Challenging Behaviors in Children with Comorbid Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder

Challenging behaviors, such as aggression, destruction, self-injurious behaviors, or stereotypic movements, affect the majority of individuals with Autism Spectrum Disorder. One factor that is known to influence the frequency at which challenging behaviors occur is the presence of a comorbid disorder. Attention-deficit/hyperactivity disorder (ADHD) is thought to be one such disorder. This study aimed to compare the prevalence rates of challenging behaviors, according to the Autism Spectrum Disorder-Behavior Problems, Child Version (ASD-BPC), in children ages 6-16 with parent reported symptoms of ASD, ADHD, comorbid ASD/ADHD, and no diagnosis. Differences existing overall were examined as well as differences on the ASD-BPC’s two factors, behaviors directed towards self and behaviors directed towards others. Results indicate that individuals with symptoms of ASD/ADHD display significantly higher rates of challenging behavior than those with symptoms of ADHD only and no diagnosis. They also indicate that those with symptoms of ADHD displayed higher rates of challenging behavior than those with no diagnosis. A better understanding of challenging behaviors in individuals with comorbid ASD/ADHD will assist in more accurate differential diagnoses

‘Yes-in-my-backyard’: Spatial differences in the valuation of forest services and local co-benefits for carbon markets in México

Forests provide many and large benefits, including cost-efficient climate change mitigation. However international carbon markets have not stimulated the demand for forestry offsets. Domestic market-mechanisms are emerging inmany countries and forests could be highly valued through these policies asmost of the benefits produced by forests are enjoyed locally. Here, a choice experiment explores drivers of valuation and willingness to pay for forest carbon services in voluntary markets in Mexico by comparing the valuation of citizens from four regions to test geographical preference for projects (n = 645). Findings from multinomial-logit models show valuation of forest carbon services is transferable and citizens would pay more for offsets from projects closer to their homes. Proximate forests provide a range of co-benefits to local users, including environmental services and opportunities for recreation. Factors related to valuation include sense of responsibility, previous knowledge of carbon emissions, previous visits to the sites, regional identification and the valuation of local environmental services (e.g. improvements in local air quality). Knowledge of spatial heterogeneity in valuation of the use of forest services can help to design market-based instruments by identifying highly valued areas for environmental services programs and carbon markets

Does gaining control of smoking behaviours have a positive impact on glycaemic control in patients with Type 2 diabetes?

Background Smoking cigarettes is a well-documented cause of ill-health and is associated (Cigarette smoking among people with diabetes increases the risk of developing long-term complications. Although smoking cessation is considered important for all, it is especially significant for people with diabetes and is recommended throughout the literature. Few studies have investigated the impact of a smoking cessation intervention tailored to the needs of people with Type 2 diabetes. This study attempts to address this. Aims The overall aim was to assess the impact of a smoking cessation psychological intervention for people with Type 2 diabetes and whether the intervention had a positive impact on their glycated haemoglobin levels.awd_pdtunpub1920_ethesesunpu

Cellular Therapy for Fanconi Anemia: The Past, Present, and Future

Allogeneic hematopoietic cell transplantation (HCT) remains the only proven curative therapy for the hematologic manifestation of Fanconi anemia (FA). Over the past 2 decades, major advances have been made such that transplant outcomes have markedly improved. With the development of in vitro fertilization and preimplantation genetic diagnosis, HLA-matched sibling donor umbilical blood transplantation may be an option for more patients with FA. Recently, the use of pluripotent stem cells has been explored as a novel approach to model the hematopoietic developmental defects in FA, and to provide a potential source of autologous stem cells that can be genetically manipulated and used to generate corrected hematopoietic progenitors

Neurobehavioral Abnormalities in Firest-Degree Relative of Individuals With Autism

CONTEXT: Studying sensorimotor and neurocognitive impairments in unaffected family members of individuals with autism may help identify familial pathophysiological mechanisms associated with the disorder. OBJECTIVE: To determine whether atypical sensorimotor or neurocognitive characteristics associated with autism are present in first-degree relatives of individuals with autism. DESIGN: Case-control comparison of neurobehavioral functions. SETTING: University medical center. PARTICIPANTS: Fifty-seven first-degree relatives of individuals with autism and 40 age-, sex-, and IQ-matched healthy control participants (aged 8-54 years). MAIN OUTCOME MEASURES: Oculomotor tests of sensorimotor responses (saccades and smooth pursuit); procedural learning and response inhibition; neuropsychological tests of motor, memory, and executive functions; and psychological measures of social behavior, communication skills, and obsessive-compulsive behaviors. RESULTS: On eye movement testing, family members demonstrated saccadic hypometria, reduced steady-state pursuit gain, and a higher rate of voluntary response inhibition errors relative to controls. They also showed lateralized deficits in procedural learning and open-loop pursuit gain (initial 100 milliseconds of pursuit) and increased variability in the accuracy of large-amplitude saccades that were confined to rightward movements. In neuropsychological studies, only executive functions were impaired relative to those of controls. Family members reported more communication abnormalities and obsessive-compulsive behaviors than controls. Deficits across oculomotor, neuropsychological, and psychological domains were relatively independent from one another. CONCLUSIONS: Family members of individuals with autism demonstrate oculomotor abnormalities implicating pontocerebellar and frontostriatal circuits and left-lateralized alterations of frontotemporal circuitry and striatum. The left-lateralized alterations have not been identified in other neuropsychiatric disorders and are of interest given atypical brain lateralization and language development associated with the disorder. Similar oculomotor deficits have been reported in individuals with autism, suggesting that they may be familial and useful for studies of neurophysiological and genetic mechanisms in autism

Twenty Years of Unrelated Donor Bone Marrow Transplantation for Pediatric Acute Leukemia Facilitated by the National Marrow Donor Program

AbstractThe National Marrow Donor Program (NMDP) has facilitated unrelated donor hematopoietic cell transplants for more than 20 years. In this time period, there have been many changes in clinical practice, including improvements in HLA typing and supportive care, and changes in the source of stem cells. Availability of banked unrelated donor cord blood (incorporated into the NMDP registry in 2000) as a source of stem cells has become an important option for children with leukemia, offering the advantages of immediate availability for children with high-risk disease, the need for a lesser degree of HLA match, and expanding access for those with infrequent HLA haplotypes. Overall survival (OS) in children with acute leukemia transplanted with unrelated donor bone marrow (BM) is markedly better in more recent years, largely attributable to less treatment-related mortality (TRM). Within this cohort, 2-year survival was markedly better for patients with acute lymphoblastic leukemia (ALL) in first complete response (CR1) (74%) versus second complete response (CR2) (62%) or more advanced disease (33%). Similar findings are observed with patients with AML, suggesting earlier referral to bone marrow transplant (BMT) is optimal for survival. Notably, this improvement over time was not observed in unmodified peripheral blood stem cell (PBSC) recipients, suggesting unmodified PBSC may not be the optimal stem cell source for children

West End Walkers 65+: a randomised controlled trial of a primary care-based walking intervention for older adults:study rationale and design

<p>Background: In Scotland, older adults are a key target group for physical activity intervention due to the large proportion who are inactive. The health benefits of an active lifestyle are well established but more research is required on the most effective interventions to increase activity in older adults. The 'West End Walkers 65+' randomised controlled trial aims to examine the feasibility of delivering a pedometer-based walking intervention to adults aged ≥65 years through a primary care setting and to determine the efficacy of this pilot. The study rationale, protocol and recruitment process are discussed in this paper.</p> <p>Methods/Design: The intervention consisted of a 12-week pedometer-based graduated walking programme and physical activity consultations. Participants were randomised into an immediate intervention group (immediate group) or a 12-week waiting list control group (delayed group) who then received the intervention. For the pilot element of this study, the primary outcome measure was pedometer step counts. Secondary outcome measures of sedentary time and physical activity (time spent lying/sitting, standing or walking; activPAL™ monitor), mood (Positive and Negative Affect Schedule), functional ability (Perceived Motor-Efficacy Scale for Older Adults), quality of life (Short-Form (36) Health Survey version 2) and loneliness (UCLA Loneliness Scale) were assessed. Focus groups with participants and semi-structured interviews with the research team captured their experiences of the intervention. The feasibility component of this trial examined recruitment via primary care and retention of participants, appropriateness of the intervention for older adults and the delivery of the intervention by a practice nurse.</p> <p>Discussion: West End Walkers 65+ will determine the feasibility and pilot the efficacy of delivering a pedometer-based walking intervention through primary care to Scottish adults aged ≥65 years. The study will also examine the effect of the intervention on the well-being of participants and gain an insight into both participant and research team member experiences of the intervention.</p&gt