67 research outputs found

    The Utah psychotropic oversight program: collaboratively addressing antipsychotic use within youth in foster care without prior authorization

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    ObjectivesFostered youth have increased risk of exposure to trauma. Antipsychotic medications are often utilized within the foster care system, potentially to address problematic behaviors that may be associated with trauma. The Utah Psychotropic Oversight Program (UPOP) was formed to support prescribers and encourage evidence-based treatment approaches for fostered youth. However, it is unclear what impact an oversight program can have on a high turnover population and without tools such as prior authorization. This study evaluates 4 years of collected data from the UPOP program for efficacy and to identify future intervention targets.MethodsDeidentified data were collected as a routine function of the oversight program over 4 years (01/2019-12/2022), from individuals aged 0–18 years old (total N = 8,523, 48.3% female). UPOP oversight criteria: ≤6yo + any psychotropic medication, ≥7yo + 2 or more psychotropic medications. For this analysis, youth were divided by UPOP individuals ever receiving an antipsychotic (AP) prescription (UPOP_AP; N = 755, 42.3% female) or not (UPOP_NAP, N = 1,006, 48.3% female) and non-UPOP fostered (N = 6,762, 48.9% female). Comparisons were made across demographic and clinical variables via ANOVA, Chi-square, unpaired t-test, and logistic regression.ResultsUPOP_AP more likely to be older males with behavioral diagnoses, increased polypharmacy, longer duration of fostering, and higher care level. AP prescription rates dropped from 52.8 to 39.1% for males and 43.3 to 38.2% in females with unchanged number of psychotropic prescriptions and care level across 2019-2022. UPOP_AP that discontinued AP treatment had fewer average psychotropic medications, but increased antidepressant and sleep prescriptions, as compared with individuals that remained on AP.ConclusionYouth within the foster care system receive antipsychotics at high rates and in an uneven distribution. Prescribing practices can change in the context of supportive oversight programs without components such as prior authorization, and without increasing the need for higher levels of care. Specific emphasis on the treatment of mood, anxiety, and sleep issues may also lead to greater success in discontinuing AP treatment. Oversight may support treatment providers while reducing exposure to medications with considerable side effect burden that could cause future comorbidity

    Persistent starspot signals on M dwarfs: multi-wavelength Doppler observations with the Habitable-zone Planet Finder and Keck/HIRES

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    Young, rapidly-rotating M dwarfs exhibit prominent starspots, which create quasiperiodic signals in their photometric and Doppler spectroscopic measurements. The periodic Doppler signals can mimic radial velocity (RV) changes expected from orbiting exoplanets. Exoplanets can be distinguished from activity-induced false positives by the chromaticity and long-term incoherence of starspot signals, but these qualities are poorly constrained for fully-convective M stars. Coherent photometric starspot signals on M dwarfs may persist for hundreds of rotations, and the wavelength dependence of starspot RV signals may not be consistent between stars due to differences in their magnetic fields and active regions. We obtained precise multi-wavelength RVs of four rapidly-rotating M dwarfs (AD Leo, G 227-22, GJ 1245B, GJ 3959) using the near-infrared (NIR) Habitable-zone Planet Finder, and the optical Keck/HIRES spectrometer. Our RVs are complemented by photometry from Kepler, TESS, and the Las Cumbres Observatory (LCO) network of telescopes. We found that all four stars exhibit large spot-induced Doppler signals at their rotation periods, and investigated the longevity and optical-to-NIR chromaticity for these signals. The phase curves remain coherent much longer than is typical for Sunlike stars. Their chromaticity varies, and one star (GJ 3959) exhibits optical and NIR RV modulation consistent in both phase and amplitude. In general, though, we find that the NIR amplitudes are lower than their optical counterparts. We conclude that starspot modulation for rapidly-rotating M stars frequently remains coherent for hundreds of stellar rotations, and gives rise to Doppler signals that, due to this coherence, may be mistaken for exoplanets.Comment: Accepted for publication in the Astrophysical Journa

    The Habitable Zone Planet Finder Reveals a High Mass and Low Obliquity for the Young Neptune K2-25b

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    Using radial velocity data from the Habitable Zone Planet Finder, we have measured the mass of the Neptune-sized planet K2-25b, as well as the obliquity of its M4.5 dwarf host star in the 600–800 Myr Hyades cluster. This is one of the youngest planetary systems for which both of these quantities have been measured and one of the very few M dwarfs with a measured obliquity. Based on a joint analysis of the radial velocity data, time-series photometry from the K2 mission, and new transit light curves obtained with diffuser-assisted photometry, the planet's radius and mass are 3.44 ± 0.12 R_⊕ and 24.5_(-5.2)^(+5.7) M_⊕. These properties are compatible with a rocky core enshrouded by a thin hydrogen–helium atmosphere (5% by mass). We measure an orbital eccentricity of e = 0.43 ± 0.05. The sky-projected stellar obliquity is λ = 3° ± 16°, compatible with spin–orbit alignment, in contrast to other "hot Neptunes" that have been studied around older stars

    The Habitable-zone Planet Finder Reveals A High Mass and a Low Obliquity for the Young Neptune K2-25b

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    Using radial-velocity data from the Habitable-zone Planet Finder, we have measured the mass of the Neptune-sized planet K2-25b, as well as the obliquity of its M4.5-dwarf host star in the 600-800MYr Hyades cluster. This is one of the youngest planetary systems for which both of these quantities have been measured, and one of the very few M dwarfs with a measured obliquity. Based on a joint analysis of the radial velocity data, time-series photometry from the K2 mission, and new transit light curves obtained with diffuser-assisted photometry, the planet's radius and mass are 3.44±0.12R⊕3.44\pm 0.12 \mathrm{R_\oplus} and 24.5−5.2+5.7M⊕24.5_{-5.2}^{+5.7} \mathrm{M_\oplus}. These properties are compatible with a rocky core enshrouded by a thin hydrogen-helium atmosphere (5% by mass). We measure an orbital eccentricity of e=0.43±0.05e=0.43 \pm 0.05. The sky-projected stellar obliquity is λ=3±16∘\lambda=3 \pm 16^{\circ}, compatible with spin-orbit alignment, in contrast to other "hot Neptunes" that have been studied around older stars.Comment: Accepted for publication in AJ, 31 pages, 14 figure
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