic health records among outpatients with a positive SARS-CoV-2 PCR test between January and August 2022. We evaluated the association of nirmatrelvir/ritonavir therapy with time to hospitalization by estimating adjusted HRs and assessed the impact of nirmatrelvir/ritonavir on predicted COVID-19 hospitalizations using machine-learning methods. Results Among 44 671 patients, 4948 (11%) received nirmatrelvir/ritonavir, and 201 (0.4%) were hospitalized within 28 days of COVID-19 diagnosis. Nirmatrelvir/ritonavir recipients were more likely to be older, white, vaccinated, have comorbidities and reside in areas with higher average socioeconomic status. The 28 day cumulative incidence of hospitalization was 0.06% (95% CI: 0.02%–0.17%) among nirmatrelvir/ritonavir recipients and 0.52% (95% CI: 0.46%–0.60%) among non-recipients. For nirmatrelvir/ritonavir versus no therapy, the age-adjusted HR was 0.08 (95% CI: 0.03–0.26); the fully adjusted HR was 0.16 (95% CI: 0.05–0.50). In the machine-learning model, the primary features reducing predicted hospitalization risk were nirmatrelvir/ritonavir, younger age, vaccination, female gender and residence in a higher socioeconomic status area. Conclusions COVID-19 hospitalization risk was reduced by 84% among nirmatrelvir/ritonavir recipients in a large, diverse healthcare system during the Omicron wave. These results suggest that nirmatrelvir/ritonavir remained highly effective in a setting substantially different than the original clinical trials. [ABSTRACT FROM AUTHOR]

Behavioral inhibition (BI) is a temperamental style characterized by cautious and fearful behaviors in novel situations. The present multi‐method, longitudinal study examined whether young children's observed and parent‐reported BI in social versus non‐social contexts predicts different long‐term psychosocial outcomes. Participants (N = 279) were drawn from a longitudinal study of socioemotional development. BI in social contexts ("social BI") was measured via children's observed wariness toward unfamiliar adults and peers at 24 and 36 months and parents' reports of children's social fear/shyness at 24, 36, and 48 months. BI in non‐social contexts ("non‐social BI") was measured via children's observed fearful responses to masks and novel toys, and parents' reports of children's distress to non‐social novelty at 9 months and non‐social fear at 48 months. At 15 years, anxiety was assessed via adolescent‐ and parent‐reports, and global internalizing and externalizing problems were assessed via parent‐reports. Confirmatory factor analysis showed that a two‐factor model fit the BI data significantly better than a single‐factor model, providing evidence for the dissociation of BI in social versus non‐social contexts. Social BI was uniquely associated with adolescent social anxiety, whereas non‐social BI was specifically associated with adolescent separation anxiety. Neither social BI nor non‐social BI predicted global internalizing and externalizing problems, providing evidence for the specific relations between BI and anxiety problems. Together, these results suggest that young children's inhibited responses in social versus non‐social situations predict different subtypes of anxiety problems in adolescence, highlighting the multifaceted nature of BI and the divergent trajectories of different anxiety problems. [ABSTRACT FROM AUTHOR]

It has been theorized that the contagion of behaviors may be related to social cognitive abilities, but empirical findings are inconsistent. We recorded young adults' behavioral expression of contagious yawning and contagious smiling to video stimuli and employed a multi-method assessment of sociocognitive abilities including self-reported internal experience of emotional contagion, self-reported trait empathy, accuracy on a theory of mind task, and observed helping behavior. Results revealed that contagious yawners reported increases in tiredness from pre- to post-video stimuli exposure, providing support for the internal experience of emotional contagion, and were more likely to provide help to the experimenter relative to non-contagious yawners. Contagious smilers showed stably high levels of self-reported happiness from pre- to post-video exposure, were more likely to provide help to the experimenter, and had increased accuracy on a theory of mind task relative to non-contagious smilers. There were no differences in self-reported trait empathy for contagious versus non-contagious yawners or smilers. Contagious yawning may be related to some basic (i.e., emotional contagion) and advanced (i.e., helping behavior) sociocognitive processes, whereas contagious smiling is related to some advanced sociocognitive processes (i.e., theory of mind and helping behavior). [ABSTRACT FROM AUTHOR]

Background: There is evidence that ambulatory people with incomplete spinal cord injury (iSCI) have an impaired ability to control lateral motion of their whole- body center of mass (COM) during walking. This impairment is believed to contribute to functional deficits in gait and balance, however that relationship is unclear. Thus, this cross-sectional study examines the relationship between the ability to control lateral COM motion during walking and functional measures of gait and balance in people with iSCI. Methods: We assessed the ability to control lateral COM motion during walking and conducted clinical gait and balance outcome measures on 20 ambulatory adults with chronic iSCI (C1-T10 injury, American Spinal Injury Association Impairment Scale C or D). To assess their ability to control lateral COM motion, participants performed three treadmill walking trials. During each trial, real-time lateral COM position and a target lane were projected on the treadmill. Participants were instructed to keep their lateral COM position within the lane. If successful, an automated control algorithm progressively reduced the lane width, making the task more challenging. If unsuccessful, the lane width increased. The adaptive lane width was designed to challenge each participant's maximum capacity to control lateral COM motion during walking. To quantify control of lateral COM motion, we calculated lateral COM excursion during each gait cycle and then identified the minimum lateral COM excursion occurring during five consecutive gait cycles. Our clinical outcome measures were Berg Balance Scale (BBS), Timed Up and Go test (TUG), 10-Meter Walk Test (10MWT) and Functional Gait Assessment (FGA). We used a Spearman correlation analysis (ρ) to examine the relationship between minimum lateral COM excursion and clinical measures. Results: Minimum lateral COM excursion had significant moderate correlations with BBS (ρ=-0.54, =0.014), TUG (ρ=0.59, p = 0.007), FGA (ρ=-0.59, p=0.007), 10MWT-preferred (ρ=-0.59, p = 0.006) and 10MWT-fast (ρ=-0.68, p = 0.001). Conclusion: Control of lateral COM motion during walking is associated with a wide range of clinical gait and balance measures in people with iSCI. This finding suggests the ability to control lateral COM motion during walking could be a contributing factor to gait and balance in people with iSCI. [ABSTRACT FROM AUTHOR]

Social connections are critical for mental and physical health; however, the developmental pathways to children's social connectedness outcomes are not well understood. This study examined the pathways from children's inhibitory control at 4 years to two social connectedness outcomes – loneliness and friendship quality at age 10 – through behavioral problems at age 7. As part of a longitudinal study (N = 291, 54% girls), children's inhibitory control was assessed via a Go/No-Go task when children were 4 years old. Mothers reported on children's behavioral problems at ages 4 and 7 years. Children reported on their friendship quality and loneliness at ages 7 and 10 years. Greater inhibitory control at 4 years predicted lower behavioral problems at 7 years, which in turn predicted better friendship quality and lower loneliness at 10 years. Indirect effects from inhibitory control at 4 years to loneliness and friendship quality at 10 years via behavioral problems at 7 years were significant. Findings suggest that inhibitory control in early childhood may play a key role for the development of social connectedness in middle childhood via its impact on children's behavioral problems. [ABSTRACT FROM AUTHOR]

Previous work has shown that children's shyness is related to personal anxiety during social stress, but we know little about how shyness is related to anxiety during a peer's social stress. Children (Mage = 10.22 years, SD = 0.81, N = 62) were paired with an unfamiliar peer and engaged in a speech task while electrocardiography was recorded. We modeled changes in children's heart rate, a physiological correlate of anxiety, while they observed their peer prepare and deliver a speech. Results revealed that the observing child's shyness related to increases in their heart rate during their peer's preparation period, but modulation of this arousal was sensitive to the presenting peer's anxious behavior while delivering their speech. Specifically, if the presenting child displayed high levels of anxious behavior, the observing child's shyness was related to further increases in heart rate, but if the presenting child displayed low levels of anxious behavior, the observing child's shyness was related to decreases in heart rate from the preparation period. Shy children may experience physiological arousal to a peer's social stress but can regulate this arousal based on social cues from the peer, which may be due to heightened social threat detection and/or empathic anxiety. [ABSTRACT FROM AUTHOR]

Extant research has produced conflicting findings regarding the link between social fearfulness and prosocial behavior, with some studies reporting negative relations and others reporting null effects. Furthermore, these studies have focused predominantly on toddlerhood, and few have examined prosociality between peers. The present study investigated whether the link between social anxiety and prosocial behavior (i.e., providing encouragement) varied depending on interpersonal and situational factors (i.e., one's familiarity with a peer, and the level of support sought by a peer, respectively). We tested this question using a multimethod approach, which included ecologically valid stress‐inducing task and dyadic design with a sample of 9‐ to 10‐year‐olds (N = 447). Results revealed that social anxiety was related negatively to providing encouragement among familiar and unfamiliar dyads. In familiar dyads, however, this main effect was qualified by an interaction with the level of support sought by one's peer. Compared to those low in social anxiety, children high in social anxiety provided relatively less encouragement in response to higher levels of support seeking from their peers. The findings are considered in relation to theorizing regarding the effect of overarousal on children's prosocial behavior. [ABSTRACT FROM AUTHOR]

Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within‐child and socio‐contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio‐contextual factors influence differential pathways to anxiety versus resilience. Read the Commentary on this article at doi: 10.1111/jcpp.13771. [ABSTRACT FROM AUTHOR]

The professionalization of the fields of health education and health promotion has largely coincided with the completion of job task analysis conducted by major organizations in the field (e.g., the National Commission for Health Education Credentialing, Society for Public Health Education). The process through which these job task analyses and skill-based competencies are implemented in professional preparation programs poses a risk to stifle advancement and innovation in health education and promotion. In this perspective, we discuss Competency Focused Practice (the current state of the field) to a goal of Philosophically Grounded Practice. We provide comparisons of the implications of these two schools of thought with respect to ethics, social determinants of health, and practical methods in health education and promotion. [ABSTRACT FROM AUTHOR]

Objective: This document is designed to outline the definition, pathogenesis, diagnostic modalities and therapeutic measures to treat antibody‐mediated rejection in children postheart transplant Methods: Literature review was conducted by a Pediatric Heart Transplant Society (PHTS) working group to identify existing pediatric and adult studies on antibody‐mediated rejection (AMR). In addition, the centers participating in PHTS were asked to submit their approach to diagnosis and management of pediatric AMR. This document synthesizes information gathered from both these sources to highlight a practical approach to diagnosing and managing a child with AMR postheart transplant. This document may not represent the practice at all centers in the PHTS and serves as a starting point to understand an approach to this clinical scenario. [ABSTRACT FROM AUTHOR]

This manuscript outlines a clinical approach to vasoplegia incorporating the current state of knowledge regarding vasoplegia in pediatric patients immediately post‐transplant and to identify modifiable factors both pre‐ and post‐transplant that may reduce post‐operative morbidity, end‐organ dysfunction, and mortality. Centers participating in the Pediatric Heart Transplant Society (PHTS) were asked to provide their internal protocols and rationale for vasoplegia management, and applicable adult and pediatric data were reviewed. The authors synthesized the above protocols and literature into the following description of clinical approaches to vasoplegia highlighting areas of both broad consensus and of significant practice variation. [ABSTRACT FROM AUTHOR]

Background Medically vulnerable individuals are at increased risk of acquiring multidrug-resistant Enterobacterales (MDR-E) infections. People with HIV (PWH) experience a greater burden of comorbidities and may be more susceptible to MDR-E due to HIV-specific factors. Methods We performed an observational study of PWH participating in an HIV clinical cohort and engaged in care at a tertiary care center in the Southeastern United States from 2000 to 2018. We evaluated demographic and clinical predictors of MDR-E by estimating prevalence ratios (PRs) and employing machine learning classification algorithms. In addition, we created a predictive model to estimate risk of MDR-E among PWH using a machine learning approach. Results Among 4734 study participants, MDR-E was isolated from 1.6% (95% CI, 1.2%–2.1%). In unadjusted analyses, MDR-E was strongly associated with nadir CD4 cell count ≤200 cells/mm3 (PR, 4.0; 95% CI, 2.3–7.4), history of an AIDS-defining clinical condition (PR, 3.7; 95% CI, 2.3–6.2), and hospital admission in the prior 12 months (PR, 5.0; 95% CI, 3.2–7.9). With all variables included in machine learning algorithms, the most important clinical predictors of MDR-E were hospitalization, history of renal disease, history of an AIDS-defining clinical condition, CD4 cell count nadir ≤200 cells/mm3, and current CD4 cell count 201–500 cells/mm3. Female gender was the most important demographic predictor. Conclusions PWH are at risk for MDR-E infection due to HIV-specific factors, in addition to established risk factors. Early HIV diagnosis, linkage to care, and antiretroviral therapy to prevent immunosuppression, comorbidities, and coinfections protect against antimicrobial-resistant bacterial infections. [ABSTRACT FROM AUTHOR]

The authors examined temperamental and sociocognitive predictors of socially anxious behavior from preschool to early adolescence. Children (N = 227; 59% male; 69% White) completed a speech task at ages 5, 7, 10, and 13 and socially anxious behaviors were coded. Behavioral inhibition (BI) was assessed at ages 2/3 and Theory of Mind (ToM) was assessed at age 4. Data collection occurred between 2003 and 2016. Three trajectories of socially anxious behavior were identified: high stable, average increasing, and low stable. Higher BI was related to the high stable trajectory, whereas lower ToM was related to the increasing trajectory of socially anxious behavior. There are heterogenous pathways of socially anxious behavior, which may be uniquely influenced by early temperamental and sociocognitive factors. [ABSTRACT FROM AUTHOR]

Recent models of psychopathology suggest the presence of a general factor capturing the shared variance among all symptoms along with specific psychopathology factors (e.g., internalizing and externalizing). However, few studies have examined predictors that may serve as transdiagnostic risk factors for general psychopathology from early development. In the current study we examine, for the first time, whether observed and parent-reported infant temperament dimensions prospectively predict general psychopathology as well as specific psychopathology dimensions (e.g., internalizing and externalizing) across childhood. In a longitudinal cohort (N = 291), temperament dimensions were assessed at 4 months of age. Psychopathology symptoms were assessed at 7, 9, and 12 years of age. A bifactor model was used to estimate general, internalizing, and externalizing psychopathology factors. Across behavioral observations and parent-reports, higher motor activity in infancy significantly predicted greater general psychopathology in mid to late childhood. Moreover, low positive affect was predictive of the internalizing-specific factor. Other temperament dimensions were not related with any of the psychopathology factors after accounting for the general psychopathology factor. The results of this study suggest that infant motor activity may act as an early indicator of transdiagnostic risk. Our findings inform the etiology of general psychopathology and have implications for the early identification for children at risk for psychopathology. [ABSTRACT FROM AUTHOR]

Background Multidrug-resistant Enterobacterales (MDR-E) are important pathogens. People living with human immunodeficiency virus (HIV; PLWH) may be at greater risk for MDR-E infection given relatively high antibiotic exposure and burden of comorbidities. Methods We analyzed data from 36 521 patients in a healthcare system in North Carolina who had a clinical culture with growth of an Enterobacterales species from 2000 to 2018; 440 were PLWH. We used generalized linear models to estimate prevalence ratios and differences, contrasting PLWH and people not living with HIV (PNLWH) for resistance to individual antibiotic classes, as well as MDR-E. We assessed trends in prevalence over time by calculating the 5-year moving average and fitting restricted cubic spline models. Results The overall prevalence of MDR-E was higher among PLWH (21.5%; 95% confidence interval [CI], 18.2%–25.1%) vs PNLWH (16.5%; 95% CI, 16.2%–16.9%), with an adjusted prevalence ratio of 1.38 (95% CI, 1.14–1.65). PLWH had higher rates of antimicrobial resistance than PNLWH for all antibiotic classes analyzed, including penicillins, penicillin/beta lactamase inhibitor combinations, and sulfonamides. MDR-E prevalence was 3 to 10 percentage points higher among PLWH than PNLWH throughout the study period based on the 5-year moving average. Conclusions In a large clinical study population in the southeastern United States from 2000 to 2018, the prevalence of antibacterial resistance among Enterobacterales was consistently higher among PLWH than PNLWH. These data highlight the importance of identifying and mitigating the factors that contribute to antimicrobial resistance in PLWH, given the potential clinical consequences of these resistant pathogens. [ABSTRACT FROM AUTHOR]

An abundance of literature has examined barriers to women's equitable representation in science, technology, engineering, and math (STEM) fields, with many studies demonstrating that STEM fields are not perceived to afford communal goals, a key component of women's interest in future careers. Using Goal Congruity Theory as a framework, we tested the longitudinal impact of perceptions of STEM career goal affordances, personal communal and agentic goal endorsements, and their congruity on persistence in science from the second through fourth years of college among women in STEM majors in the United States. We found that women's intent to persist in science were highest in the fall of their second year, that persistence intentions exhibited a sharp decline, and eventually leveled off by their fourth year of college. This pattern was moderated by perceptions of agentic affordances in STEM, such that women who believe that STEM careers afford the opportunity for achievement and individualism experienced smaller declines. We found that higher perceptions of communal goal affordances in STEM consistently predicted higher persistence intentions indicating women may benefit from perceptions that STEM affords communal goals. Finally, we found women with higher agentic affordances in STEM also had greater intentions to persist, and this relationship was stronger for women with higher agentic goals. We conclude that because STEM fields are stereotyped as affording agentic goals, women who identify interest in a STEM major during their first years of college may be drawn to these fields for this reason and may benefit from perceptions that STEM affords agentic goals. [ABSTRACT FROM AUTHOR]

Objectives: To explore misconceptions regarding addiction potential of prescription opioids among cancer survivors. Methods: A qualitative study using semi‐structured interviews were conducted with a purposive sample of cancer survivors (N = 25) treated with prescription opioids for pain management. Interviews were audio recorded, transcribed and coded using Atlas.ti version 8. Inductive applied thematic analysis techniques were employed to identify emergent themes. Results: The majority of participants were breast cancer survivors (88%) who underwent a combination of surgery, chemotherapy and radiation (72%). Thematic analysis revealed that (1) cancer survivors view opioids as an illicit drug, (2) media narrative of the opioid epidemic increased negative perception of opioid use for cancer‐related pain, (3) perceptions of opioids were also informed by experiences of friends and family with an opioid use disorder, (4) poor understanding of terminology resulted in misconceptions of opioid use and addiction and (5) fear of opioid addiction resulted in unrelieved cancer pain and poor quality of life. Conclusion: Our findings support previously identified concerns among cancer patients about fear of addiction to opioids, a barrier to effective pain management. It highlights the importance for health care providers caring for cancer survivors to continue to address misconceptions about prescribed opioids. [ABSTRACT FROM AUTHOR]

Introduction: Research suggests that certain parenting behaviors are best suited to promote optimal child development, depending on a child's distinctive temperamental presentation. This multimethod, longitudinal study examines the interactive effect of parenting and temperament in early childhood on the developmental trajectory of social anxiety in adolescence. Methods: Longitudinal growth modeling was used to examine the developmental trajectory of child social anxiety from age 9–15 and the interactive effect of parenting and child temperament at 36 months on the developmental trajectory of child social anxiety from age 9–15. Results: The slope of social anxiety from age 9–15 suggested a decrease in social anxiety throughout early adolescence. Furthermore, 36‐month behavioral inhibition (BI) predicted the trajectory of child social anxiety from age 9–15 when parents displayed low and high levels of dismissive and supportive parenting (at 36 months). Conclusions: Results support an interactive effect of infant temperament and parenting in early childhood (at 36 months) on the developmental trajectory of child social anxiety from age 9–15. Specifically, results suggest that engaging highly inhibited children with high supportive and low dismissive parenting may help reduce social anxiety over time in adolescence. Furthermore, parenting needs may differ for children high or low in BI to impact the developmental trajectory of social anxiety in adolescence, such that children who are high BI seem to benefit from low dismissive and high supportive parenting, and children who are low in BI seem to benefit more from high dismissive parenting. [ABSTRACT FROM AUTHOR]

Background: Although mortality has decreased considerably in pediatric heart transplantation, waitlist and post‐transplant death rates remain notable. End‐of‐life focused research in this population, however, is very limited. This Pediatric Heart Transplant Society study aimed to describe the circumstances surrounding death of pediatric heart transplant patients. Methods: A retrospective analysis of the multi‐institutional, international, Pediatric Heart Transplant Society registry was conducted. Descriptive statistics and univariate analyses were performed to 1) describe end‐of‐life in pediatric pre‐ and post‐heart transplant patients and 2) examine associations between location of death and technological interventions at end‐of‐life with demographic and disease factors. Results: Of 9217 patients (0–18 years) enrolled in the registry between 1993 and 2018, 2804 (30%) deaths occurred; 1310 while awaiting heart transplant and 1494 post‐heart transplant. The majority of waitlist deaths (89%) occurred in the hospital, primarily in ICU (74%) with most receiving mechanical ventilation (77%). Fewer post‐transplant deaths occurred in the hospital (22%). Out‐of‐hospital death was associated with older patient age (p <.01). Conclusions: ICU deaths with high use of technological interventions at end‐of‐life were common, particularly in patients awaiting heart transplant. In this high mortality population, findings raise challenging considerations for clinicians, families, and policy makers on how to balance quality of life amidst high risk for hospital‐based death. [ABSTRACT FROM AUTHOR]

Background: Routine surveillance protocols rely heavily on endomyocardial biopsy (EMB) for detection of rejection in pediatric heart transplant recipients. More sensitive echocardiographic tools to assess rejection may help limit the number of EMBs. This study compared changes in left ventricular (LV) strain in patients who had rejection versus those who did not. Methods: A single center retrospective review was conducted between 2013 and 2020. Patients were categorized based on rejection history. Echocardiograms were evaluated at the time of 2 consecutive EMBs; in the rejection group, the second echocardiogram was collected at the time of a rejection episode. Conventional measures of LV function and speckle‐tracking echocardiography‐derived longitudinal (LS) and circumferential strain (CS) were measured. Results: 17 patients were in the non‐rejection group and 17 were in the rejection group (30 total rejection episodes). The rejection group was older at the time of transplant (12.5 vs. 1.3 years, p =.01). A decline in CS was seen in the rejection group at the second echocardiogram [−18.5 (IQR −21.5, −14.6) to −15.7 (IQR −19.8, −13.2)] while CS improved in the non‐rejection group [−20.8 (IQR −23.9, −17.8) to −23.9 (IQR −24.9, −20.1)]. This difference in change reached significance (p =.02). A similar pattern was seen in LS that neared significance (p =.06). There was no significant difference in ejection fraction change (p =.24). Conclusions: Patients in the non‐rejection group displayed improvement in CS between echocardiograms while patients in the rejection group showed subsequent decline. Worsening of LV CS may help identify acute rejection in the early post‐transplant period. [ABSTRACT FROM AUTHOR]

Background: Social anxiety is amongst the most prevalent adolescent mental health problems; however, it is often unrecognized due to its comorbidity with other anxiety problems such as generalized anxiety. Thus, understanding the unique developmental pathways to social anxiety is critical for improving its prevention. We examined the pathway from maternal shyness, when children were 4 years old, to adolescents' social anxiety at age 15 through social wariness at age 7. We hypothesized that childhood social wariness would mediate the association between maternal shyness and social anxiety in adolescence. Methods: Participants (N = 291; 54% female) were followed from early childhood to adolescence. Mothers reported on their own shyness when children were 4 years old. Social wariness toward unfamiliar peers was observed in the laboratory at ages 4 and 7. Adolescent social anxiety and generalized anxiety were assessed via self‐report, parent‐report, and clinical diagnoses at age 15. Results: Maternal shyness was positively associated with adolescent social anxiety but not generalized anxiety at age 15. Higher levels of maternal shyness at age 4 predicted greater social wariness at age 7, which in turn predicted greater social anxiety but not generalized anxiety at age 15. Social wariness at age 7 partially mediated the association between maternal shyness and adolescent social anxiety. Conclusions: This study identifies a unique developmental pathway from maternal shyness to adolescent social anxiety. Findings suggest that childhood social wariness connects maternal shyness to adolescent social anxiety. [ABSTRACT FROM AUTHOR]

We examined behavioral and electrophysiological indices of self-referential and valence processing during a Self-Referential Encoding Task in 9- to 12-year-old children, followed by surprise memory tasks for self- and other-referential trait adjectives. Participants endorsed more positive than negative self-referential information but equally endorsed positive and negative information about the other character. Children demonstrated enhanced parietal LPP amplitudes in response to self- compared to other-referential trait adjectives. Positive and negative information was differentially remembered depending on the order of the referent cues presented, suggesting that social information undergoes differential consolidation processes depending on the referent and the order of presentation. [ABSTRACT FROM AUTHOR]

Purpose: Prescription opioid medication can be of great benefit for cancer patients and survivors who suffer from cancer-related pain throughout their cancer care trajectory. However, the current opioid epidemic has influenced how such medications are perceived. The purpose of this study was to explore the perceptions of opioid use and misuse in cancer survivorship within the context of the opioid epidemic. Methods: pt?>A qualitative study using a semi-structured interview was conducted with a purposive sample of health care professionals (n = 24), community-level stakeholders (n = 6), and cancer survivors (n = 25) using applied thematic analysis techniques. Results: Crosscutting themes include (1) fear of addiction and living with poorly managed pain, (2) the importance of good patient/provider communication and the need for education around the use/handling/disposal of prescription opioid medication, (3) preference for nonopioid alternatives for pain management, (4) cancer survivors perceived to be low risk for developing opioid use disorder (include inconsistent screening), and (5) impact of policies aimed at curbing the opioid epidemic on cancer survivors. Conclusion: This study illustrates the intersecting and sometimes conflicting assumptions surrounding the use of opioids analgesics in the management of cancer pain among survivors embedded within the national discourse of the opioid epidemic. Implications for Cancer Survivors: A system of integrated cancer care using psychosocial screening, opioid risk mitigation tools, opioid treatment agreements, and specialist expertise that cancer care providers can rely on to monitor POM use in conjunction with patient-centered communication to empower patients informed decision making in managing their cancer pain could address this critical gap in survivorship care. [ABSTRACT FROM AUTHOR]

Cancer survivors' perceptions of prescription opioid medication (POM) and the health communications they receive about POM's safety and effectiveness are embedded within the national discourse of the opioid epidemic. Using qualitative methods, this community-based study explored the health communication and the educational needs of diverse cancer survivors who received opioid agonist treatment to manage cancer pain. Our community-based sample consisted of 25 cancer survivors, 24 healthcare providers, and six community-level stakeholders. Over half of the cancer survivors interviewed were from underrepresented minority groups (52% African American and 12% Hispanic/Latino). The data were analyzed using applied thematic analysis techniques. The over-arching themes include the need to (1) provide clear, consistent, and comprehensive education and information about POM to ensure safe use; (2) discuss the risks, benefits, and proper use of POM in the treatment of cancer-related pain; (3) communicate realistic expectations and address common misconceptions about pain; and (4) address cancer survivor beliefs and concerns surrounding fear of addiction. Our findings highlight the need for effective cancer education and communication about opioid agonist treatment and POM in plain simple language that is easy to understand, relevant, and culturally appropriate. Recommendations for cancer education and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

Extensive research has demonstrated the transactional nature of parent-child psychopathology, with limited studies examining these effects during late adolescence and none, to our knowledge, longitudinally during the COVID-19 pandemic. The current study examined the cross-lagged effects of parent and adolescent internalizing symptoms during the COVID-19 pandemic and the moderating role of avoidant coping. A sample of 291 adolescents (Agemean = 18.27; 53% female; 61% White) and their parents rated their own anxiety and depressive symptoms and coping during the first two months following stay-at-home orders during the COVID-19 pandemic. Parent internalizing symptoms at the first assessment predicted adolescent internalizing symptoms at the second assessment. Adolescent avoidant coping style moderated this effect of parent internalizing symptoms on adolescent internalizing symptoms in the subsequent month, such that parent internalizing symptoms predicted child internalizing symptoms only among adolescents with moderate to high rates of avoidant coping. Follow-up analyses indicated different patterns when examining depressive and anxiety symptoms separately. The results highlight complex family dynamics between adolescents and their parents and begin to differentiate how individual characteristics impact the response to a significant life event such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Individuals with a behaviorally inhibited (BI) temperament are more likely to develop social anxiety. However, the mechanisms by which socially anxious behavior emerges from BI are unclear. Variation in different forms of top‐down control, specifically executive functions (EF), may play distinct roles and characterize differential pathways to social anxiety. Here 291 children were assessed for BI in toddlerhood (ages 2 and 3), parent‐reported inhibitory control and set shifting during middle childhood (age 7), and multidimensional assessment of socially anxious behavior completed during late childhood and early adolescence (ages 9 and 12). Structural equation modeling revealed that early variation in BI predicted the development of socially anxious behavior through either higher levels of parent‐reported inhibitory control or lower levels of parent‐reported set shifting. These data reinforce the notion that top‐down control does not uniformly influence relations between temperament and socially anxious behavior. These data suggest novel approaches to thinking about the role of EFs and social anxiety outcomes as children approach adolescence. [ABSTRACT FROM AUTHOR]

Consequently, it is bequest us all to ensure health promotion and public health pedagogy is embedded in learning and teaching theories and frameworks. Teaching behavior change theory in Canada: Establishing consensus on behavior change theories that are recommended to Be taught to undergraduate students in courses addressing health behavior change. Advancing pedagogy in health promotion: Innovations in student participation, place-based pedagogy, and service learning. Historically, the work of Scholarship of Teaching and Learning (SoTL) scholars has been grounded in multi-disciplinary connections to educational psychology and pedagogical research. [Extracted from the article]

The current study examined the interplay between children's dispositional anger and susceptibility to peers' influence in increasing children's risk‐taking behaviors. Participants in the current study were children from a larger study of temperament and social–emotional development who were followed across 9, 24, 36, 48, and 60 months. Dispositional anger was measured using mothers' reports across 9 and 48 months. At 60 months, children played a risk‐taking computer game in presence of an unfamiliar peer who watched the child play. The child's risk‐taking was assessed during the game as the unfamiliar peers' reactions were coded based on comments that were peer directed, reflective of praising the target child's performance, or object directed, indicative of excitement toward the game. A latent profile analysis revealed three longitudinal anger profiles across infancy to early childhood: high stable, average stable, and low stable anger. Results suggested that as peers' object‐directed comments predicted risk‐taking independent of children's anger, the association between peer‐directed comments and risk‐taking was dependent on children's dispositional anger. Specifically, when peers praised the target child's performance, children in the high stable anger profile showed increased risk‐taking propensity. Findings are discussed based on the importance of considering both temperamental characteristics and aspects of the peer context in relation to children's risk‐taking. [ABSTRACT FROM AUTHOR]

Background Predicting mortality risk in patients is important in research settings. The Pitt bacteremia score (PBS) is commonly used as a predictor of early mortality risk in patients with bloodstream infections (BSIs). We determined whether the PBS predicts 14-day inpatient mortality in nonbacteremia carbapenem-resistant Enterobacteriaceae (CRE) infections. Methods Patients were selected from the Consortium on Resistance Against Carbapenems in Klebsiella and Other Enterobacteriaceae, a prospective, multicenter, observational study. We estimated risk ratios to analyze the predictive ability of the PBS overall and each of its components individually. We analyzed each component of the PBS in the prediction of mortality, assessed the appropriate cutoff value for the dichotomized score, and compared the predictive ability of the qPitt score to that of the PBS. Results In a cohort of 475 patients with CRE infections, a PBS ≥4 was associated with mortality in patients with nonbacteremia infections (risk ratio [RR], 21.9; 95% confidence interval [CI], 7.0, 68.8) and with BSIs (RR, 6.0; 95% CI, 2.5, 14.4). In multivariable analysis, the hypotension, mechanical ventilation, mental status, and cardiac arrest parameters of the PBS were independent risk factors for 14-day all-cause inpatient mortality. The temperature parameter as originally calculated for the PBS was not independently associated with mortality. However, a temperature <36.0°C vs ≥36°C was independently associated with mortality. A qPitt score ≥2 had similar discrimination as a PBS ≥4 in nonbacteremia infections. Conclusions Here, we validated that the PBS and qPitt score can be used as reliable predictors of mortality in nonbacteremia CRE infections. [ABSTRACT FROM AUTHOR]

The current study had three goals. First, we replicated recent evidence that suggests a concurrent relation between attention bias to reward and externalizing and attention problems at age 7. Second, we extended these findings by examining the relations between attention and behavioral measures of early exuberance (3 years), early effortful control (4 years), and concurrent effortful control (7 years), as well as later behavioral problems (9 years). Third, we evaluated the role of attention to reward in the longitudinal pathways between early exuberance and early effortful control to predict externalizing and attention problems. Results revealed that attention bias to reward was associated concurrently and longitudinally with behavioral problems. Moreover, greater reward bias was concurrently associated with lower levels of parent-reported effortful control. Finally, attention bias to reward moderated the longitudinal relations between early risk factors for behavioral problems (gender, exuberance, and effortful control) and later externalizing and attention problems, such that these early risk factors were most predictive of behavioral problems for males with a large attention bias to reward. These findings suggest that attention bias to reward may act as a moderator of early risk, aiding the identification of children at the highest risk for later behavioral problems. [ABSTRACT FROM AUTHOR]

Social anxiety typically emerges by adolescence and is one of the most common anxiety disorders. Many clinicians and researchers utilize the Screen for Child Anxiety Related Disorders (SCARED) to quantify anxiety symptoms, including social anxiety, throughout childhood and adolescence. The SCARED can be administered to both children and their parents, though reports from each informant tend to only moderately correlate. Here, we investigated parent-child concordance on the SCARED in a sample of adolescents (N = 360, Mage = 13.2) using a multi-trait multi-method (MTMM) model. Next, in a selected sample of the adolescents, we explored relations among child report, parent report, and latent social anxiety scores with two laboratory tasks known to elicit signs of social anxiety in the presence of unfamiliar peers: a speech task and a "Get to Know You" task. Findings reveal differences in variance of the SCARED accounted for by parent and child report. Parent report of social anxiety is a better predictor of anxiety signs elicited by a structured speech task, whereas child report of social anxiety is a better predictor of anxiety signs during the naturalistic conversation with unfamiliar peers. Moreover, while latent social anxiety scores predict both observed anxiety measures, parent report more closely resembles latent scores in relation to the speech task, whereas child report functions more similarly to latent scores in relation to the peer conversation. Thus, while latent scores relate to either observed anxiety measure, parent and child report on the SCARED each provide valuable information that differentially relate to naturalistic social anxiety-related behaviors. [ABSTRACT FROM AUTHOR]

The Val158Met rs4680 single‐nucleotide polymorphism (SNP) at the catechol‐O‐methyltransferase (COMT) gene, primarily involved in dopamine breakdown within prefrontal cortex, has shown relations with inhibitory control (IC) in both adults and children. However, little is known about how COMT genotype relates to developmental trajectories of IC throughout childhood. Here, our study explored the effects of the COMT genotype (Val/Val, Val/Met, and Met/Met) on IC trajectories between the ages of 5 and 10 years. Children (n = 222) completed a Go/Nogo task at ages 5, 7, and 10; IC was characterized using signal detection theory to examine IC performance (d′) and response strategy (RS) (criterion). COMT genotype was not related to initial levels of IC performance and RS at age 5 or change in RS from ages 5 to 10. In contrast, COMT genotype was related to change in IC performance between 5 and 10 years. While Val/Val children did not differ from Val/Met children in development of IC performance, children with the Met/Met genotype exhibited more rapid development of IC performance when compared with Val/Met peers. These results suggest that COMT genotype modulates the development of IC performance in middle childhood. [ABSTRACT FROM AUTHOR]

Behavioral inhibition (BI), a temperament trait characterized by fear and wariness in novel situations, has been identified as a risk factor for later social reticence and avoidance of peer interactions. However, the ability to regulate fearful responses to novelty may disrupt the link between BI and socially reticent behavior. The present study examined how and whether both behaviorally-manifested and physiological indices of emotion regulation moderate the relation between BI and later social reticence. Participants in this study included 88 children followed longitudinally from ages 2 to 4. At age 2, children completed the BI Paradigm in which children's responses to novel objects and adults were observed. At age 4, children's baseline respiratory sinus arrhythmia (RSA) was assessed and mothers reported on children's negative emotionality and soothability. Social reticence at age 4 was observed during a free play session with 3 unfamiliar peers. Results from saturated path models revealed a significant two-way interaction between BI and baseline RSA and a three-way interaction between BI, negative emotionality, and baseline RSA when predicting socially reticent behavior at age 4. At high levels of baseline RSA and high levels of negative emotionality, the association between BI and social reticence was negative. The relation between BI and later social reticence was only positive and significant at low levels of baseline RSA combined with high levels of negative emotionality. The results suggest that either strong physiological regulation or low negative emotionality seems sufficient to buffer inhibited young children against later social reticence. [ABSTRACT FROM AUTHOR]

Background: Children with the temperament of behavioral inhibition (BI) face increased risk for social anxiety. However, not all children with BI develop anxiety symptoms. Inhibitory control (IC) has been suggested as a moderator of the pathway between BI and social anxiety. This study uses longitudinal data to characterize development of IC and tests the hypothesis that IC moderates associations between early BI and later social anxiety symptoms. Methods: Children completed a Go/Nogo task at ages 5, 7, and 10 years as part of a longitudinal study of BI (measured at 2–3 years) and social anxiety symptoms (measured at 12 years). To assess IC development, response strategy (criterion) and inhibitory performance (d′) were characterized using signal detection theory. Latent growth models were used to characterize the development of IC and examine relations among BI, IC parameters, and social anxiety symptoms. Results: IC response strategy did not change between 5 and 10 years of age, whereas IC performance improved over time. BI scores in toddlerhood predicted neither initial levels (intercept) nor changes (slope) in IC response strategy or IC performance. However, between ages 5 and 10, rate of change in IC performance, but not response strategy, moderated relations between BI and later parent‐reported social anxiety symptoms. Specifically, greater age‐related improvements in IC performance predicted higher levels of social anxiety in high BI children. Conclusions: IC development in childhood occurs independent of BI levels. However, rapid increases in IC performance moderate risk for social anxiety symptoms in children with BI. Implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

Ongoing efforts to broaden the participation of women and people of colour in engineering degree programmes and careers have had limited success. This paper describes a different approach to broadening participation that seeks to work with all students and develop inclusive engineering identities. Researchers worked with the instructors of two first-year engineering courses to integrate curriculum activities designed to promote the formation of engineering identities and build an appreciation for how diversity and inclusion strengthen engineering practice. Multilevel modelling results indicated positive effects of the intervention on appreciation for diversity but no effects on engineering identity, and qualitative results indicated students learned the most about diversity not through one of the intervention activities, but through team projects in the courses. We also describe lessons learned in how to teach engineering students about diversity in ways that are relevant to engineering. [ABSTRACT FROM AUTHOR]

This study characterized patterns and correlates of parent-youth agreement on social anxiety in youth with and without autism spectrum disorder (ASD). Participants (279 verbally-fluent youth aged 8-16 years, NASD = 144, NTD = 135) completed the SASC-R. Youth with ASD exhibited higher social anxiety across informants. While TD youth endorsed higher anxiety than did parents, self- and parent-reports did not differ in youth with ASD. For children with ASD, higher parent-youth agreement was associated with lower lifetime ASD symptoms and higher adaptive skills. For TD youth, agreement on high anxiety was associated with lowest adaptive skills. Demographic factors (age, verbal IQ, gender) did not relate to agreement for either group. In ASD, parent-child agreement on youth anxiety, either high or low, was associated with better outcomes. [ABSTRACT FROM AUTHOR]

This study compared how adolescents with and without autism spectrum disorder (ASD) evaluated unfamiliar peers (i.e., perceptions), as well as how adolescents believed they were evaluated by peers (i.e., metaperceptions). The Perceptions and Metaperceptions Questionnaire was designed to quantify perceptions and metaperceptions following a live interaction. For all adolescents, more positive perceptions of the peer were associated with more positive metaperceptions. Adolescents with ASD exhibited more accurate metaperceptions than did typically developing adolescents. More positive perceptions and metaperceptions were associated with higher levels of observed social competence across groups. Findings extend our understanding of typically and atypically developing adolescents’ impressions of unfamiliar peers and their ability to discern what peers think of them. [ABSTRACT FROM AUTHOR]

Children and adolescents with autism spectrum disorder (ASD) demonstrate atypical processing of, and memory for, self-referenced information, which may contribute to the heightened rates of co-occurring internalizing problems. We assessed affective and cognitive aspects of self-referential processing in verbally-fluent children with ASD ( N = 79), and an age-matched comparison sample (COM, N = 73) of children without an autism diagnosis. We examined group differences in these two aspects of the self-system, and their joint contributions to individual differnces in internalizing problems. Using a self-referenced memory (SRM) task, participants indicated whether a series of positive and negative trait adjectives described themselves and a well-known fictional character. Participants were then surprised with a recognition memory test on the same adjectives. Overall, individuals with ASD showed a reduction in the extent to which they preferentially endorsed positive over negative trait adjectives about themselves, and a reduction in their preferential memory for self- over other-referenced information. Across the full sample, these two aspects of self-referential processing jointly predicted self-reported internalizing problems. Specifically, self-evaluations were strongly and inversely associated with internalizing problems but only for children with relatively high SRM. These findings suggest that the salience of the self influences the extent to which affective self-evaluations impact emotional functioning for youth both with and without ASD. Implications for basic (e.g., developmental) and translational (e.g., intervention) research are discussed. Autism Res 2017, 10: 949-960. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

This study examined relations between behavioral inhibition (BI) assessed in toddlerhood (n = 268) and attention biases (AB) to threat and positive faces and maternal-reported anxiety assessed when children were 5- and 7-year-old. Results revealed that BI predicted anxiety at age 7 in children with AB toward threat, away from positive, or with no bias, at age 7; BI did not predict anxiety for children displaying AB away from threat or toward positive. Five-year AB did not moderate the link between BI and 7-year anxiety. No direct association between AB and BI or anxiety was detected; moreover, children did not show stable AB across development. These findings extend our understanding of the developmental links among BI, AB, and anxiety. [ABSTRACT FROM AUTHOR]