The Relationship Between Pediatric Quality of Life and Post Concussion Symptoms

This will be presented at the American Academy of Pediatric Neuropsychology. Objective: To understand how symptoms impact the the pediatric patient’s day to day functioning during recovery. The tasks that students are exposed to in school deplete cognitive reserves, which further has consequences for learning, emotional functioning, symptom expression, and quality of life. Methods: 280 participants with concussion, age 7 to 21, completed a packet that included the Post Concussion Symptom Scale (PCSS) and a self report measure, at their medical visit to a regional concussion clinic. A pencil and paper self rating instrument (Pediatric Life After Concussion Evaluation Scale) was developed to examine pediatric concussion patient’s self perceptions of their recovery. The Pediatric Life After Concussion Evaluation Scale (PLACES) consisted of 20 questions. The instrument took less than 15 minutes to complete. Results: There was a strong positive relationship between total quality of life symptom load (PLACES Total) and total post concussion symptom load (PCSS) (r = .732, p2=.549, F(1,196)=238.43, p Conclusions: Children and adolescents have important perspectives on their recovery from concussion. The impact of concussion affects multiple domains of function. In addition to post concussion symptoms, pediatric patients with concussion report concerns about their learning, emotions, and social interactions. Further, elevated post concussion symptom load is related to overall worse quality of life

Evidence for the Need for a Pediatric Concussion Quality of Life Measure in addition to the PCSS

While pediatric concussion is an area of significant scientific concern, only recently has the field begun to consider health related quality of life issues after concussion. The clinical management of pediatric concussion generally focuses on symptoms and epidemiology. The purpose of the current evaluation was to examine whether a quality of life measure can provide important information not readily measured by a symptom scale. 280 participants with concussion, age 7 to 21 completed two pencil and paper measures, the Post Concussion Symptom Scale (PCSS) and the newly created Pediatric Life After Concussion Evaluation Scale (PLACES). Data showed that the emotion domain on the PCSS was not significant for time since injury F(2,248) = 6.23, p F(2,253) = 1.96, p =.143). While the PCSS and PLACES had a strong correlation (r = .73, p This poster will be presented at the American Academy of Clinical Neuropsycholog

Does mode of administration affect health-related quality-of-life outcomes after stroke?

Telephone interviews and postal surveys may be a resource-efficient way of assessing health-related quality-of-life post-stroke, if they produce data equivalent to face-to-face interviews. This study explored whether telephone interviews and postal surveys of the Stroke and Aphasia Quality of Life Scale (SAQOL-39g) yielded similar results to face-to-face interviews. Participants included people with aphasia and comprised two groups: group one (n =22) were 3-6 months post-stroke; group two (n =26) were ≥1 year post-stroke. They completed either a face-to-face and a telephone interview or a face-to-face interview and a postal survey of the SAQOL-39g. Response rates were higher for group two (87%) than for group one (72-77%). There were no significant differences between respondents and non-respondents on demographics, co-morbidities, stroke severity, or communication impairment. Concordance between face-to-face and telephone administrations (.90-.98) was excellent; and very good-excellent between face-to-face and postal administrations (.84-.96), although scores in postal administrations were lower (significant for psychosocial domain and overall SAQOL-39g in group two). These findings suggest that the SAQOL-39g yields similar results in different modes of administration. Researchers and clinicians may employ alternative modes, particularly in the longer term post-stroke, in order to reduce costs or facilitate clients with access difficulties

Preditivos das atitudes em relação à cirurgia cosmética entre mulheres universitárias colombianas e estadunidenses: os papeis das condutas de alimentação e das variáveis demográficas

Cross-cultural studies on eating behaviors and related constructs can identify cultural and social factors that contribute to eating disorder symptomatology. Eating disorders (EDs) are a major cause for concern in the U.S., and recent studies in Colombia have shown growing rates among their female population. In addition, cosmetic surgery procedures have been increasing rapidly in both the U.S. and Colombia, and preliminary research suggests a positive relation between disordered eating and endorsement of plastic surgery. In samples of college women from Colombia and the U.S., we investigated patterns of association between disordered eating variables and cosmetic surgery acceptance. Our approach utilized separate analyses for various subcomponents of disordered eating (to determine their unique associations with cosmetic surgery acceptance) while adjusting for potentially relevant covariates and examining cross-cultural patterns. Participants were students at an urban, public college in the U.S. (n=163) and an urban, private college in Colombia (n=179). Overall, our findings suggested that participants from Colombia with greater disordered eating were more likely to endorse cosmetic surgery for social reasons, while those from the U.S. were more likely to consider undergoing cosmetic surgery for personal reasons. Differing findings between the two samples may be due to cultural and social factors, which we delineate. These findings also have potential implications for presurgical counseling of cosmetic surgery candidates.Los estudios transculturales sobre las conductas re- lacionadas con la alimentación pueden identificar los factores culturales y sociales que contribuyen a la sintomatología de los trastornos alimentarios (TCA). Los TCA son causa de preocupación en los Estados Unidos, y estudios recientes en Colombia han mostrado tasas de crecimiento entre la población femenina. Además, los procedimientos de cirugía estética se han incrementado rápidamente en los Estados Unidos y Colombia, e investigaciones preliminares sugieren una relación positiva entre los TCA y el respaldo de la cirugía plástica. En muestras de mujeres universitarias de Colombia y los Estados Unidos, se han investigado los patrones de asociación entre los trastornos de la alimentación y la aceptación de la cirugía cosmética. Nuestro enfoque utilizó análisis separados para los subcomponentes del consumo alimentario desordenado (para determinar asociaciones únicas con la aceptación de cirugía estética), ajustando covariables potencialmente pertinentes y examinando patrones transculturales. Los participantes fueron estudiantes de un colegio público urbano en los Estados Unidos (n = 163) y de un colegio privado urbano de Colombia (n = 179). En general, nuestros resultados sugieren que los participantes de Colombia con valores más altos en medidas del consumo alimentario desordenado eran más propensos a apoyar la cirugía estética por razones sociales, mientras que los de los Estados Unidos eran más propensos a considerar el someterse a la cirugía estética por razones personales. Resultados divergentes entre las dos muestras puede ser debido a factores culturales y sociales, que delinearemos. Estos resultados también tienen implicaciones potenciales para el asesoramiento prequirúrgico de los candidatos de cirugía estética.Os estudos transculturais sobre as condutas relacionadas com a alimentação podem identificar os fatores culturais e sociais que contribuem à sintomatologia dos transtornos alimentares (TCA). os TCA são causa de preocupação nos Estados Unidos, e estudos recentes Na Colômbia têm mostrado taxas de crescimento entre apopulação feminina. Além disso, os procedimentos de cirurgia estética se têm incrementado rapidamente nos Estados Unidos e na Colômbia, e pesquisadores preliminares sugerem uma relação positiva entre os TCA e o respaldo da cirurgia plástica. Em amostras de mulheres universitárias da Colômbia e dos Estados Unidos, se têm investigado os patrões de associação entre os transtornos da alimentação e a aceitação da cirurgia cosmética. Nosso enfoque utilizou análises separadas para os subcomponentes do consumo alimentar des- ordenado (para determinar associações únicas com a aceitação da cirurgia estética), ajustando covariáveis potencialmente pertinentes e examinando patrões transculturais. os participantes foram estudantes de uma escola pública urbana nos Estados Unidos (n = 163) e de uma escola privada urbana da Colômbia (n = 179). Em geral, nossos resultados sugerem que os participantes da Colômbia com valores mais altos em medidas do consumo alimentar desordenado eram mais propensos a apoiar a cirurgia estética por razões sociais, enquanto os dos Estados Unidos eram mais propensos a considerar submeterse à cirurgia estética por razões pessoais. os resultados divergentes entre as duas amostras podem ser devido a fatores culturais e sociais, que delinearemos. Estes resultados também têm implicações potenciais para o assessoramento précirúrgico dos candidatos de cirurgia estética

Predictivos de las actitudes hacia la cirugía cosmética entre mujeres universitarias colombianas y estadounidenses: los roles de las conductas de alimentación y de las variables demográficas

Los estudios transculturales sobre las conductas re- lacionadas con la alimentación pueden identificar los factores culturales y sociales que contribuyen a la sintomatología de los trastornos alimentarios (TCA). Los TCA son causa de preocupación en los Estados Unidos, y estudios recientes en Colombia han mostrado tasas de crecimiento entre la población femenina. Además, los procedimientos de cirugía estética se han incrementado rápidamente en los Estados Unidos y Colombia, e investigaciones preliminares sugieren una relación positiva entre los TCA y el respaldo de la cirugía plástica. En muestras de mujeres universitarias de Colombia y los Estados Unidos, se han investigado los patrones de asociación entre los trastornos de la alimentación y la aceptación de la cirugía cosmética. Nuestro enfoque utilizó análisis separados para los subcomponentes del consumo alimentario desordenado (para determinar asociaciones únicas con la aceptación de cirugía estética), ajustando covariables potencialmente pertinentes y examinando patrones transculturales. Los participantes fueron estudiantes de un colegio público urbano en los Estados Unidos (n = 163) y de un colegio privado urbano de Colombia (n = 179). En general, nuestros resultados sugieren que los participantes de Colombia con valores más altos en medidas del consumo alimentario desordenado eran más propensos a apoyar la cirugía estética por razones sociales, mientras que los de los Estados Unidos eran más propensos a considerar el someterse a la cirugía estética por razones personales. Resultados divergentes entre las dos muestras puede ser debido a factores culturales y sociales, que delinearemos. Estos resultados también tienen implicaciones potenciales para el asesoramiento prequirúrgico de los candidatos de cirugía estética

Impact of the COVID-19 Pandemic on Patient Preferences and Decision Making for Symptomatic Urolithiasis

Background: Pandemic restrictions have changed how patients approach symptomatic kidney stones. We used a mixed-methods digital ethnographic approach to evaluate social media discussions about patient concerns and preferences for urolithiasis care during the COVID-19 pandemic. Materials and Methods: We retrospectively analyzed kidney stone-related discussions on a large social media platform using qualitative analysis and natural language processing-based sentiment analysis. Posts were mined for demographic details, treatments pursued, and health care encounters. Pre-COVID-19 (January 1, 2020-February 29, 2020) and COVID-19 (March 1, 2020-June 1, 2020) posts were extracted from the popular online Reddit discussion board, r/KidneyStones, which is dedicated to discussions related to urolithiasis. Results: We extracted n = 649 posts (250 pre-COVID-19, 399 COVID-19); 150 from each cohort underwent thematic analysis and data extraction. Quantitative sentiment analysis was performed on 418 posts (179 pre-COVID-19, 239 COVID-19) that described stone-related decision making before intervention. Notable discussion themes during COVID-19 focused on barriers to care and concerns about stone management. Discussants exhibited more negative and anxious tones during COVID-19, based on sentiment analysis (p \u3c 0.01). Patient preferences shifted away from in-person visits and procedures (p \u3c 0.001). Mean reported stone size among those visiting emergency room (ER) increased from 5.1 to 10.5 mm (p \u3c 0.001). The proportion of discussants preferring conservative management with stones ≥10 mm increased (12.5% pre-COVID-19 vs 26% during COVID-19, p = 0.002). Opioid mentions increased from 9% to 27% of posts (p \u3c 0.001) and were most associated with conservative management discussions. Conclusions: Online discussion forums provide contemporaneous insight into patients\u27 experiences during a time when traditional patient-centered research methodologies are limited due to social distancing. During the pandemic, patients with symptomatic kidney stones expressed anxiety regarding outpatient encounters and reluctance toward procedural intervention. Patients opted instead for at-home conservative treatment beyond clinical guidelines and reserved ER visits for larger stones, potentially causing self-harm. Opioid discussions proliferated, an alarming consequence of the pandemic

Motor outcome, executive functioning, and health‐related quality of life of children, adolescents, and young adults after ventricular assist device and heart transplantation

Objective The aim of the current study is to measure long‐term executive function, motor outcome, and QoL in children, adolescents, and young adults after VAD and Htx. Methods Patients were examined during routine follow‐up. Investigation tools were used as follows: Examination for MND of motor outcomes, Epitrack® for attention and executive functioning, and Kidscreen‐52 and EQ‐5D‐5L questionnaires for QoL. Additional data were retrospectively obtained by an analysis of patient medical records. Results Out of 145 heart transplant recipients at the department of pediatric cardiology of the University Hospital Munich, 39 were implanted with a VAD between 1992 and 2016. Seventeen (43.6%) patients died before or after Htx; 22 (56.4%) patients were included in our study. Mean age at transplant was 9.52 years (range: 0.58‐24.39 years, median 9), and the mean follow‐up time after Htx was 6.18 years (range: 0.05‐14.60 years, median 5.82). MND examination could be performed in 13 patients (normal MND: n = 11, simple MND: n = 1, complex MND: n = 1). Executive functioning was tested in 15 patients. Two (13.3%) patients had good results, six (40%) average results, three (20%) borderline results, and four (26.7%) impaired results. QoL (Kidscreen n = 7, EQ‐5D‐5L n = 8) was similar to a healthy German population. Conclusion Motor outcome, executive functioning and QoL in survivors of VAD bridging therapy and Htx can be good, though underlying diseases and therapies are associated with a high risk of cerebral ischemic or hemorrhagic complications

Variants in the estrogen receptor alpha gene and its mRNA contribute to risk for schizophrenia

Estrogen modifies human emotion and cognition and impacts symptoms of schizophrenia. We hypothesized that the variation in the estrogen receptor alpha (ESR1) gene and cortical ESR1 mRNA is associated with schizophrenia. In a small case–control genetic association analysis of postmortem brain tissue, genotype CC (rs2234693) and haplotypes containing the C allele of a single-nucleotide polymorphism (SNP) in intron1 (PvuII) were more frequent in African American schizophrenics (P = 0.01–0.001). In a follow-up family-based association analysis, we found overtransmission of PvuII allele C and a PvuII C-containing haplotype (P = 0.01–0.03) to African American and Caucasian patients with schizophrenia. Schizophrenics with the ‘at risk’ PvuII genotype had lower ESR1 mRNA levels in the frontal cortex. Eighteen ESR1 splice variants and decreased frequencies of the wild-type ESR1 mRNA were detected in schizophrenia. In one patient, a unique ESR1 transcript with a genomic insert encoding a premature stop codon and a truncated ESR1 protein lacking most of the estrogen binding domain was the only transcript detected. Using a luciferase assay, we found that mRNA encoding a truncated ESR1 significantly attenuates gene expression at estrogen-response elements demonstrating a dominant negative function. An intron 6 SNP [rs2273207(G)] was associated with an ESR1 splice variant missing exon seven. The T allele of another intron 6 SNP was part of a 3′ haplotype less common in schizophrenia [rs2273206(T), rs2273207(G), rs2228480(G)]. Thus, the variation in the ESR1 gene is associated with schizophrenia and the mechanism of this association may involve alternative gene regulation and transcript processing

Dysregulated protocadherin-pathway activity as an intrinsic defect in induced pluripotent stem cell-derived cortical interneurons from subjects with schizophrenia.

We generated cortical interneurons (cINs) from induced pluripotent stem cells derived from 14 healthy controls and 14 subjects with schizophrenia. Both healthy control cINs and schizophrenia cINs were authentic, fired spontaneously, received functional excitatory inputs from host neurons, and induced GABA-mediated inhibition in host neurons in vivo. However, schizophrenia cINs had dysregulated expression of protocadherin genes, which lie within documented schizophrenia loci. Mice lacking protocadherin-α showed defective arborization and synaptic density of prefrontal cortex cINs and behavioral abnormalities. Schizophrenia cINs similarly showed defects in synaptic density and arborization that were reversed by inhibitors of protein kinase C, a downstream kinase in the protocadherin pathway. These findings reveal an intrinsic abnormality in schizophrenia cINs in the absence of any circuit-driven pathology. They also demonstrate the utility of homogenous and functional populations of a relevant neuronal subtype for probing pathogenesis mechanisms during development

Did people really drink bleach to prevent COVID-19? A guide for protecting survey data against problematic respondents

Survey respondents who are non-attentive, respond randomly, or misrepresent who they are can impact the outcomes of surveys. Prior findings reported by the CDC have suggested that people engaged in highly dangerous cleaning practices during the COVID-19 pandemic, including ingesting household cleaners such as bleach. In our attempts to replicate the CDC’s results, we found that 100% of reported ingestion of household cleaners are made by problematic respondents. Once inattentive, acquiescent, and careless respondents are removed from the sample, we find no evidence that people ingested cleaning products to prevent a COVID-19 infection. These findings have important implications for public health and medical survey research, as well as for best practices for avoiding problematic respondents in all survey research conducted online