What Influences Educators’ Design Preferences for Bullying Prevention Programs? Multi-level Latent Class Analysis of a Discrete Choice Experiment

School Mental Health - We used a discrete choice conjoint experiment to model the anti-bullying (AB) program preferences of 1080 junior kindergarten to Grade 8 educators. Participants chose between...     

Slapping and spanking in childhood and its association with lifetime prevalence of psychiatric disorders in a general population sample

BACKGROUND: Little information is available in Canada about the prevalence of and outcomes associated with a history of slapping and spanking in childhood. The objectives of this study were to estimate the prevalence of a history of slapping or spanking in a general population sample and to assess the relation between such a history and the lifetime prevalence of psychiatric disorders. METHODS: In this general population survey, a probability sample of 9953 residents of Ontario aged 15 years and older who participated in the Ontario Health Supplement was used to examine the prevalence of a history of slapping and spanking. A subgroup of this sample (n = 4888), which comprised people aged 15 to 64 years who did not report a history of physical or sexual abuse during childhood, was used to assess the relation between a history of slapping or spanking and the lifetime prevalence of 4 categories of psychiatric disorder. The measures included a self-administered questionnaire with a question about frequency of slapping and spanking during childhood, as well as an interviewer-administered questionnaire to measure psychiatric disorder. RESULTS: The majority of respondents indicated that they had been slapped or spanked, or both, by an adult during childhood "sometimes" (33.4%) or "rarely" (40.9%); 5.5% reported that this occurred "often." The remainder (20.2%) reported "never" experiencing these behaviours. Among the respondents without a history of physical or sexual abuse during childhood, those who reported being slapped or spanked "often" or "sometimes" had significantly higher lifetime rates of anxiety disorders (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.04-1.96), alcohol abuse or dependence (adjusted OR 2.02, 95% CI 1.27-3.21) and one or more externalizing problems (adjusted OR 2.08, 95% CI 1.36-3.16), compared with those who reported "never" being slapped or spanked. There was also an association between a history of slapping or spanking and major depression, but it was not statistically significant (adjusted OR 1.64, 95% CI 0.96-2.80). INTERPRETATION: There appears to be a linear association between the frequency of slapping and spanking during childhood and a lifetime prevalence of anxiety disorder, alcohol abuse or dependence and externalizing problems.     

Psychometric Properties of the Spence Children’s Anxiety Scale: Parent Report in Children with Autism Spectrum Disorder

Although anxiety is frequently reported in children with autism spectrum disorder (ASD), existing anxiety scales are often psychometrically inappropriate for this population. This study examined the internal structure, reliability, convergent and discriminant validity of the Spence Children’s Anxiety Scale-Parent Report (SCAS-P; Spence 1999) in 238 school-aged children with ASD. While confirmatory factor analysis did not support the original six-correlated-factor structure, structural support as well as acceptable internal consistency and convergent validity was found for Generalized Anxiety, Separation Anxiety, Panic, and Agoraphobia subscales. Use of the SCAS-P in its original form for assessment in children with ASD was not supported. However, four subscales showed viability, and may benefit re-analyses of existing SCAS-P data and future scale adaptations for research and clinical purposes.     

Signal measurement strategies: are they feasible and do they offer any advantage in outcome measurement in osteoarthritis?

The applicability of a signal measurement strategy was compared with a traditional method of measuring outcome in osteoarthritis. The signal method detected statistically significant alterations in health status with small sample sizes and with a relative efficiency close to or at unity. The prevalence of deterioration in nonsignal items was low. Signal methods of measurement may provide an alternative approach to outcome measurement in osteoarthritis clinical trials.     

Prevalence and Factors Associated with the Triple Burden of Malnutrition among Mother-Child Pairs in Sub-Saharan Africa

Despite concerns about the coexistence of overnutrition, undernutrition and micronutrient deficiencies, which is compositely referred to as the triple burden of malnutrition (TBM), little is known about the phenomenon in sub-Saharan Africa (SSA). We, therefore, aimed to examine the prevalence and investigate the factors associated with TBM in SSA. This study uses cross-sectional survey data collected through the Demographic and Health Surveys (DHS) Program from 2010 to 2019. Data from 32 countries in SSA were used for the analysis. The prevalence of TBM were presented in tables and maps using percentages. The predictors of TBM were examined by fitting a negative log-log regression to the data. The results were then presented using adjusted odds ratios (aORs) at 95% Confidence Intervals (CIs). Out of the 169,394 children, 734 (1%) suffered from TBM. The highest proportion of children with TBM in the four geographic regions in SSA was found in western Africa (0.75%) and the lowest in central Africa (0.21%). Children aged 1 [aOR = 1.283; 95% CI = 1.215–1.355] and those aged 2 [aOR = 1.133; 95% CI = 1.067–1.204] were more likely to experience TBM compared to those aged 0. TBM was less likely to occur among female children compared to males [aOR = 0.859; 95% CI = 0.824–0.896]. Children whose perceived size at birth was average [aOR = 1.133; 95% CI = 1.076–1.193] and smaller than average [aOR = 1.278; 95% CI = 1.204–1.356] were more likely to suffer from TBM compared to those who were larger than average at birth. Children born to mothers with primary [aOR = 0.922; 95% CI = 0.865–0.984] and secondary [aOR = 0.829; 95% CI = 0.777–0.885] education were less likely to suffer from TBM compared to those born to mothers with no formal education. Children born to mothers who attended antenatal care (ANC) had lower odds of experiencing TBM compared to those born to mothers who did not attend ANC [aOR = 0.969; 95% CI = 0.887–0.998]. Children born to mothers who use clean household cooking fuel were less likely to experience TBM compared to children born to mothers who use unclean household cooking fuel [aOR = 0.724; 95% CI = 0.612–0.857]. Essentially, higher maternal education, ANC attendance and use of clean cooking fuel were protective factors against TBM, whereas higher child age, low size at birth and being a male child increased the risk of TBM. Given the regional variations in the prevalence and risk of TBM, region-specific interventions must be initiated to ensure the likelihood of those interventions being successful at reducing the risk of TBM. Countries in Western Africa in particular would have to strengthen their current policies and programmes on malnutrition to enhance their attainment of the SDGs.     

Investigating the Measurement Properties of the Social Responsiveness Scale in Preschool Children with Autism Spectrum Disorders

The purpose of this study was to examine the measurement properties of the Social Responsiveness Scale in an accelerated longitudinal sample of 4-year-old preschool children with the complementary approaches of categorical confirmatory factor analysis and Rasch analysis. Measurement models based on the literature and other hypothesized measurement models which were tested using categorical confirmatory factor analysis did not fit well and were not unidimensional. Rasch analyses showed that a 30-item subset met criteria of unidimensionality and invariance across item, person, and over time; and this subset exhibited convergent validity with other child outcomes. This subset was shown to have enhanced psychometric properties and could be used in measuring social responsiveness among preschool age children with Autism Spectrum Disorders.     

Phenotypic Overlap Between Core Diagnostic Features and Emotional/Behavioral Problems in Preschool Children with Autism Spectrum Disorder

This study examined the phenotypic overlap between core diagnostic features and emotional/behavioral problems in a sample of 335 preschool children with autism spectrum disorder (ASD). Results from principal component analysis (2 components; 49.70% variance explained) suggested substantial phenotypic overlap between core diagnostic features and emotional/behavioral problems. Component I, Emotional Behavioral Repetitive Problems, was independent of the children's intellectual, adaptive functioning, and structural language abilities. Component II, Social Communication Deficits, was negatively related to the children's intellectual, adaptive functioning, and structural language abilities. Both components were positively related to parental stress. This exploratory study contributes to our understanding of the ASD phenotype and provides further support for including emotional/behavioral problems as part of the clinical characterization of children with ASD.     

Influence of reporting effects on the association between maternal depression and child autism spectrum disorder behaviors

Background: Maximizing measurement accuracy is an important aim in child development assessment and research. Parents are essential informants in the diagnostic process, and past research suggests that certain parental characteristics may influence how they report information about their children. This has not been studied in autism spectrum disorders (ASD) to date. We aimed, therefore, to investigate the possible effect that maternal depression might have on a mother’s reports of her child’s ASD behaviors. Using structural equation modeling, we disaggregated shared from unique variation in the association between latent variable measures of maternal depression and ASD behaviors. Methods: Data were obtained from a study of preschoolers aged 2–4 newly diagnosed with ASD (n = 214). Information from a parent questionnaire, a semi‐structured parent interview, and a semi‐structured observational assessment was used to develop a latent variable measure of child ASD behaviors. Mothers reported on their own depression symptoms. We first modeled the covariance between maternal depression and child ASD behavior. Then, to quantify unique variation, we added covariance terms between maternal depression and the residual variation associated with the individual measures of child ASD behaviors. Results: The model demonstrated excellent fit to the underlying data. Maternal self‐report of depression symptoms exhibited a significant association with the unique variance of the questionnaire report but not with the latent variable measure of child ASD behavior. A gradient pattern of association was demonstrated between maternal depression and the unique variance of the ASD measures: most strongly for the maternal questionnaire report, more weakly for the maternal semi‐structured interview, and to a trivial extent for the observational interview. Conclusions: Parental depression may influence reporting of ASD behaviors in preschoolers. Shared method effects may also contribute to bias. This finding highlights the importance of obtaining multimethod reports of child ASD symptoms.     

The role of systematic reviews in clinical research and practice

Well-conducted systematic reviews and meta-analyses provide the best quality evidence for clinical decision-making. This article presents the key role of systematic reviews in clinical decision-making, discussing the steps and pitfalls to avoid in conducting systematic reviews and meta-analyses.