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Between July 2020 and January 2021, 230 principal caregivers completed a questionnaire to measure proxy-assessed health-related quality of life outcomes (HRQoL), behavioral outcomes in children with syndromic autism spectrum disorders and COVID-19 induced changes to lifestyle and environments. HRQoL and behavioral outcomes reported earlier during the pandemic were generally worse compared to those reported later. COVID-19 induced reduction to a caregiver's mental health appointments, and hours spent watching TV were associated with decreases in HRQoL and increased the likelihood of problematic behaviors. Increasing time outdoors and time away from digital devices were positively associated with HRQoL and behaviors and might protect children from COVID-19 induced restrictions.

Children with autism have a significantly lower quality of life compared with their neurotypical peers. While multiple studies have quantified the impact of autism on health-related quality of life (HRQoL) through standardized surveys such as the PedsQL, none have specifically investigated the impact of syndromic autism. Here we evaluate HRQoL in children diagnosed with three genetic disorders that strongly predispose to syndromic autism: Phelan-McDermid syndrome (PMD), Rett syndrome (RTT), and SYNGAP1-related intellectual disability (SYNGAP1-ID). We find the most severely impacted dimension is physical functioning. Strikingly, syndromic autism results in worse quality of life than other chronic disorders including idiopathic autism. This study demonstrates the utility of caregiver surveys in prioritizing phenotypes, which may be targeted as clinical endpoints for genetically defined ASDs.

Socioemotional development in early childhood has long-term impacts on health status and social outcomes, and racial and socioeconomic disparities in socioemotional skills emerge early in life. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an early childhood nutrition intervention with the potential to ameliorate these disparities. Our objective was to assess the impact of WIC on early socioemotional development in a longitudinal study. We examined the association between WIC participation and scores on the Brief Infant Toddler Social Emotional Assessment (BITSEA) in 327 predominantly African American mother-child dyads who were participants in the longitudinal Conditions Affecting Neurocognitive Development in Early Life (CANDLE) Study (Memphis, TN). To account for selection bias, we used within-child fixed effects to model the variability in each child's BITSEA scores over two measurement occasions (ages 12 and 24 months). Final models were adjusted for time-varying characteristics including child age, maternal stress, mental health, child abuse potential, marital status, and food stamp participation. In fully adjusted models, we found no statistically significant effect of WIC on change in socioemotional development (β = 0.22 [SD = 0.39] and β = - 0.58 [SD = 0.79] for BITSEA Competence and Problem subdomains, respectively). Using rigorous methods and a longitudinal study design, we found no significant association between WIC and socioemotional development in a high needs population. This finding suggests that early childhood interventions that more specifically target socioemotional development are necessary if we are to reduce racial disparities in socioemotional skills and prevent poor social and health outcomes across the life course.

Family quality of life (FQoL) outcomes collected during the first year of COVID‐19 has been combined with 2018 data to estimate the outbreak's impact on parental outcomes on a sample of 230 families with syndromic autistic children and those with intellectual disabilities (IDs). Despite challenges imposed by the COVID‐19 outbreak, our study found that FQoL outcomes reported by participating parents during the first year of COVID‐19 appears to be similar to ratings from a prepandemic study of families with the same conditions. Parents of children in our sample generally displayed a stable functioning trajectory as measured by the validated FQoL instrument. Across syndromic autistic groups considered, families reported that their relationships with their children were positive. Our findings provide evidence of families' resilience which might explain the presence of positive parent–child interactions during COVID‐19. Exploring mechanisms which would explain how families with autistic and ID children confront, manage disruptive experiences, and buffer COVID‐19 induced stress is a fruitful direction for future research. Lay Summary: Despite challenges imposed by the COVID‐19 outbreak, our study found that the quality of life reported by participating families during the first year of COVID‐19 appears to be similar to ratings from a prepandemic study of families with the same conditions. The COVID‐19 pandemic and related lockdowns were found to be positively associated with parent–child bonding, relational satisfaction, and increased emotional connection between parents and their children. Our findings provide evidence of families' resilience which might explain the presence of positive parental–child interactions during COVID‐19. [ABSTRACT FROM AUTHOR]

Aims: Cemented hemiarthroplasty is an effective form of treatment for most patients with an intracapsular fracture of the hip. However, it remains unclear whether there are subgroups of patients who may benefit from the alternative operation of a modern uncemented hemiarthroplasty - the aim of this study was to investigate this issue. Knowledge about the heterogeneity of treatment effects is important for surgeons in order to target operations towards specific subgroups who would benefit the most., Methods: We used causal forest analysis to compare subgroup- and individual-level treatment effects between cemented and modern uncemented hemiarthroplasty in patients aged > 60 years with an intracapsular fracture of the hip, using data from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized clinical trial. EuroQol five-dimension index scores were used to measure health-related quality of life at one, four, and 12 months postoperatively., Results: Our analysis revealed a complex landscape of responses to the use of a cemented hemiarthroplasty in the 12 months after surgery. There was heterogeneity of effects with regard to baseline characteristics, including age, pre-injury health status, and lifestyle factors such as alcohol consumption. This heterogeneity was greater at the one-month mark than at subsequent follow-up timepoints, with particular regard to subgroups based on age. However, for all subgroups, the effect estimates for quality of life lay within the confidence intervals derived from the analysis of all patients., Conclusion: The use of a cemented hemiarthroplasty is expected to increase health-related quality of life compared with modern uncemented hemiarthroplasty for all subgroups of patients aged > 60 years with a displaced intracapsular fracture of the hip., Competing Interests: M. L. Costa reports funding for the WHiTE 5 trial from the NIHR to University of Oxford, related to this study., (© 2024 Bolbocean et al.)

Family quality of life (FQoL) outcomes collected during the first year of COVID-19 has been combined with 2018 data to estimate the outbreak's impact on parental outcomes on a sample of 230 families with syndromic autistic children and those with intellectual disabilities (IDs). Despite challenges imposed by the COVID-19 outbreak, our study found that FQoL outcomes reported by participating parents during the first year of COVID-19 appears to be similar to ratings from a prepandemic study of families with the same conditions. Parents of children in our sample generally displayed a stable functioning trajectory as measured by the validated FQoL instrument. Across syndromic autistic groups considered, families reported that their relationships with their children were positive. Our findings provide evidence of families' resilience which might explain the presence of positive parent-child interactions during COVID-19. Exploring mechanisms which would explain how families with autistic and ID children confront, manage disruptive experiences, and buffer COVID-19 induced stress is a fruitful direction for future research., (© 2022 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.)