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Anthropogenic climate change and ecosystem disturbances can detrimentally affect habitats and species. Areas with concentrated biodiversity, such as aridland riparian zones, often yield the greatest number of vulnerable species. A better understanding of ecological and environmental relationships can guide more effective conservation strategies. We used both visual transects and external (tape) radio telemetry to study the behavioral and spatial ecology of black-necked gartersnakes (Thamnophis cyrtopsis; n = 81)--a dietary generalist yet aquatic habitat specialist--in a heterogenous aridland riparian zone of lower Sabino Canyon, Tucson, Arizona, between 2018 and 2021. Our objectives were to (1) understand how extrinsic conditions influence population ecology dynamics, including immediately prior to and after major disturbances and environmental extremes; (2) analyze behavioral activity and microhabitat usage in relation to environmental factors; and (3) assess the efficacy of a less-invasive telemetry strategy. Between late spring 2020 and early summer 2021, ecosystem disturbances included near-record heat and drought, wildfire, and low overwinter precipitation. Many aquatic habitats either completely dried or were spatially disjunct; gartersnake prey species were noticeably sparse. Extreme drought rapidly shifted to excessive flooding during the 2021 monsoon that brought above-average streamflow magnitude and duration. Between 2019 and 2021, we observed a dramatic decline in T. cyrtopsis; odds of detection reduced by 92.8% (CI [56.0-99.1%]). Strong spatiotemporal links relative to the extent and timing of available surface water appear important. Prior to the onset of monsoonal stream recharge in early summer, shallow and drying aquatic habitats are used as parturition sites and foraging grounds; all age classes took advantage to corral fishes trapped in isolated and shrinking pools. Ambient conditions had varying effects on gartersnake behaviors. Variation in microhabitat assemblages occurred with distance from water, activity level, and developmental age class. Interestingly, associations remained consistent across seasons and years, which suggests a reliance on heterogenous habitat structure. Sampling techniques complemented each other, however, bioclimatic parameters rendered limitations and should be considered in methodological decisions. Overall, disadvantageous responses to major disturbances and climatic extremes by a presumably adaptable generalist like T. cyrtopsis are concerning. Insights from long-term monitoring of responses by common yet environmentally sensitive species such as T. cyrtopsis may serve to more broadly highlight demographic challenges that other taxa with similar semi-aquatic life histories may face in changing systems. Such information could inform more effective conservation management strategies in warming and drying ecosystems. [ABSTRACT FROM AUTHOR]

Aim: Assessing educational outcomes in high-risk populations is crucial for defining long-term outcomes. As standardized tests are costly and time-consuming, we assessed the use of the Teacher Academic Attainment Scale (TAAS) as an outcome measure. Method: Three hundred and forty three children in mainstream schools aged 10 to 11 years (144 males, 199 females; 190 extremely preterm and 153 term; mean age 10y 9mo, SD 5.5 mo, range 9y 8mo-12y 3mo) were assessed using the reading and mathematics scales of the criterion standard Wechsler Individual Achievement Test, 2nd (UK) edition (WIAT-II). Class teachers completed the TAAS, a seven-item questionnaire for assessing academic attainment. The TAAS was also completed at 6 years of age for 266 children. Results: Cronbach's alpha 0.95 indicated excellent internal consistency, and the correlation between TAAS scores at 6 and 11 years indicated good test-retest reliability (r = 0.77, p less than 0.001). Significantly higher TAAS scores for term vs preterm children demonstrated discriminative validity. TAAS scores at 6 and 11 years were significantly correlated with WIAT-II reading (r = 0.69 and 0.75, p less than 0.001) and mathematics (r = 0.75 and 0.82, p less than 0.001) scores, demonstrating good predictive and concurrent validity respectively. TAAS scores of less than 2.5 were good predictors of learning difficulties. Interpretation: The TAAS is a brief, psychometrically sound teacher-report of academic attainment that yields continuous and categorical outcomes. It provides a cost- and time-efficient outcome measure for large-scale studies.

Aim: The aim of this article was to report the prevalence of, and risk factors for, positive autism screens using the Modified Checklist for Autism in Toddlers (M-CHAT) in children born extremely preterm in England. Method: All children born at not more than 26 weeks' gestational age in England during 2006 were recruited to the EPICure-2 study. At 2 years of age, postal questionnaires incorporating the M-CHAT and additional developmental questions were sent to the parents of each survivor (n = 1031; 499 male, 532 female), of which 523 (266 male, 257 female; 51%) were returned completed. Results: The prevalence of positive M-CHAT screens in this extremely preterm population was 41% (216/523; 130 male; 86 female). Severe bronchopulmonary dysplasia, administration of postnatal steroids, late-onset bacteraemia, and being male were statistically significantly associated with a positive screen. Coexisting disabilities were present in 320 (62%) children. Of 200 children without disability, 16.5% screened positive. In contrast, 63 (95.5%) of those with severe motor impairment (odds ratio 42; 95% confidence interval [CI] 12.9-135) and 175 (55.9%) of those with cognitive impairment (odds ratio 5.3; CI 3.5-8) screened positive. All children with a significant vision or hearing impairment screened positive. Interpretation: The prevalence of positive M-CHAT screens in extremely preterm children is high, especially in children with neurodevelopmental impairment. Positive screens should be interpreted in the light of other neurodevelopmental sequelae in clinical practice to avoid false-positive referrals.

Cognitive impairment often follows preterm birth but its early underlying nature is not well understood. We used a novel approach by investigating the development of colour cognition in 54 very preterm children born less than or equal to 30 weeks gestational age without severe neurosensory impairment and 37 age-matched term-born controls, aged 2-5 years. Quantitative and qualitative differences in the development of colour cognition are well charted throughout the preschool years, enabling delayed from deviant development to be determined. Standardized domain-general and experimental colour-specific tests of language, attention, and memory were employed. Very preterm children showed significantly depressed language than term controls, with very preterm group girls significantly outperforming boys. Very preterm children also showed poorer attention and memory than term controls, but not significantly so. Importantly, colour-specific tests showed qualitatively similar performance, but for naming and executive planning quantitatively poorer performance, across groups, indicating typical but delayed development. Hence, even before school entry, compared with term-born peers, very preterm children show delayed development of cognitive processes that underpin later scholastic abilities, but the nature by which these processes operate appears to be typical of term children. If left untreated these early developmental delays may underpin later deviations from the typical developmental trajectory. (Contains 2 figures, 3 tables, and 1 note.)

Objective: To investigate the prevalence and risk factors for psychiatric disorders in extremely preterm children. Method: All babies born less than 26 weeks gestation in the United Kingdom and Ireland from March through December 1995 were recruited to the EPICure Study. Of 307 survivors at 11 years of age, 219 (71%) were assessed alongside 153 term-born classmates. Parents completed a structured psychiatric interview about their child, and teachers completed a corresponding questionnaire from which DSM-IV diagnoses were assigned for 219 (100%) extremely preterm children and 152 (99%) classmates. An IQ test and a physical evaluation were also administered. Longitudinal data were available for extremely preterm children. Results: Extremely preterm children were more than three times more likely to have a psychiatric disorder than classmates (23% vs. 9%; odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.7, 6.2). Risk was significantly increased for: attention-deficit/hyperactivity disorder (ADHD; 11.5% vs. 2.9%; OR = 4.3; CI = 1.5 to 13.0), with increased risk for ADHD inattentive subtype (OR = 10.5; CI = 1.4 to 81.1) but not ADHD combined subtype (OR = 2.1; CI = 0.5 to 7.9); emotional disorders (9.0% vs. 2.1%; OR = 4.6; CI = 1.3 to 15.9), with increased risk for anxiety disorders (OR = 3.5; CI = 1.0 to 12.4); and autism spectrum disorders (8.0% vs. 0%; p = 0.000). Psychiatric disorders were significantly associated with cognitive impairment (OR = 3.5; CI = 1.8 to 6.4). Parent-reported behavioral problems at 2.5 and 6 years were independent predictors of psychiatric disorders at 11 years. Conclusions: Extremely preterm children are at increased risk for ADHD, emotional disorders, and autism spectrum disorders at 11 years of age. The mechanism of association with psychiatric disorder may include both cognitive impairment and early traumatic experiences that have an impact on both child and parent. Early screening for cognitive and behavioral problems may identify those at greatest risk. (Contains 4 tables.)

Aim: The aim of this study was to investigate the prevalence of eating problems and their association with neurological and behavioural disabilities and growth among children born extremely preterm (EPC) at age 6 years. Method: A standard questionnaire about eating was completed by parents of 223 children (125 males [56.1%], 98 females [43.9%]) aged 6 years who were born at 25 weeks' gestation or earlier (mean 24.5wks, SD 0.7wks; mean birthweight 749.1g, SD 116.8g), and parents of 148 classmates born at term (66 males [44.6%], 82 females [55.4%]). All children underwent neurological, cognitive, and anthropometric assessment, and parents and teachers completed a behaviour scale. Results: Eating problems were more common among the EPC than the comparison group (odds ratio [OR] 3.6, 95% confidence interval [CI] 2.1-6.3), including oral motor (OR 5.2, 95% CI 2.8-9.9), hypersensitivity (OR 3.0, 95% CI 1.6-5.6), and behavioural (OR 3.8, 95% CI 1.9-7.6) problems. Group differences were reduced after adjustment for cognitive impairment, neuromotor disability, and other behaviour problems. EPC with eating problems were shorter, lighter, and had lower mid-arm circumference and lower body mass index (BMI) even after adjusting for disabilities, gestational age, birthweight, and feeding problems at 30 months. Interpretation: Eating problems are still frequent in EPC at school age. They are only partly related to other disabilities but make an additional contribution to continued growth failure and may require early recognition and intervention.

Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical association between simulation discomfort and mental illness stigma. Methods: ASPs were randomly assigned to one of two simulation conditions: one was associated with mental illness stigma and one was not. ASP training methods included carefully written case simulations, educational materials, and active teaching methods. After training, ASPs completed the adapted Project Role Questionnaire to rate anticipated role discomfort with hypothetical adolescent psychiatric conditions/adverse psychosocial experiences and to respond to open-ended questions regarding this discomfort. A mixed design ANOVA was used to compare comfort levels across simulation conditions. Narrative responses to an open-ended question were reviewed for relevant themes. Results: Twenty-four ASPs participated. A significant effect of simulation was observed, indicating that ASPs participating in the simulation associated with mental illness stigma anticipated greater comfort with portraying subsequent stigma-associated roles than did ASPs in the simulation not associated with stigma. ASPs' narrative responses regarding their reasons for anticipating discomfort focused upon the role of knowledge-related factors. Conclusion: ASPs' work with a psychiatric case simulation was associated with greater anticipated comfort with hypothetical simulations of psychiatric/adverse psychosocial conditions in comparison to ASPs lacking a similar work experience. The ASPs provided explanations for this anticipated discomfort that were suggestive of stigma-related knowledge factors. This preliminary research suggests an association between ASP anticipated role discomfort and mental illness stigma, and that ASP work may contribute to stigma reduction.

Parental questionnaires are inexpensive alternatives to standardized testing for outcome measurement. The Parent Report of Children's Abilities has previously been revised (PARCA-R) and validated for use with very-preterm infants at 2 years of age. This study revalidated the PARCA-R for assessing cognition in a larger and more inclusive sample of preterm infants. One hundred and sixty-four children (82 males, 82 females) of less than 32 weeks' gestation (median 29wks, interquartile range [IQR] 28-30wks); and median birthweight 1200g (IQR 925-1463g) were evaluated using the Mental Development Index (MDI) of the Bayley Scales of Infant Development - 2nd edition (BSID-II) at 2 years' corrected age. Parents completed the PARCA-R questionnaire. Significant correlations between PARCA-R Parent Report Composite (PRC) scores and MDI scores (r=0.77, 95% confidence interval [CI] 0.69-0.82, p less than 0.01) demonstrated concurrent validity. A receiver operating characteristic-determined PRC cut-off of less than 44 had optimal discriminatory power (area under curve 0.92) for identifying MDI less than 70, with 85% sensitivity (95% CI 0.58-0.96), 87% specificity (95% CI 0.81-0.92), 98% negative predictive value (95% CI 0.95-1), and 37% positive predictive value (95% CI 0.22-0.54). The PARCA-R has good concurrent validity and diagnostic utility for identifying cognitive delay in very-preterm infants at 2 years of age. It is useful for outcome measurement, developmental screening, and facilitating parental involvement at follow-up.

Aim: To test whether poor childhood pulmonary function explains the relationship between extremely preterm (EP) birth and attention‐deficit/hyperactivity disorder (ADHD) symptoms in young adulthood. Methods: EPICure birth cohort participants include children born <26 weeks' gestation in the United Kingdom and Ireland in 1995 and their term‐born classmates. Predictor was EP birth. Outcomes were inattention/hyperactivity subscale z‐scores at 19 years. Forced expiratory volume (FEV1) z‐scores in childhood and young adulthood were mediators. We used recursive path analysis to determine the direct effect of EP birth on inattention/hyperactivity and its indirect effect through pulmonary function. Results: Ninety EP and 47 term‐born participants had pulmonary function testing at 11 and 19 years. Inattention z‐scores were higher in the EP group (mean difference 0.55 [95% CI 0.11, 0.99]) but not hyperactivity. Compared to term‐born peers, EP participants had lower FEV1 z‐scores at 11 (mean difference−1.35 [95% CI −1.72, −0.98]) and 19 (mean difference−1.29 [95% CI −1.65, −0.92]). Path models revealed that childhood pulmonary function explained the relationship between EP birth and inattention. Conclusions: Extremely preterm young adults have increased risk for inattention compared to term‐born peers. Poor pulmonary function appears to underlie this risk. The mechanisms responsible remain unclear and warrant further study. [ABSTRACT FROM AUTHOR]

The legitimacy of urine specific gravity (USG) as a stand-alone measure to detect hydration status has recently been challenged. As an alternative to hydration status, the purpose of this study was to determine the diagnostic capability of using the traditional USG marker of >1.020 to detect insufficient recovery fluid consumption with consideration for moderate versus high sweat losses (2.00–2.99 or >3% body mass, respectively). Adequate recovery fluid intake was operationally defined as ≥100% beverage fluid intake plus food water from one or two meals and a snack. Runners (n = 59) provided 132 samples from five previous investigations in which USG was assessed 10–14 hr after 60–90 min runs in temperate-to-hot environments. Samples were collected after a meal (n = 58) and after waking (n = 74). When sweat losses exceeded 3% body mass (n = 60), the relationship between fluid replacement percentage and USG increased from r = −.55 to −.70. Correct diagnostic decision improved from 66.6 to 83.3%, and receiver operating characteristic area under the curve increased the diagnostic accuracy score from 0.76 to approaching excellent (0.86). Artifacts of significant prerun hyperhydration (eight of 15 samples has USG <1.005) may explain false positive diagnoses, while almost all (84%) cases of false positives were found when sweat losses were <3.0% of body mass. Evidence from this study suggests that euhydrated runners experiencing significant sweat losses who fail to reach adequate recovery fluid intake levels can be identified by USG irrespective of acute meal and fluid intake ∼12-hr postrun. [ABSTRACT FROM AUTHOR]

Context: As sport participation increases globally, so will injury-related risks. The process used to determine return-to-sport following injury is vital to future sport participation and injury prevention. Early specialization along with poor management of sport participation causes an increase in injury risk and potential long-term health consequences for youth athletes. Objectives: Previous injury is a common intrinsic risk factor for new injuries. Identifying functional performance deficits, defined by return-to-sport criteria, minimizes these risk factors and provides athletes with guidelines to return safely to sport. The purposes of this clinical commentary and literature review are to provide a summary of current concepts and clinical practices and to identify functional performance measures as clinical assessment tools for return-to-play criteria in the youth population. Evidence: A literature review was completed using numerous databases, where 154 relevant articles were reviewed and 22 articles were included in this commentary. Of the 22 articles using functional performance measures for return-to-sport criteria, 6 were specific to youth, 12 had mixed populations of adults and youth, and 4 were normative samples for specific youth populations. Acquisition: The gaps in the literature pertaining to functional performance measures in the youth population are addressed, and future research needs for return-to-sport criteria are identified. Evidence Synthesis: This descriptive literature review identifies 22 articles that meet the search criteria for the youth population discussing the use of clinical functional performance measures in order to identify return-to-sport criteria for lower-extremity injuries. Conclusions: Due to the inconsistencies in terminology, definitions, and standardization of clinical assessment tools, it seems necessary to create a comprehensive functional performance test battery for the lower extremity that can be used as return-to-sport criteria. [ABSTRACT FROM AUTHOR]