Relationships between parental mental health, peer victimisation and internalising symptoms in children with autism

OVERVIEW: This thesis focuses on improving our understanding of the development of internalising symptoms, such as anxiety and depression, for autistic children and adolescents. Part 1 is a systematic review of the literature examining potential environmental risk factors for internalising symptoms, within samples of autistic adolescents and young people. The systematic review identified 29 studies, all of which were included in a narrative synthesis. Of these, 23 were also included in six meta-analyses. Findings indicated that eight themes of potentially-modifiable environmental factors showed meaningful associations with internalising symptoms experienced by autistic young people: parental mental health or stress; peer victimisation; parenting behaviour or family interaction; socioeconomic status; negative life events; social interaction; social support and pet ownership. Part 2 describes the empirical paper, which uses secondary data from the Millennium Cohort Study to examine the longitudinal and bi-directional relationships between two hypothesised risk factors (parental mental health, and peer victimisation) with child internalising symptoms. Data was available for 560 young people with a diagnosis of Autism Spectrum Disorder, across 6 timepoints from birth to 17-years-old. Random-Intercept Cross-Lagged Panel Models identified consistent cross-sectional associations between risk factors and child internalising symptoms at each timepoint, and several cross-lagged associations between risk factors and child internalising symptoms, including a bi-directional effect. Part 3 is a critical appraisal of the research, and focuses on three themes: the implications of being a non-autistic researcher conducting research about autism spectrum disorder; the opportunities and limitations of using secondary data from longitudinal cohort studies; and the utility and interpretation of Random-Intercept Cross-Lagged Panel Models

Perfectionism and attitudes toward cognitive enhancers (“smart drugs”)

Perfectionism is a personality disposition characterized by exceedingly high standards of performance and pressure to be perfect which may incline students to take cognitive enhancers (“smart drugs”) to boost their academic performance. So far, however, no study has investigated the relationships of multidimensional perfectionism and attitudes toward cognitive enhancers. The present study investigated these relationships in 272 university students examining different dimensions of perfectionism. Results showed that socially prescribed perfectionism, perfectionist concerns and doubts, and perceived parental pressure to be perfect showed positive correlations with attitudes favoring the use of cognitive enhancers. In contrast, self-oriented perfectionism, perfectionist personal standards, and organization showed negative correlations. The findings suggest that perfectionism may play a role as both a risk factor for and a protective factor against using cognitive enhancers depending on what dimensions of perfectionism are regarded

Needs and availability of snake antivenoms: relevance and application of international guidelines

Background: Snakebite has recently been declared a global public health emergency. Empirical data showing the true burden of snakebite is lacking. Treatment with specific antivenoms is considered the only cure. However, several factors have led to an ongoing antivenom crisis. This study offers recommendations concerning the improvement of antivenom access and control, by providing an overview of the factors limiting the successful implementation of international guidelines within the international industry and state institutions. It further investigates the reasons for the epidemiological knowledge gap regarding snakebites. Methods: Data for this study was collected using surveys with closed- and open-ended questions, which allowed for descriptive and thematic analysis, respectively. Participants for this study were selected as follows: 46 manufacturers were contacted from the open-access World Health Organization (WHO) Database for antivenom producers; 23 National Health Authorities (NHAs) of high-burden countries were contacted; and 11 poison centers or experts were randomly contacted. Results: In total, responses from 6/46 (13%) manufacturers, 10/23 (43%) NHAs, and 3/11 (27%) poison centers were received. The low response rates had a limiting effect on the coverage of this study, allowing only exploratory conclusions to be drawn. Based on the gathered information, a probable reason for the epidemiological knowledge gap is the low priority given to snakebites on public health agendas, driving interest and funding away from research in this field. As a consequence, the ensuing lack in funding is preventing state institutions and manufacturers from implementing international guidelines to the highest standards. Furthermore, manufacturers indicated that international guidelines were often not applicable in the field, lacking technical information and protocols. Conclusion: Snakebite ranks low on international public health agendas, and partially due to this low priority, NHAs have shown limited efforts in conducting epidemiological studies, training health workers on snakebite management and creating national snakebite management strategies. The lack of NHA involvement is reflected in poor access to appropriate antivenoms as well as a lack of antivenom regulation. Manufacturers are taking positive steps toward full implementation of international guidelines and are improving quality control procedures. However, in order for international guidelines to become truly useful in the field, more technical guidance is required. This study reflects that there is a general lack of knowledge transfer amongst various actors: most producers, health authorities, and experts expect increased and improved communication and guidance from leading international bodies. Due to the low response rates observed in this study, conclusions drawn herein are not representative of the global situation; yet provide an exploratory insight on the difficulties facing antivenom managemen

Mapping high-altitude peatlands to inform a landscape conservation strategy in the Andes of northern Peru

The wetlands of the jalca ecoregion in the Andes of northern Peru form peat and play a major role in the hydrological ecosystem services of the ecoregion. Although peat is globally valued for carbon sequestration and storage, peatlands have not yet been mapped in the jalca. In this region, the Gocta waterfall, one of the 20 highest waterfalls in the world, depends on the jalca’s wetlands ecosystem. The local population depends on tourism to the waterfall and is concerned about preserving its drainage area. To inform conservation planning, in this study we delimited the drainage area of the Gocta waterfall and identified land tenure by applying Geographic Information System (GIS), remote sensing and participatory mapping techniques. Then, by classifying optical, radar and digital elevation models data, we mapped peatland in the jalca of the Gocta drainage area with an overall accuracy of 97.1%. Our results will inform conservation strategy in this complex area of communal, private and informal land tenure systems. At a regional level, this appears to be the first attempt at mapping peatlands using remote sensing imagery in the jalca ecoregion, and it represents a milestone for future efforts to map and conserve peatlands in other tropical mountain areas of the world

Effective dose of dental CBCT—a meta analysis of published data and additional data for nine CBCT units

This article analyses dose measurement and effective dose estimation of dental CBCT examinations. Challenges to accurate calculation of dose are discussed and the use of dose–height product (DHP) as an alternative to dose–area product (DAP) is explored

Sensitive diagnosis of cutaneous leishmaniasis by lesion swab sampling coupled to qPCR

Variation in clinical accuracy of molecular diagnostic methods for cutaneous leishmaniasis (CL) is commonly observed depending on the sample source, the method of DNA recovery and the molecular test. Few attempts have been made to compare these variables. Two swab and aspirate samples from lesions of patients with suspected CL (n=105) were evaluated alongside standard diagnosis by microscopic detection of amastigotes or culture of parasites from lesion material. Three DNA extraction methods were compared: Qiagen on swab and aspirate specimens, Isohelix on swabs and Boil/Spin of lesion aspirates. Recovery of Leishmania DNA was evaluated for each sample type by real-time polymerase chain reaction detection of parasitic 18S rDNA, and the diagnostic accuracy of the molecular method determined. Swab sampling combined with Qiagen DNA extraction was the most efficient recovery method for Leishmania DNA, and was the most sensitive (98%; 95% CI: 91-100%) and specific (84%; 95% CI: 64-95%) approach. Aspirated material was less sensitive at 80% (95% CI: 70-88%) and 61% (95% CI: 50-72%) when coupled to Qiagen or Boil-Spin DNA extraction, respectively. Swab sampling of lesions was painless, simple to perform and coupled with standardized DNA extraction enhances the feasibility of molecular diagnosis of C

Anatomical Overview and Imaging of the Aorta and Visceral Arteries

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