Parental awareness of sexual experience in adolescent boys with autism spectrum disorder

Parent report and adolescent self-report data on lifetime sexual experience in adolescents with ASD were compared in 43 parent-adolescent dyads. Parents tended to underestimate the lifetime sexual experience of their sons, particularly solo sexual experiences such as masturbation and experience with orgasm. Parental underestimation and unawareness of adolescents’ sexual experience may influence communication and education about sex and sexuality in families. These findings have implications for the interpretation of earlier research, based on parent and caregiver reports, on sexuality in adolescents with ASD

Towards integrated youth care : a systematic review of facilitators and barriers for professionals

To overcome fragmentation in support for children and their families with multiple and enduring problems across life domains, professionals increasingly try to organize integrated care. However, it is unclear what facilitators and barriers professionals experience when providing this integrated care. Our systematic review, including 55 studies from a broad variety of settings in Youth Care, showed that integrated care on a professional level is a multi-component entity consisting of several facilitators and barriers. Findings were clustered in seven general themes: ‘Child’s environment’, ‘Preconditions’, ‘Care process’, ‘Expertise’, ‘Interprofessional collaboration’, ‘Information exchange’, and ‘Professional identity’. The identified facilitators and barriers were generally consistent across studies, indicating broad applicability across settings and professional disciplines. This review clearly shows that when Youth Care professionals address a broad spectrum of problems, a variety of facilitators and barriers should be considered. Registration PROSPERO, registration number CRD42018084527

Combining eight research areas to foster the uptake of ecosystem-based management in fresh waters

Freshwater ecosystems are under a constant risk of being irreversibly damaged by human pressures that threaten their biodiversity, the sustainability of ecosystem services (ESs), and human well-being. Despite the implementation of various environmental regulations, the challenges of safeguarding freshwater assets have so far not been tackled successfully. A promising way forward to stop the loss of freshwater biodiversity and to sustain freshwater-based ESs is by implementing ecosystem-based management (EBM), an environmental planning and adaptive management approach that jointly considers social and ecological needs. Responsible for considerable recent success in sustainably managing and conserving marine ecosystems, EBM has not yet been championed for fresh waters. A major reason for the delayed uptake of EBM in fresh waters is likely to be its complexity, requiring planners to be familiar with the latest developments in a range of different research areas. EBM would therefore benefit from becoming more tangible to receive attention on the ground. To facilitate uptake, eight core research areas for EBM and their innovations are introduced, and the way in which they feed into the workflow that guides the EBM planning stage is explained. The workflow links biodiversity distributions with ES supply-and-demand modelling and SMART (specific, measurable, attainable, relevant, and timely) target planning, including scenario- and cross-realm perspectives, the prioritization of management alternatives, spatial prioritization of biodiversity conservation and ES areas, and the quantification of uncertainties. Given the extensive resources, time, and technical capacity required to implement the full workflow, a light and an ultralight version of the workflow are also provided. Applied in concert, the eight well-known research areas allow for better planning and operationalizing, and eventually for implementing EBM in freshwater ecosystems. EBM has great potential to increase public acceptance by introducing the consideration of human needs and aspirations into typically biodiversity-driven conservation and management approaches. This will ultimately improve the integrity of freshwater ecosystems. © 2019 John Wiley & Sons, Ltd.German Federal Ministry of Education and Research, Grant/Award Number: 01 LN1320A; Horizon 2020 Framework Programme, Grant/Award Number: 642317; Marie Sklodowska‐Curie Global Fellowship, Grant/Award Number: 748625; Ramón y Cajal, Grant/Award Number: RYC‐2013‐1397

Assessing the psychometric properties and the perceived usefulness of the BasisRaadsOnderzoek (BARO) as a first-line screening instrument for juvenile offenders

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to investigate the psychometric properties and the perceived usefulness of the BARO (Dutch: BAsisRaadsOnderzoek; Protection Board Preliminary Examination of Juvenile Suspects). The BARO is a first-line screening instrument for the identification of psychiatric disorders, adverse environmental factors, and levels of (dys)function in adolescent offenders (age 12 to 18), to be used by social workers of the Child Protection Board (CPB) following a police arrest.</p> <p>Method</p> <p>CPB workers administered the BARO to 295 juvenile offenders (91% boys, 9% girls). A subgroup of 66 offenders (89% boys, 11% girls) underwent an elaborate diagnostic assessment by forensic psychologists and psychiatrists. Using these assessments the most relevant psychometric properties of the BARO were studied. The perceived usefulness was studied using questionnaires to be filled in by the CPB social workers.</p> <p>Results</p> <p>The internal consistency of the instrument was sufficient to good, the concurrent validity of the CPB social workers applying the BARO and the forensic experts carrying out the comprehensive diagnostic assessment was strong, the discriminatory value of the instrument was moderate to strong, and the perceived usefulness of the instrument was evaluated as good to very good by the majority of the CPB workers.</p> <p>Discussion</p> <p>The BARO has sufficient to good psychometric properties including moderate to strong discriminatory value and is considered a good screening instrument by the CPB social workers. In conclusion, the BARO seems to be a very promising first-line screening instrument to identify psychiatric and psychosocial problems in young offenders.</p

Age- and Disease-Specific Changes of the Kynurenine Pathway in Parkinson's and Alzheimer's Disease

The Kynurenine (Kyn) pathway, which regulates neuroinflammation and n-methyl-d-aspartate (NMDA) receptor activation, is implicated in Parkinson's disease (PD) and Alzheimer's disease (AD). Age-related changes in Kyn metabolism and altered cerebral Kyn uptake along large-neutral amino acid (LNAA) transporters, could contribute to these diseases. To gain further insight into the role and prognostic potential of the Kyn pathway in PD and AD, we investigated systemic and cerebral Kyn metabolite production and estimations of their transporter-mediated uptake in the brain. Kyn metabolites and LNAAs were retrospectively measured in serum and cerebrospinal fluid (CSF) of clinically well-characterized PD patients (n=33), AD patients (n=33) and age-matched controls (n=39) using solid-phase extraction-liquid chromatographic-tandem mass spectrometry. Aging was disease-independently associated with increased Kyn, kynurenic acid and quinolinic acid in serum and CSF. Concentrations of kynurenic acid were reduced in CSF of PD and AD patients (p=.001; p=.002) but estimations of Kyn brain uptake did not differ between diseased and controls. Furthermore, serum Kyn and quinolinic acid levels strongly correlated with their respective content in CSF and Kyn in serum negatively correlated with AD disease severity (p=.002). Kyn metabolites accumulated with aging in serum and CSF similarly in PD patients, AD patients and control subjects. In contrast, kynurenic acid was strongly reduced in CSF of PD and AD patients. Differential transporter-mediated Kyn uptake is unlikely to majorly contribute to these cerebral Kyn pathway disturbances. We hypothesize that the combination of age- and disease-specific changes in cerebral Kyn pathway activity could contribute to reduced neurogenesis and increased excitotoxicity in neurodegenerative disease. This article is protected by copyright. All rights reserved

A systematic review exploring characteristics of youth with severe and enduring mental health problems (SEMHP)

A small group of youth and emerging adults deals with severe and enduring mental health problems (SEMHP). Current mental health care struggles to recognize and treat this group timely and adequately, leaving these youth between the cracks of the system. A first step to improve care for this group is to gain a deeper understanding of the characteristics of youth with SEMHP. Therefore, this study aimed at reviewing current literature about this target group and what is known so far about their characteristics. We included 39 studies with a focus on youth aged 12-25 years with SEMHP. After critical appraisal, a content analysis and in-depth thematic analysis were conducted. According to the included studies, youth with SEMHP were characterized by severe distress and recurrent comorbid mental health problems, with pervasive suicidality. Further, underlying trauma, family conflicts, peer rejection, deep feelings of hopelessness, and psychosocial malfunctioning characterized SEMHP. It was described that for youth with SEMHP a pervasive pattern of dysfunction in multiple domains is present leading to a detrimental impact. Subsequently, this pattern exerts a reciprocal influence on the mental health problems, causing a vicious circle further worsening SEMHP. Our findings emphasize the need for a holistic approach and to look beyond the traditional classification system in order to meet the needs of these youth with wide-ranging comorbid mental health problems.New methods for child psychiatric diagnosis and treatment outcome evaluatio