Publications by authors named "Michael Boyle"

424 Publications

Parent experience of Beads of Courage program in a neonatal intensive care unit.

Early Hum Dev 2021 Oct 1;163:105480. Epub 2021 Oct 1.

Department of Neonatology, Rotunda Hospital, Parnell Square, Dublin 1 D01 P5W9, Ireland; Department of Paediatrics, Royal College of Surgeons of Ireland, 123 St Stephens Green, Dublin 2 D02 YN77, Ireland. Electronic address:

Aim: The neonatal intensive care unit can be a stressful environment for parents. The Beads of Courage program is an arts-in-medicine, psychosocial intervention, designed to strengthen and support children and families who are coping with serious or life-threatening illness. We hypothesised that the program would improve the parent experience in the neonatal unit.

Methods: Infants less than 32 weeks' gestation were eligible for enrolment on the program. The study was conducted from 2016 to 2018. A 13 point questionnaire was sent to participating parents post discharge from the unit including a combination of Likert scale and open-ended questions.

Results: During the study period 123 infants were enrolled. Mean gestational age was 27.7(±2.2) weeks and median length of stay was 49 days (lower quartile 34; upper quartile 76). All respondents rated the program as "helpful and enjoyable" with 72.5% rating it "extremely helpful and enjoyable", 85% felt the program made their stay in the neonatal unit easier.

Conclusion: The Beads of Courage program was found to be an extremely popular initiative for parents in a neonatal unit setting and was found to be a useful adjunct to communication and inclusion of parents in the care of their infants.

Summary: The Beads of Courage program in a NICU setting was found to be very helpful for parents in improving awareness of procedures and understanding overall care of their infants. Parents felt their journey was made easier with the additional engagement and communication with being in the program.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.earlhumdev.2021.105480DOI Listing
October 2021

Consensus Guidelines for the Assessments of Individuals who Stutter Across the Lifespan.

Am J Speech Lang Pathol 2021 Sep 13:1-15. Epub 2021 Sep 13.

Department of Communicative Sciences & Disorders, Michigan State University, East Lansing.

Purpose This project sought to develop consensus guidelines for clinically meaningful, comprehensive assessment procedures for people who stutter across the lifespan. Method Twelve expert clinicians and researchers who have written extensively about stuttering provided detailed descriptions of the type of data that they routinely collect during diagnostic evaluations of preschool children, school-age children, adolescents, and adults who stutter. Iterative content analysis, with repeated input from the respondents, was used to identify core areas that reflect common domains that these experts judge to be important for evaluating stuttering for varying age groups. Results Six core areas were identified as common components of a comprehensive evaluation of stuttering and people who stutter. These areas should be included to varying degrees depending upon the age and needs of the client or family. The core areas include the following: (a) stuttering-related background information; (b) speech, language, and temperament development (especially for younger clients); (c) speech fluency and stuttering behaviors; (d) reactions to stuttering by the speaker; (e) reactions to stuttering by people in the speaker's environment; and (f) adverse impact caused by stuttering. Discussion These consensus recommendations can help speech-language pathologists who are uncertain about appropriate stuttering assessment procedures to design and conduct more thorough evaluations, so that they will be better prepared to provide individualized and comprehensive treatment for people who stutter across the lifespan.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1044/2021_AJSLP-21-00107DOI Listing
September 2021

The 25-Item Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B): Test-Retest Reliability and Construct Validity When Used as Categorical Measures : Échelles comportementales émotionnelles en 25 items de l'Étude sur la santé des enfants de l'Ontario, version abrégée (OCHS-EBS-B) : fiabilité test-retest et validité du construit lorsqu'elles servent de mesures catégoriques.

Can J Psychiatry 2021 Aug 23:7067437211037125. Epub 2021 Aug 23.

62703Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario.

Objective: Child and youth mental health problems are often assessed by parent self-completed checklists that produce dimensional scale scores. When converted to binary ratings of disorder, little is known about their psychometric properties in relation to classifications based on lay-administered structured diagnostic interviews. In addition to estimating agreement, our objective is to test for statistical equivalence in the test-retest reliability and construct validity of two instruments used to classify child emotional, behavioural, and attentional disorders: the 25-item, parent completed Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B) and the Mini International Neuropsychiatric Interview for Children and Adolescents-parent version (MINI-KID-P).

Methods: This study draws on independent samples ( = 452) and uses the confidence interval approach to test for statistical equivalence. Reliability is based on kappa (κ). Construct validity is based on standardized beta coefficients (β) estimated in structural equation models.

Results: The average differences between the MINI-KID-P and OCHS-EBS-B in κ and β were -0.022 and -0.020, respectively. However, in both instances, criteria for statistical equivalence were met in only 5 of 12 comparisons. Based on κ, between-instrument agreement on the classifications of disorder went from 0.481 (attentional disorder) to 0.721 (emotional disorder) but were substantially higher (0.731 to 0.895, respectively) when corrected for attenuation due to measurement error.

Conclusions: Although falling short of equivalence, the results suggest on balance that the reliability and validity of the two instruments for classifying child psychiatric disorder assessed by parents are highly comparable. This conclusion is supported by the high levels of agreement between the instruments after correcting for attenuation due to measurement error.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/07067437211037125DOI Listing
August 2021

Experience of low-dose dexamethasone use in the respiratory management of ichthyosis prematurity syndrome.

BMJ Case Rep 2021 Aug 20;14(8). Epub 2021 Aug 20.

Department of Neonatology, Rotunda Hospital Neonatal Unit, Dublin, Ireland

Ichthyosis prematurity syndrome (IPS) is a rare disorder of autosomal recessive inheritance. The cardinal features include prematurity, vernix like hyperkeratosis, eosinophilia and neonatal asphyxiation. This case report discusses the presentation and management of IPS. We aim to characterise the common features, the spectrum of disease within a single family and discuss a potential role for low-dose dexamethasone in the management of ventilator-dependent patients with IPS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2021-243348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381299PMC
August 2021

Grafted Nanoparticle Surface Wetting during Phase Separation in Polymer Nanocomposite Films.

ACS Appl Mater Interfaces 2021 Aug 29;13(31):37628-37637. Epub 2021 Jul 29.

Department of Materials Science and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States.

Wetting of polymer-grafted nanoparticles (NPs) in a polymer nanocomposite (PNC) film is driven by a difference in surface energy between components as well as bulk thermodynamics, namely, the value of the interaction parameter, χ. The interplay between these contributions is investigated in a PNC containing 25 wt % polymethyl methacrylate (PMMA)-grafted silica NPs (PMMA-NPs) in poly(styrene--acrylonitrile) (SAN) upon annealing above the lower critical solution temperature (LCST, 160 °C). Atomic force microscopy (AFM) studies show that the areal density of particles increases rapidly and then approaches 80% of that expected for random close-packed hard spheres. A slightly greater areal density is observed at 190 °C compared to 170 °C. The PMMA-NPs are also shown to prevent dewetting of PNC films under conditions where the analogous polymer blend is unstable. Transmission electron microscopy (TEM) imaging shows that PMMA-NPs symmetrically wet both interfaces and form columns that span the free surface and substrate interface. Using grazing-incidence Rutherford backscattering spectrometry (GI-RBS), the PMMA-NP surface excess (*) initially increases rapidly with time and then approaches a constant value at longer times. Consistent with the areal density, * is slightly greater at deeper quench depths, which is attributed to the more unfavorable interactions between the PMMA brush and SAN segments. The * values at early times are used to determine the PMMA-NP diffusion coefficients, which are significantly larger than theoretical predictions. These studies provide insights into the interplay between wetting and phase separation in PNCs and can be utilized in nanotechnology applications where surface-dependent properties, such as wettability, durability, and friction, are important.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acsami.1c09233DOI Listing
August 2021

Nurse-Family Partnership nurses' attitudes and confidence in identifying and responding to intimate partner violence: An explanatory sequential mixed methods evaluation.

J Adv Nurs 2021 Sep 20;77(9):3894-3910. Epub 2021 Jul 20.

Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.

Aims: To evaluate the effect of an intimate partner violence intervention education component on nurses' attitudes in addressing intimate partner violence; complementary aims included understanding nurses' perceptions of the education and how it influenced their attitudes and confidence to address intimate partner violence in practice.

Design: An explanatory sequential mixed methods design embedded within a 15-site cluster randomized clinical trial that evaluated an intimate partner violence intervention within the Nurse-Family Partnership programme.

Methods: Data were collected between February 2011 and September 2016. Quantitative assessment of nurses' attitudes about addressing intimate partner violence was completed by nurses in the intervention (n = 77) and control groups (n = 101) at baseline, 12 months and at study closure using the Public Health Nurses' Responses to Women Who Are Abused Scale. Qualitative data were collected from nurses in the intervention group at two timepoints (n = 14 focus groups) and focused on their perceptions of the education component. Data were analysed using content analysis.

Results: Nurses in the intervention group reported large improvements in their thoughts, feelings and perceived behaviours related to addressing intimate partner violence; a strong effect of the education was found from baseline to 12 months and baseline to study closure timepoints. Nurses reported that the education component was acceptable and increased their confidence to address intimate partner violence.

Conclusion: Nurses reported improved attitudes about and confidence in addressing intimate partner violence after receiving the education component. However, these findings need to be considered together with trial results showing no main effects for clients, and a low level of intervention fidelity.

Impact: These evaluation findings underscore that improvement in nurses' self-reported educational outcomes about addressing intimate partner violence cannot be assumed to result in adherence to intervention implementation or improvement in client outcomes. These are important considerations for developing nurse education on intimate partner violence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jan.14979DOI Listing
September 2021

Review of flipped learning in engineering education: Scientific mapping and research horizon.

Educ Inf Technol (Dordr) 2021 Jul 8:1-26. Epub 2021 Jul 8.

School of Education, The University of Queensland, St Lucia, QLD 4072 Australia.

The COVID-19 pandemic makes flipped learning more relevant to address the challenges of remote learning. Therefore, renewed attention is warranted in critically appraising the implications on which flipped learning is built. Though several studies have reviewed the flipped learning research in the past, the majority has qualitatively synthesized the flipped learning literature, thus, lacking the overall perspective provided quantitatively for appraising the existing state of affairs of flipped learning research in engineering education. This study addresses this gap by objectively mapping the conceptual, intellectual, and social structure of research development in flipped learning using a bibliometric review method. Findings reveal that flipped learning in engineering education is a relatively new field of research and in recent time it has entered into the stage of exponential growth. Findings also show the effectiveness of the flipped learning model to address the challenges of complex pedagogical applications in different fields of engineering education. This study provides a quantitative synopsis of the flipped learning literature which can be used as an anchor for future study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10639-021-10630-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265293PMC
July 2021

Perceptions of self-efficacy in providing multidimensional school-age stuttering therapy among board certified fluency specialists in the United States.

J Fluency Disord 2021 09 17;69:105862. Epub 2021 Jun 17.

Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ, United States.

Purpose: The purpose of this study was to document fluency specialists' self-efficacy beliefs for providing multidimensional treatment to children who stutter and to identify cognitive, affective, and behavioral correlates of self-efficacy.

Method: Sixty-six Board Certified Specialists in Fluency in the United States completed an online survey measuring self-efficacy in providing multidimensional stuttering therapy, perceived importance of multidimensional aspects of therapy, feelings of comfort in providing therapy, perceived treatment success, and employment and demographic questions. Open-ended questions were also asked for participants to describe why they chose to specialize and what benefits they received from it.

Results: Participants reported high levels of self-efficacy (averages above 9 on a scale from 0 to 10) in speech-related, cognitive, emotional, and social domains of stuttering therapy, as well as high levels of comfort and clinical success. Higher ratings of overall self-efficacy were significantly correlated with beliefs about the importance of multidimensional treatment, τ = 0.27, treatment comfort, τ = 0.25, and self-reported treatment success, τ = .49. Responses indicated that many participants believed that their self-efficacy grew because of specialty certification.

Conclusion: Although not the same as treatment outcome data, self-efficacy among clinical service providers is an important variable to consider. Board Certified Specialists in Fluency in the United States report very high levels of self-efficacy for school-age stuttering treatment. The process of certification helps to increase self-efficacy and provides a means for advertising competence in stuttering treatment. This information could help in recruiting the next generation of fluency specialists.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jfludis.2021.105862DOI Listing
September 2021

Cohort Profile: Multimorbidity in Children and Youth Across the Life-course (MY LIFE) Study.

J Can Acad Child Adolesc Psychiatry 2021 May 1;30(2):104-115. Epub 2021 May 1.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.

Objective: This manuscript serves to provide an overview of the methods of the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study, profile sample characteristics of the cohort, and provide baseline estimates of multimorbidity to foster collaboration with clinical and research colleagues across Canada.

Method: MY LIFE is comprised of 263 children (2-16 years) with a physical illness recruited from McMaster Children's Hospital, their primary caregiving parent, and their closest-aged sibling. Participants are followed with data collection at recruitment, 6, 12, and 24 months which includes structured interviews, self-reported measures, and biological samples and occur in a private research office or at participants' homes. Post-COVID-19, data collection transitioned to mail and telephone surveys.

Results: At recruitment, children were 9.4 (4.2) years of age and 52.7% were male. The mean duration of their physical illness was 4.5 (4.1) years; 25% represent incident cases (duration <1 year). Most (69.7%) had healthy body weight and intelligence in the average range (73.5%). Overall, 38.2% of children screened positive for ≥1 mental illness according to parent report (24.8% screened positive based on child self-report). Compared to 2016 Census data, the MY LIFE cohort overrepresents families of higher socioeconomic status.

Conclusions: Multimorbidity is common among children and these baseline data will serve to measure relative changes in the mental health of children with physical illness over time. MY LIFE will provide new information for understanding multimorbidity among children, though underrepresentation of lower socioeconomic families may have implications for the generalizability of findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056956PMC
May 2021

Resolving organoid brain region identities by mapping single-cell genomic data to reference atlases.

Cell Stem Cell 2021 06 11;28(6):1148-1159.e8. Epub 2021 Mar 11.

Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland. Electronic address:

Self-organizing tissues resembling brain structures generated from human stem cells offer exciting possibilities to study human brain development, disease, and evolution. These 3D models are complex and can contain cells at various stages of differentiation from different brain regions. Single-cell genomic methods provide powerful approaches to explore cell composition, differentiation trajectories, and genetic perturbations in brain organoid systems. However, it remains a major challenge to understand the heterogeneity observed within and between individual organoids. Here, we develop a set of computational tools (VoxHunt) to assess brain organoid patterning, developmental state, and cell identity through comparisons to spatial and single-cell transcriptome reference datasets. We use VoxHunt to characterize and visualize cell compositions using single-cell and bulk genomic data from multiple organoid protocols modeling different brain structures. VoxHunt will be useful to assess organoid engineering protocols and to annotate cell fates that emerge in organoids during genetic and environmental perturbation experiments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.stem.2021.02.015DOI Listing
June 2021

Severe hypothyroidism following a single topical exposure to iodine in a premature neonate.

BMJ Case Rep 2021 Feb 26;14(2). Epub 2021 Feb 26.

Department of Neonatology, Rotunda Hospital, Dublin, Ireland.

A neonate, born at 24 weeks, underwent a patent ductus arteriosus ligation, with previous normal thyroid stimulating hormone (TSH) levels, developed severe hypothyroidism from topical exposure to iodine following a single surgical procedure at 28 days of life. A low free T4 level of 0.05 ng/dL and a high TSH level of 228 mIU/L was detected with an increased urinary iodine excretion level of 178 mg/L (reference range 0.30-1.97 mg/L). The thyroid ultrasound was normal. Levothyroxine was started immediately but thyroid function did not recover fully during admission and levothyroxine was required beyond term corrected. This case highlighted how susceptible extremely preterm infants are to iodine induced hypothyroidism, even short-term topical exposure. Delayed treatment of hypothyroidism can lead to profound neurodevelopmental delay. As surgical advances allow for interventions at earlier gestations, the importance of early thyroid function testing postexposure to iodine is highlighted and ultimately topical iodine should be avoided in these susceptible infants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2020-240006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919561PMC
February 2021

Pharmacovigilance for chlorhexidine anaphylaxis: a preventable adverse reaction.

Med J Aust 2021 03 1;214(4):162-163.e1. Epub 2021 Feb 1.

John Hunter Hospital, Newcastle, NSW.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5694/mja2.50929DOI Listing
March 2021

Neonatal thyroid storm: the importance of an accurate antenatal history.

BMJ Case Rep 2021 Jan 11;14(1). Epub 2021 Jan 11.

Department of Neonatology, Rotunda Hospital Neonatal Unit, Dublin, Ireland

A near-term infant became unwell immediately after birth with cardiorespiratory compromise-persistent tachycardia, pulmonary hypertension and reduced cardiac function. There had been no concerns during the pregnancy and the obstetrical and maternal medical history was unremarkable apart from hypothyroidism. A thyroid function test on admission revealed a significantly elevated free T4 and a diagnosis of a thyroid storm was made. On questioning it became apparent that she had Graves' disease after her last pregnancy and was rendered hypothyroid post surgery, she was not aware of the relevance of this at her booking visit. This case highlights the importance of monitoring of women who have a history of a diagnosis of Graves' disease, regardless of thyroid function status, to allow for appropriate antenatal monitoring, preparedness of the NICU (neonatal intensive care unit) team and correct follow-up of the neonate. It also demonstrates the importance of ensuring a patient is properly educated about their condition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2020-239278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802644PMC
January 2021

Does Beckwith-Wiedemann syndrome require intensive Wilms tumour surveillance?

Arch Dis Child 2021 Jan 6. Epub 2021 Jan 6.

Neonatology, Rotunda Hospital, Dublin, Ireland.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/archdischild-2020-320936DOI Listing
January 2021

World Travelers: DNA Barcoding Unmasks the Origin of Cloning Asteroid Larvae from the Caribbean.

Biol Bull 2020 10 6;239(2):73-79. Epub 2020 Oct 6.

AbstractThe identity of wild cloning sea star larvae has been a mystery since they were first documented in the Caribbean. The most commonly collected cloning species was thought to belong to the Oreasteridae, on the basis of similarity with sequences from and . This larval form has recently been linked to a rare benthic juvenile. As part of two larger DNA barcoding projects, we collected cloning asteroid larvae from the Caribbean coast of Panama and compared them to a large reference database of tropical echinoderms. Morphological and DNA barcode data from the cytochrome oxidase subunit I gene demonstrated that Panamanian larvae belonged to the same operational taxonomic unit as those recovered in previous studies of cloning larvae from the Caribbean. Much to our surprise, sequences from these larvae clearly identified them as belonging to , a species typically considered to be endemic to the Indo-West Pacific. A lineage of that occurs in both the Caribbean and the Indo-West Pacific also has cloning larvae, suggesting that this unusual life history has allowed larvae to pass around the Cape of Good Hope and the Benguela upwelling region, which is a barrier to dispersal for most tropical marine invertebrates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1086/710796DOI Listing
October 2020

Nurse home visiting and prenatal substance use in a socioeconomically disadvantaged population in British Columbia: analysis of prenatal secondary outcomes in an ongoing randomized controlled trial.

CMAJ Open 2020 Oct-Dec;8(4):E667-E675. Epub 2020 Oct 27.

Children's Health Policy Centre, Faculty of Health Sciences (Catherine, Zheng, Lever, Sheehan, Cullen, Hjertaas, Riebe, Rikert, Sunthoram, Waddell), Simon Fraser University, Vancouver, BC; Offord Centre for Child Studies, Faculty of Health Sciences (Boyle, Gonzalez, Jack, MacMillan), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (McCandless, Xie), Simon Fraser University, Burnaby, BC; Arthritis Research Canada (Xie), Richmond, BC; School of Nursing, Faculty of Health Sciences (Jack) and Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Gafni), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Tonmyr), Ottawa, Ont.; School of Nursing (Marcellus), University of Victoria, Victoria, BC; School of Nursing (Varcoe); Department of Pediatrics (Barr), Faculty of Medicine, University of British Columbia, Vancouver, BC

Background: Nurse-Family Partnership (NFP) involves public health nurses providing frequent home visits from early pregnancy until children reach age 2 years, focusing on first-time parents experiencing socioeconomic disadvantage. Our aim was to evaluate NFP's effectiveness in improving child and maternal health.

Methods: We conducted an analysis of prenatal secondary outcomes in an ongoing randomized controlled trial in British Columbia; the data used in this analysis were collected from January 2014 to May 2017. Participants were pregnant girls and women aged 14-24 years who were preparing to parent for the first time and experiencing socioeconomic disadvantage. They were randomly allocated 1:1 to the intervention (NFP plus existing services) or control group (existing services). Prespecified prenatal secondary outcome indicators were changes in use of nicotine cigarettes and alcohol use by 34-36-weeks' gestation. We also report on prespecified exploratory cannabis and street drug use measures. We used mixed-effect models for longitudinal and clustered data to estimate intervention effects. Analyses were by intention to treat.

Results: The median gestational age at baseline for the 739 participants (368 participants in the intervention group, 371 in the comparison group) was 20 weeks, 6 days. By 34-36 weeks' gestation, NFP significantly reduced cigarette counts (over the past 2 d) (difference in changes [DIC] of count -1.6, 95% confidence interval [CI] -6.4 to -1.3) in those who smoked. NFP also significantly reduced rates of prenatal cannabis use (DIC -6.4, 95% CI -17.0 to -1.7), but not rates of street drug or "any" substance use. While we observed decreased rates of cigarette and alcohol use in both groups (DIC of proportions -2.8, 95% CI -15.3 to 0.6; DIC -0.5, 95% CI -8.7 to 1.8, respectively), these changes were not statistically significant.

Interpretation: We found no evidence that NFP was effective in reducing rates of prenatal cigarette and alcohol use; however, it led to reduced prenatal cannabis use, and in smokers it led to modest reductions in cigarette use. NFP may therefore hold promise for reducing some types of prenatal substance use in disadvantaged populations. ClinicalTrials.gov, no. NCT01672060.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.9778/cmajo.20200063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595754PMC
May 2021

Should levetiracetam rather than phenobarbitone be the first-line treatment for neonatal seizures?

Arch Dis Child 2021 Mar 23;106(3):301-303. Epub 2020 Oct 23.

Department of Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/archdischild-2020-320311DOI Listing
March 2021

School-Based Speech-Language Pathologists' Perceived Self-Efficacy in Conducting Multidimensional Treatment With Children Who Stutter.

Lang Speech Hear Serv Sch 2020 10 23;51(4):1172-1186. Epub 2020 Sep 23.

Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ.

Purpose The purposes of this study were to examine the self-efficacy of school-based speech-language pathologists (SLPs) in conducting multidimensional treatment with children who stutter (CWS) and to identify correlates of self-efficacy in treating speech-related, social, emotional, and cognitive domains of stuttering. Method Three hundred twenty randomly selected school-based SLPs across the United States responded to an online survey that contained self-efficacy scales related to speech, social, emotional, and cognitive components of stuttering. These ratings were analyzed in relation to participants' beliefs about stuttering treatment and their comfort level in treating CWS, perceived success in therapy, and empathy levels, in addition to their academic and clinical training in fluency disorders as well as demographic information. Results Overall, SLPs reported moderate levels of self-efficacy on each self-efficacy scale and on a measure of total self-efficacy. Significant positive associations were observed between SLPs' self-efficacy perceptions and their comfort level in treating CWS, self-reported success in treatment, beliefs about the importance of multidimensional treatment, and self-reported empathy. There were some discrepancies between what SLPs believed was important to address in stuttering therapy and how they measured success in therapy. Conclusions Among school-based SLPs, self-efficacy for treating school-age CWS with a multidimensional approach appears stronger than previously reported; however, more progress in training and experience is needed for SLPs to feel highly self-efficacious in these areas. Continuing to improve clinician self-efficacy for stuttering treatment through improved academic training and increased clinical experiences should remain a high priority in order to enhance outcomes for CWS. Supplemental Material https://doi.org/10.23641/asha.12978194.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1044/2020_LSHSS-20-00044DOI Listing
October 2020

"Openness and progress with communication and confidence have all gone hand in hand": Reflections on the experience of transitioning between concealment and openness among adults who stutter.

J Fluency Disord 2020 09 14;65:105781. Epub 2020 Aug 14.

Department of Rehabilitation Sciences, University of Toledo, Toledo, OH, United States.

Purpose: The purpose of this study was to gain a deeper understanding of the experience of people who stutter as they navigate through the growth process from concealment to openness.

Method: Twelve adults who stutter who are active in self-help/support groups for stuttering described their experiences of concealment and openness in a semi-structured interview. Purposeful selection was utilized to recruit participants who could comment thoughtfully on previous concealing, but became more open about their stuttering. A phenomenological approach was utilized to gain a deeper understanding of how people who stutter experience the transition from concealment to openness regarding their stuttering and identity. Thematic analysis contributed to identification of themes and subthemes describing participants' experiences.

Results: Participants described precursors to concealment that led to hiding and avoidance, which grew in strength until they reached a turning point. They then changed how they related to their stuttering by changing their behaviors and perceptions of stuttering, which led to increased openness about their identity. This process of continued adaptation to stuttering was ongoing and non-linear, but suggested general trends from concealment to more openness over time. Level of openness was impacted by situational context and individual differences.

Conclusions: The findings extend our understanding of how people who stutter navigate transitions from concealment to openness. This deeper understanding could be helpful in explaining the complexities involved in managing the identity of a person who stutters, and the process of adapting to living with stuttering over time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jfludis.2020.105781DOI Listing
September 2020

Teacher-student relationships and mental health help seeking behaviors among elementary and secondary students in Ontario Canada.

J Sch Psychol 2020 08 17;81:1-10. Epub 2020 Jun 17.

Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada. Electronic address:

This study examined associations between teacher-student relationship quality at school and teachers' responsiveness to students' emotional concerns in a classroom and (a) students' intention to seek help at school for mental health concerns and (b) mental health-related service use. Data for analyses came from the School Mental Health Survey, a cross-sectional survey of 31,120 grade 6-12 students, in 1968 classrooms, attending 248 schools in Ontario, Canada. Three-level (student, classroom, school) binary logistic regression was used to address the study objectives. Student ratings of the quality of teacher-student relationships and teachers' responsiveness were included as predictors, both at the individual student level and aggregated to represent a contextual level characteristic at the school and classroom level, respectively. At the student level, both teacher-student relationship quality and teacher responsiveness were positively associated with intentions to seek help at school among both elementary and secondary students (ORs ranged from 1.14-1.19 for relationships and 1.06-1.08 for responsiveness). Aggregated to the school level, teacher-student relationship quality was positively associated with mental health service use for secondary students (OR = 1.36, 95% CI [1.10, 1.69]). Positive and responsive teacher-student relationships were associated with help-seeking behaviors among students. Longitudinal studies are warranted to disentangle the temporality of these associations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jsp.2020.05.003DOI Listing
August 2020

Nonclinical Safety Assessment of AMG 553, an Investigational Chimeric Antigen Receptor T-Cell Therapy for the Treatment of Acute Myeloid Leukemia.

Toxicol Sci 2020 09;177(1):94-107

Kite Pharma, Inc., Santa Monica, California 90404.

Feline McDonough Sarcoma-like tyrosine kinase 3 (FLT3), a tyrosine-protein kinase involved in hematopoiesis, is detectable on the cell surface of approximately 80% of leukemia isolates from adult patients with acute myeloid leukemia (AML). AMG 553 is an investigational chimeric antigen receptor (CAR) T-cell immunotherapy for the treatment of AML. FLT3 expression analysis and in vitro and in vivo studies were leveraged to evaluate the nonclinical safety of AMG 553. Cynomolgus monkeys administered autologous anti-FLT3 CAR T cells demonstrated no evidence of CAR T-cell-mediated toxicity, expansion, or persistence, likely due to restricted cell surface FLT3 protein expression in healthy animals. This highlights the limited value of such in vivo studies for safety assessment of the CAR T-cell modality when directed against a target with restricted expression. To complement these studies and directly evaluate the potential toxicities of eliciting T-cell-mediated cytotoxicity against cells with surface expression of FLT3 protein in vivo, data from cynomolgus monkey toxicology studies with 2 bispecific T-cell engager molecules targeting FLT3 were leveraged; findings were consistent with the targeted killing of bone marrow cells expressing cell surface FLT3. Potential AMG 553-induced cytotoxicity was assessed against a wide range of normal human primary cells and cell lines; cytotoxicity was observed against FLT3-positive AML cell lines and a percentage of primary bone marrow CD34+ cells. In conclusion, the nonclinical safety data suggest that AMG 553 can target FLT3 protein on AML cells, whereas only affecting a percentage of normal hematopoietic stem and progenitor cells, supporting clinical development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/toxsci/kfaa098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553704PMC
September 2020

Infectious Complications of Biological and Small Molecule Targeted Immunomodulatory Therapies.

Clin Microbiol Rev 2020 06 10;33(3). Epub 2020 Jun 10.

Department of Infectious Diseases and Immunology, John Hunter Hospital, Newcastle, NSW, Australia.

The past 2 decades have seen a revolution in our approach to therapeutic immunosuppression. We have moved from relying on broadly active traditional medications, such as prednisolone or methotrexate, toward more specific agents that often target a single receptor, cytokine, or cell type, using monoclonal antibodies, fusion proteins, or targeted small molecules. This change has transformed the treatment of many conditions, including rheumatoid arthritis, cancers, asthma, and inflammatory bowel disease, but along with the benefits have come risks. Contrary to the hope that these more specific agents would have minimal and predictable infectious sequelae, infectious complications have emerged as a major stumbling block for many of these agents. Furthermore, the growing number and complexity of available biologic agents makes it difficult for clinicians to maintain current knowledge, and most review articles focus on a particular target disease or class of agent. In this article, we review the current state of knowledge about infectious complications of biologic and small molecule immunomodulatory agents, aiming to create a single resource relevant to a broad range of clinicians and researchers. For each of 19 classes of agent, we discuss the mechanism of action, the risk and types of infectious complications, and recommendations for prevention of infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1128/CMR.00035-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289788PMC
June 2020

Characterization of a Novel FLT3 BiTE Molecule for the Treatment of Acute Myeloid Leukemia.

Mol Cancer Ther 2020 09 9;19(9):1875-1888. Epub 2020 Jun 9.

Amgen Research, Amgen Inc., South San Francisco, California.

Despite advances in the treatment of acute myeloid leukemia (AML), novel therapies are needed to induce deeper and more durable clinical response. Bispecific T-cell Engager (BiTE) molecules, which redirect patient T cells to lyse tumor cells, are a clinically validated modality for hematologic malignancies. Due to broad AML expression and limited normal tissue expression, fms-related tyrosine kinase 3 (FLT3) is proposed to be an optimal BiTE molecule target. Expression profiling of FLT3 was performed in primary AML patient samples and normal hematopoietic cells and nonhematopoietic tissues. Two novel FLT3 BiTE molecules, one with a half-life extending (HLE) Fc moiety and one without, were assessed for T-cell-dependent cellular cytotoxicity (TDCC) of FLT3-positive cell lines , and FLT3 protein was detected on the surface of most primary AML bulk and leukemic stem cells but only a fraction of normal hematopoietic stem and progenitor cells. FLT3 protein detected in nonhematopoietic cells was cytoplasmic. FLT3 BiTE molecules induced TDCC of FLT3-positive cells , reduced tumor growth and increased survival in AML mouse models Both molecules exhibited reproducible pharmacokinetic and pharmacodynamic profiles in cynomolgus monkeys , including elimination of FLT3-positive cells in blood and bone marrow. In cultures of primary AML samples, patient T cells induced TDCC of FLT3-positive target cells. Combination with PD-1 blockade increased BiTE activity. These data support the clinical development of an FLT3 targeting BiTE molecule for the treatment of AML.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1158/1535-7163.MCT-19-1093DOI Listing
September 2020

Social assistance and trajectories of child mental health problems in Canada: evidence from the National Longitudinal Survey of Children and Youth.

Can J Public Health 2020 08 2;111(4):585-593. Epub 2020 Mar 2.

Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.

Objectives: To examine the link between stability and change in social assistance (SA) use and children's mental health trajectories to better understand whether social policies targeted at low-income families might be an effective population-based mechanism for preventing mental health problems among children at risk.

Methods: The National Longitudinal Survey of Children and Youth (N = 8981) is used to classify children into 5 categories based on their family's pattern of SA use from age 4-5 to 10-11: always or never on SA, a single transition on or off SA, or fluctuations on and off SA. Latent growth modelling is used to compare trajectories of emotional and behavioural problems among children with different patterns of SA exposure to their counterparts never on SA over this same time period.

Results: Child emotional and behavioural problems are exacerbated over time in accordance with patterns of SA use: chronic SA use (behavioural) and moving onto SA (emotional and behavioural). These differential rates of change result in mental health disparities at age 10-11 that were not present at age 4-5. Children exposed to SA when they were age 4-5 but subsequently moved off continue to demonstrate elevated levels of emotional and behavioural problems at age 10-11.

Conclusions: Successful social policies and interventions will require understanding the specific mechanisms through which SA undermines child mental health and how programs can be modified to reduce its negative consequences.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.17269/s41997-020-00299-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438430PMC
August 2020

The Mental Health of Young Canadian Mothers.

J Adolesc Health 2020 04 10;66(4):464-469. Epub 2020 Feb 10.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.

Purpose: Although many young mothers (aged <21 years) are exposed to multiple adversities that increase their risk for mental illness, prevalence data are largely limited self-report questionnaires estimating only the prevalence of postpartum depression. Gaining a greater understanding of the burden of a broader range of common mental illnesses affecting these young women has the potential to improve their health as well as the development and functioning of their children.

Methods: The Young Mothers Health Study recruited 450 mothers aged <21 years and 100 comparison mothers (aged >20 years old at first delivery) living in urban and rural central-west Ontario. Age-matched young mothers were also compared with 15- to 17-year-old women without children (N = 630) from the 2014 Ontario Child Health Study. The prevalence of current mental disorders was assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents.

Results: Nearly 2 of 3 young mothers reported at least one mental health problem, and almost 40% had more than one. Young mothers were 2 to 4 times as likely to have an anxiety disorder (generalized anxiety disorder, separation anxiety disorder, social phobia, and specific phobia), attention-deficit/hyperactivity disorder, oppositional defiant disorder, or conduct disorder and were 2 to 4 times more likely to have more than one psychiatric problem than older comparison mothers or women aged 15-17 years.

Conclusions: Given the high rates of mental health problems and complex needs of young mothers in Canada and the possible adverse effects of maternal psychopathology on their children, further efforts should be directed at engaging and treating this high-risk group.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jadohealth.2019.10.024DOI Listing
April 2020

Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders.

Soc Psychiatry Psychiatr Epidemiol 2020 Nov 13;55(11):1469-1478. Epub 2020 Feb 13.

Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, McMaster Innovation Park, Hamilton Ontario, L8S 4K1, Canada.

Objectives: To quantify the strength of association between passive and active forms of screen time and adolescent major depressive episode and anxiety disorders.

Methods: Data from the 2014 Ontario Child Health Study, a representative sample of 2,320 adolescents aged 12-17 years in Ontario (mean age = 14.58, male = 50.7%) were used. Screen time was measured using adolescent self-report on time spent on screen-based activities. Past 6-month occurrence of DSM-IV-TR defined major depressive episode, social phobia, generalized anxiety disorder, and specific phobia which were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents.

Result: Adolescents reporting 4 or more hours of passive screen time per day, compared to those reporting less than 2 h, were three times more likely to meet the DSM-IV-TR criteria for major depressive episode [OR = 3.28(95% CI = 1.71-6.28)], social phobia [OR = 3.15 (95% CI = 1.57-6.30)] and generalized anxiety disorder [OR = 2.92 (95% CI = 1.64-5.20)]. Passive screen time continued to be significantly associated with increased odds of disorders, after adjusting for age, sex, low income, active screen time use, sleep and physical activity. A small-to-moderate attenuation of the estimated ORs was observed in the fully adjusted model. In contrast, associations between active screen time use and depression and anxiety disorders were smaller in magnitude and failed to reach statistical significance.

Conclusions: Passive screen time use was associated with mood and anxiety disorders, whereas active screen time was not. Further research is needed to better understand the underlying processes contributing to differential risk associated with passive versus active screen time use and adolescent mood and anxiety disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00127-020-01833-9DOI Listing
November 2020

Area-Level Variation in Children's Unmet Need for Community-Based Mental Health Services: Findings from the 2014 Ontario Child Health Study.

Adm Policy Ment Health 2020 09;47(5):665-679

Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.

There is limited empirical evidence documenting the magnitude and correlates of area-level variability in unmet need for children's mental health services. Research is needed that identifies area-level characteristics that can inform strategies for reducing unmet need in the population. The study purpose is to: (1) estimate area-level variation in children's unmet need for mental health services (using Service Areas as defined by the Ontario Ministry of Children and Youth Services), and (2) identify area-level service arrangements, and geographic and population characteristics associated with unmet need. Using individual-level general population data, area-level government administrative data and Census data from Ontario, Canada, we use multilevel regression models to analyze unmet need for mental health services among children (level 1) nested within Service Areas (level 2). The study finds that 1.64% of the reliable variance in unmet need for mental health services is attributable to between-area differences. Across areas, we find that Service Areas with more agencies had a lower likelihood of unmet need for mental health services. Compared to other Service Areas, Toronto had much lower likelihood of unmet need compared to the rest of Ontario. Rural areas, areas with unsatisfactory public transport, and areas with higher levels of socio-economic disadvantage had a higher likelihood of unmet need for mental health services. These findings identify challenges in service provision that researchers, policymakers and administrators in children's mental health services need to better understand. Policy implications and potential Service Area strategies that could address equitable access to mental health services are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10488-020-01016-3DOI Listing
September 2020

Toward a better understanding of the process of disclosure events among people who stutter.

J Fluency Disord 2020 03 8;63:105746. Epub 2020 Jan 8.

School of Intervention and Wellness, Speech-Language Pathology, University of Toledo, Toledo, OH, United States.

Purpose: The purpose of this study was to identify components of disclosure events among people who stutter, and identify possible relations between these components in order to understand how disclosure events unfold.

Method: Twelve adults who stutter participated in semi-structured interviews focused on disclosure of stuttering. Participants were purposefully selected due to their self-reported history of disclosing stuttering. Qualitative content analysis using a grounded theory approach helped to identify relevant themes and subthemes related to the process of disclosure of stuttering.

Results: The findings describe the complex process of disclosure as being comprised of antecedents (including considerations about when and why to disclose), the disclosure event itself (including the content and form of the disclosure, most and least helpful methods of disclosure, as well as immediate listener reactions), and the perceived outcomes of the disclosure at individual, dyadic, and societal/contextual levels. These components of the process are linked and affect one another, resulting in a feedback loop. Disclosure methods are context-dependent and not mutually exclusive within individuals who stutter.

Conclusion: Professionals and advocates gaining a more nuanced understanding of the process of disclosure events can increase their ability to help people who stutter make optimal decisions about disclosure. Making good disclosure decisions can help PWS improve their quality of life and reduce a variety of environmental communicative barriers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jfludis.2020.105746DOI Listing
March 2020

Multimorbidity in Children and Youth Across the Life-course (MY LIFE): protocol of a Canadian prospective study.

BMJ Open 2019 11 3;9(11):e034544. Epub 2019 Nov 3.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.

Introduction: Multimorbidity, the co-occurrence of a chronic physical condition and mental disorder, affects a substantial number of children and youth and can lead to compromised quality of life, hardship for families, and an increased burden on the healthcare system. We are conducting a study to document the course of mental disorder in children and youth diagnosed with a chronic physical condition; identify predictors of child and youth multimorbidity; examine whether the effects of these predictors are moderated by relevant psychosocial and biological factors; explore potential inflammatory and stress biomarkers that mediate the onset of child and youth multimorbidity; and, assess whether multimorbidity in children and youth alters patterns of mental health service use.

Methods And Analysis: Multimorbidity in Children and Youth Across the Life-course (MY LIFE) is a prospective study. Two hundred and fifty children and youth aged 2-16 years diagnosed with a chronic physical condition along with one parent will be recruited from the outpatient clinics at a paediatric tertiary care centre. Data will be collected using a multi-informant, multimethod design at four time-points (at recruitment, and at 6, 12 and 24 months postrecruitment). Parents will provide reports for all children/youth. In addition, youth ≥10 years will self-report. Mental disorder will be assessed using structured interviews. On completion of data collection, participant-reported data will be linked to provincial health records to identify mental health services use. Multilevel analyses (survival, proportional hazard, structural equation modelling) will be used to address MY LIFE objectives.

Ethics And Dissemination: This study has been approved by the University of Waterloo Human Research Ethics Board and the Hamilton Integrated Research Ethics Board. Findings will be disseminated to key stakeholders using a number of outlets (peer-reviewed publications and conferences, lay informational pamphlets, social media).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2019-034544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859408PMC
November 2019
-->