A serious game for children with Attention Deficit Hyperactivity Disorder: Who benefits the most?

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Патогенетические механизмы повреждений бета-клеток панкреатических островков при диабете и влияние прерывистой гипоксии

У щурів з експериментальним цукровим діабетом та впливом на них переривчастої гіпоксії вивчені особливості синтезу інсуліну, цитоархітектоніки бета-клітин та експресія маркерів апоптозу та проліферації. Кількість бета-клітин підвищується, концентрація інсуліну залишається в межах інтактного показника. Значною мірою підвищується вироблення антиапоптотичного білку Bcl2. Гіпокситерапія призводить до суттєвого підвищення проліферативної активності ендокриноцитів панкреатичних острівців.At rats with an experimental diabetes and influence on intermittent hypoxia, features of synthesis of insulin, cells-architectonics beta-cells and an expression of markers apoptotic and proliferative are studied. Amount beta-cells increase, and concentration of insulin remains border of a control indicator. The production of anti-apoptotic protein Bcl2 increase to a considerable extent. Intermittent hypoxia significantly increase the proliferative activity endokrinotsitis pancreatic islets

The effectiveness of Video-feedback Intervention to promote Positive Parenting for Foster Care (VIPP-FC)

Background: Foster children are at higher risk of the development of behavior and emotional problems, which can contribute to the development of insecure attachment bonds with their foster parents and (subsequently) to placement breakdown. Sensitive parenting might minimize the adverse effects of the behavior and emotional problems. Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care (VIPP-FC) is an adaptation of the evidence-based Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and aims at increasing sensitive parenting and the use of sensitive discipline strategies of foster parents. The current study is the first to examine the effectiveness of VIPP-FC. Methods: A randomized controlled trial is used with 60 foster parent-child dyads (intervention group n=30, control group n=30). The primary outcomes are parental sensitivity, parental disciplining, and parental attitudes towards parenting. Data about attachment (in)security, behavioral and emotional problems, neurobiological parameters, and possible confounders is additionally collected. Discussion: Examining the effectiveness of VIPP-FC contributes to the knowledge of evidence-based prevention and intervention programs needed in foster care practice

Intensive specialised multi-family therapy for multi-stressed families

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families

A systematic review of the literature on ethical aspects of transitional care between child- and adult-orientated health services

Background Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services (CAMHS). Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. Methods A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Results Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. Conclusions There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area

Attachment representations and autonomic regulation in maltreating and nonmaltreating mothers.

This study assessed attachment representation and attachment-related autonomic regulation in a sample of 38 maltreating and 35 nonmaltreating mothers. Mothers' state of mind regarding attachment was measured using the Adult Attachment Interview. They further watched an attachment-based comfort paradigm, during which we measured skin conductance and vagal tone. More maltreating mothers (42%) than nonmaltreating mothers (17%) had an unresolved/disoriented attachment classification. Attachment representation was related to physiology during the comfort paradigm: an unresolved state of mind and a nonautonomous classification were associated with a decrease in skin conductance during the comfort paradigm, specifically during the responsive caregiver scenario. However, physiology did not differ between maltreating and nonmaltreating mothers. The decrease in skin conductance of unresolved mothers during the comfort paradigm might be indicative of a deactivating response, which is congruent with the dissociative nature of the unresolved state of mind. The results point to the potential utility of interventions focused on attachment representations for maltreating mothers.The study was supported by Yulius mental health clinic, the Netherlands Organization for Scientific Research (MHvIJ: NWO SPINOZA prize; MJBK: VICI grant; LRAA: VIDI grant), and the Wellcome Trust (WT103343MA).This is the author accepted manuscript. The final version is available from Cambridge University Press via https://doi.org/10.1017/S095457941600103

Positive parenting in foster care: Testing the effectiveness of a video-feedback intervention program on foster parents’ behavior and attitudes

The current randomized controlled trial examined the effectiveness of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care (VIPP-FC) on parenting behavior and attitudes in foster parents (N = 60, 31–61 years, 83% female). The intervention group (n = 30) received VIPP-FC, consisting of six sessions. During the first four sessions, a specific theme from Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD; e.g., attachment vs. exploration behavior), and an additional foster care theme (e.g., subtle or missing attachment signals) are discussed. Each theme is discussed during the consecutive sessions and the last two sessions are booster sessions during which all themes are discussed. The control group (n = 30) received a dummy intervention consisting of six telephone calls about general child developmental topics. The Ainsworth Scales for sensitivity and non-interference, the Erickson scale for supportive presence, and the Questionnaire Attitudes towards Parenting were used to measure parental sensitivity, sensitive discipline, and attitudes towards parenting, respectively. The intervention and control group did not differ on demographic characteristics or outcome variables at pretest. Multilevel analyses based on the intent-to-treat principle yielded no evidence that VIPP-FC was more effective in improving foster parents’ sensitive parenting behavior or eliciting more positive attitudes compared to the control condition. We suggest that the outcomes in this study may be explained by a possible selection bias, which may have resulted in a ceiling effect. Future research might include foster families that experience more severe challenges (i.e., elevated levels of child behavior problems) or indicate a need for help and support

Psychosexual Functioning of Cognitively-able Adolescents with Autism Spectrum Disorder Compared to Typically Developing Peers

To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD

Effect of Key2Teach on Dutch teachers' relationships with students with externalizing problem behavior:A randomized controlled trial

The teacher-student relationship plays an important role in the academic and behavioral development of primary school children with externalizing problem behavior. However, such problem behavior often threatens the quality of the teacher-student relationship. Teacher-focused coaching intervention Key2Teach aims to improve elements of the relationship between teachers and students with externalizing problem behavior and consists of two phases and four building blocks. This intervention provides primary school teachers with insight into their mental representation of the relationship and opportunities to practice functional interaction skills. In a randomized controlled trial (RCT), effects of Key2Teach on different aspects of the relationship between teachers and students with externalizing problem behavior were examined. In two cohorts, 103 dyads consisting of a teacher and a student with externalizing problem behavior in grades 3-6 were assessed three times during a school year. Fifty-three dyads received the intervention (intervention group), whereas 50 dyads received no intervention (control group). Data were collected on teacher-reported teacher-student closeness and conflict, and on teacher interaction skills in various domains. Results show a significant increase in closeness and a decrease in conflict as a result of Key2Teach, with substantial effect sizes. No effects on teacher interaction skills were found. This study indicates that Key2Teach may help teachers to improve elements of the relationship they have with students with externalizing problem behavior. Implications for practice and future research are discussed

Challenges during the transition from child and adolescent mental health services to adult mental health services

The transition from child and adolescent to adult mental health services for young people with mental health problems is of international concern. Despite the high prevalence of mental disorders during adolescence and their tendency to continue during adulthood, the majority of young people do not experience continuity of care. The aim of this review paper is to unravel the complexity of transitional mental healthcare to clinicians, policy makers and mental health service managers, and to address challenges to a smooth transition process at all levels