Intricacies of development : the impact of maternal experience and isolation on the social development of juvenile male rats

Reproductive experience induces changes in females. Parity-related differences in maternal treatment of offspring can induce enduring changes in offspring. The relationships between maternal experience, early social isolation, and development were explored in rodents in this experiment. Male rats were weaned from multiparous (MP) and primiparous (PP) mothers and placed into isolation or social housing for four weeks. They were then observed in a social-interaction test. Social behavior and neural oxytocin and vasopressin were assessed post-testing, while corticosterone levels were measured across the four weeks. Weaning was extremely stressful for all offspring. PP- and MP-raised pups exhibited differences in social behavior, and trends towards different hormonal and neural profiles. The isolation paradigm was examined in a multidimensional fashion, revealing novel and provocative associations. This study further clarified some of the many ways that offspring development may be altered

Practices of professionals providing services to children with autism spectrum disorders: Testing the theory of planned behavior in predicting use of evidence-based interventions and family-centered care

Autism spectrum disorders (ASDs) are chronic and pervasive developmental disorders; children with ASDs require more multidisciplinary services than children with other developmental, behavioral, and emotional disorders (Kogan et al., 2008). Little research has been done on the practices and perspectives of the professionals providing services to children with ASDs. Evidence-based practice (combining use of evidence-based interventions [EBIs], family-centered care [FCC] respecting patient/family values, and clinical expertise) leads to the best outcomes for children with ASDs (APA Presidential Task Force on Evidence-Based Practice, 2006). The aim of this study was to assess the extent to which psychological constructs (attitudes, subjective norms, perceived behavioral control) within the Theory of Planned Behavior (Ajzen, 1991) are helpful for understanding the behavior of professionals in regards to two areas of evidence-based practice: recommending and/or providing EBIs and using a FCC approach to care with children with ASDs. Professionals (N=709) providing direct services to children with ASDs were recruited from different disciplines (Education, Medicine/Nursing, Occupational and Physical Therapy, Psychology, Social Work, Speech Language Pathology/Audiology) and were asked to fill out an Internet or paper survey including measures on TPB constructs and EBI and FCC behavior. Participants were recruited from a convenience Internet sample and a stratified random sample of online provider listings (from professional and autism-specific organizations). Professionals’ attitudes and familiarity with EBIs significantly predicted their self-reported recommendation and provision of EBIs in the positive direction. Professionals’ attitudes, perceived-behavioral control, and years in practice significantly predicted self-reported use of an FCC approach with children with ASDs in the positive direction. There was a trend for explicit training on EBI or FCC to predict professionals’ behavior, but these findings did not reach conventional levels of significance. Subjective norms did not significantly predict EBI or FCC behavior. Discipline membership did not moderate the relationship between TPB and EBI and FCC self-reported behavior measures. The TPB is a useful framework for better understanding professionals’ evidence-based practice behavior. This study sheds light on practices and perspectives of professionals working with children with ASDs and highlights areas for future research and training with this population

Disparities in the Clinical Encounter: Virginia's African American Children with Special Health Care Needs

This study analyzed Virginia data from the most recent National Survey of Children with Special Health Care Needs. Logistic regression models were run for six Maternal and Child Health Bureau core outcomes and included demographics, child characteristics, health care providers, and health care access variables as predictors. Race/ethnicity disparities were judged to be present if the race/ethnicity variable was a significant predictor in the final model. Examining the components of disparate outcomes, African American children were found to be less likely than their white counterparts to have a usual source for sick and preventive care and to have a personal doctor or nurse. Their parents were less likely to say that doctors spent enough time, listened carefully, were sensitive to values and customs, and made them feel like a partner. These findings emphasize the need to examine health care disparities at a state level in order to guide efforts at remediation

Evidence-Based Assessment Meets Evidence-Based Treatment: An Approach to Science-Informed Case Conceptualization

Though case conceptualization is considered to be a component of evidence-based practice, the case conceptualization process is not always guided by scientific findings. Case conceptualization is a collaborative process of generating hypotheses about causes, antecedents, and maintaining influences for an individual client’s problems within a biopsychosocial context. We argue that adopting a scientific approach to case conceptualization informed by research findings and evidence-based assessment tools can help inform clinical decision-making from intake to treatment termination. Our approach to case conceptualization involves 5 stages. In the first stages, a clinician synthesizes and integrates research evidence from various literatures to identify presenting problems and casual and maintaining factors (Stage 1), to classify diagnoses (Stage 2), to inform the development of hypotheses about variables contributing to a client’s problems (Stage 3), and to select a treatment approach and plan (Stage 4). In the final stage, the clinician takes a scientific approach to developing individualized assessment methods that can be used to test and revise hypotheses through the treatment process and to measure outcomes (Stage 5). A case example illustrating practical use of these steps is presented. •A science-informed case conceptualization approach can help inform clinical decision-making.•Integrating research findings and evidence-based assessment (EBA) tools can aid in this process.•We present a 5-stage approach to case conceptualization grounded in EBA strategies.•A case example illustrating practical use of these steps is presented

Design and rationale of a pilot randomized clinical trial investigating the use of a mHealth app for sarcoidosis-associated fatigue

Fatigue is the most reported symptom in patients with sarcoidosis (SPs) and is a significant predictor of decreased quality of life that is strongly associated with stress and negative mood states. Few medications exist for treating fatigue in SPs, and outpatient physical rehabilitation programs are limited by availability and cost. Sarcoidosis in the US predominantly impacts minorities and underserved populations who are of working age and often have limited resources (e.g., financial, transportation, time off work) that may prevent them from attending in-person programs. The use of mobile health (mHealth) is emerging as a viable alternative to provide access to self-management resources to improve quality of life. The Sarcoidosis Patient Assessment and Resource Companion (SPARC) App is a sarcoidosis-specific mHealth App intended to improve fatigue and stress in SPs. It prompts SPs to conduct breathing awareness meditation (BAM) and contains educational modules aimed at improving self-efficacy.Herein we describe the design and methods of a 3-month randomized control trial comparing use of the SPARC App (10-min BAM twice daily) to standard care in 50 SPs with significant fatigue (FAS ≥22). A Fitbit® watch will provide immediate heartrate feedback after BAM sessions to objectively monitor adherence. The primary outcomes are feasibility and usability of the SPARC App (collected monthly). Secondary endpoints include preliminary efficacy at improving fatigue, stress, and quality of life. We expect the SPARC App to be a useable and feasible intervention that has potential to overcome barriers of more traditional in-person programs