School and cognitive functioning problems in adolescent bariatric surgery candidates

BackgroundPrior studies have reported that students with overweight and obesity have impairments in performance IQ and executive function and worse school functioning in comparison with peers of normal weight. The present study assessed school and cognitive functioning in a sample of adolescents with severe obesity being evaluated for laparoscopic adjustable gastric banding.MethodsEligible candidates for bariatric surgery were referred for psychiatric evaluation, which included a semistructured clinical interview measuring school functioning and the vocabulary and matrix reasoning subtests of the Wechsler Abbreviated Scale of Intelligence (WASI).ResultsSelf-reported school problems were common, with 55.5% of adolescents failing a grade or subject, 38.7% attending summer school, and 17.8% failing a citywide examination. A significant relationship was observed between body mass index, estimated WASI IQ (r = ?.250; P = .005), and the vocabulary subtest (r = ?.241; P = .006), but not matrix reasoning (r = ?.126; P = NS).ConclusionEven among a sample of adolescents with severe obesity, increased body mass index was associated with lower WASI IQ and vocabulary subtest scores. Increasing awareness of potential cognitive and school problems in bariatric candidates among teachers, school counselors, and other mental health providers is an important first step to improving academic support and educational systems deficiencies for students with overweight and obesity.     

Cortical and trabecular bone adaptation to incremental load magnitudes using the mouse tibial axial compression loading model

The mouse tibial axial compression loading model has recently been described to allow simultaneous exploration of cortical and trabecular bone adaptation within the same loaded element. However, the model frequently induces cortical woven bone formation and has produced inconsistent results with regards to trabecular bone adaptation. The aim of this study was to investigate bone adaptation to incremental load magnitudes using the mouse tibial axial compression loading model, with the ultimate goal of revealing a load that simultaneously induced lamellar cortical and trabecular bone adaptation. Adult (16 weeks old) female C57BL/6 mice were randomly divided into three load magnitude groups (5, 7 and 9 N), and had their right tibia axially loaded using a continuous 2-Hz haversine waveform for 360 cycles/day, 3 days/week for 4 consecutive weeks. In vivo peripheral quantitative computed tomography was used to longitudinally assess midshaft tibia cortical bone adaptation, while ex vivo micro-computed tomography and histomorphometry were used to assess both midshaft tibia cortical and proximal tibia trabecular bone adaptation. A dose response to loading magnitude was observed within cortical bone, with increasing load magnitude inducing increasing levels of lamellar cortical bone adaptation within the upper two thirds of the tibial diaphysis. Greatest cortical bone adaptation was observed at the midshaft where there was a 42% increase in estimated mechanical properties (polar moment of inertia) in the highest (9 N) load group. A dose response to load magnitude was not clearly evident within trabecular bone, with only the highest load (9 N) being able to induce measureable adaptation (31% increase in trabecular bone volume fraction at the proximal tibia). The ultimate finding was that a load of 9 N (engendering a tensile strain of 1833 με on medial surface of the midshaft tibia) was able to simultaneously induce measurable lamellar cortical and trabecular bone adaptation when using the mouse tibial axial compression loading model in 16 week old female C57BL/6 mice. This finding will help plan future studies aimed at exploring simultaneous lamellar cortical and trabecular bone adaptation within the same loaded element.     

The long arm of parental addictions: The association with adult children’s depression in a population-based study

Parental addictions have been associated with adult children’s depression in several clinical and population-based studies. However, these studies have not examined if gender differences exist nor have they controlled for a range of potential explanatory factors. Using a regionally representative sample of 6268 adults from the 2005 Canadian Community Health Survey (response rate=83%), we investigated the association between parental addictions and adulthood depression controlling for four clusters of variables: adverse childhood experiences, adult health behaviors, adult socioeconomic status and other stressors. After controlling for all factors, adults exposed to parental addiction had 69% higher odds of depression compared to their peers with non-addicted parents (OR=1.69; 95% CI, 1.25–2.28). The relationship between parental addictions and depression did not vary by gender. These findings underscore the intergenerational consequences of drug and alcohol addiction and reinforce the need to develop interventions that support healthy childhood development.     

Improving evidence‐based practice in rehabilitation: Introducing PsycBITETM

Background: Clinicians face significant obstacles in their access to evidence for the efficacy of different communicative and cognitive treatments after brain impairment. These include the need to search across diverse journals and different clinical conditions to find potential treatments and the lack of easily accessible standards by which to evaluate the methodological rigour of treatment studies once found.

Aims: We aimed to address these issues by developing a freely available, user‐friendly database of all relevant treatment trials for psychologically based disorders that arise from brain impairment.

Methods & Procedures: PsycBITE^TM (http://www.psycbite.com) was developed as an internet‐based database and was officially launched in 2004. Included on PsycBITE^TM are all trials that have been published that evaluate treatment for any communication, cognitive, or psychological disorder arising from any form of acquired brain impairment in children (above the age of 5 years) and adults. PsycBITE^TM also provides a rating for the methodological rigour of each trial using the previously established PEDro scale (Maher, Sherrington, Herbert, Moseley, & Elkins, 2003 Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M. and Elkins, M. 2003. Reliability of the PEDro scale for rating quality of randomized controlled trials.. Physical Therapy, 83: 713–721. [PubMed], [Web of Science ®] , [Google Scholar]) for randomised controlled trials (RCT) and non‐RCT group comparisons. A PsycBITE^TM rating scale for single case experimental studies is still under development. This report overviews the database, its contents, and the methodology by which papers are selected for inclusion.

Outcomes & Results: As of June 2005 there are 1167 treatment studies listed on PsycBITE^TM with prospective searches being conducted on a regular basis. The highest proportion of studies report treatments for communication disorders followed by behavioural problems and memory. Ratings of the randomised controlled trials, group comparisons, and single case studies are available for a proportion of papers and are being updated continuously.

Conclusions: PsycBITE^TM is an invaluable resource for clinicians and researchers interested in an evidence‐based practice approach to treatment. It is a free, fast, and effective way of accessing and evaluating treatments for communicative and cognitive disorders following brain impairment.     

Measuring the social interactions of people with traumatic brain injury and their communication partners: The adapted Kagan scales

Background: Considerable attention has been given to the nature of communication impairments of individuals with TBI (Coelho, 2007 Coelho, C. A. 2007. Management of discourse deficits following traumatic brain injury: Progress, caveats, and needs. Seminars in Speech & Language, 28(2): 122–135.  [Google Scholar]; Ylvisaker, Turkstra, & Coelho, 2005 Ylvisaker, M., Turkstra, L. S. and Coelho, C. 2005. Behavioral and social interventions for individuals with traumatic brain injury: A summary of the research with clinical implications. Seminars in Speech & Language, 26: 256–267. [Crossref], [PubMed] , [Google Scholar]). However, there have been few data focusing on the way communication partners deal with the often distressing sequelae of TBI.

Aims: This study reports inter- and intra-rater reliability of the Adapted Measure of Support in Conversation (MSC) and Measure of Participation in Conversation (MPC) for TBI interactions.

Method & Procedures: The MSC and MPC were adapted to reflect theoretical models of cognitive-communication support for people with TBI. A total of 10 casual and 10 purposeful TBI interactions were independently rated by two raters to establish inter-rater reliability and by one rater on two separate occasions to determine intra-rater reliability.

Outcomes & Results: Excellent inter-rater agreement was established on the MSC (ICC?=?0.85–0.97) and the MPC (ICC?=?0.84–0.89). Intra-rater agreement was also strong (MSC: ICC?=?0.80–0.90; MPC: ICC?=?0.81–0.92). Over 90% of all ratings scored within 0.5 on a 9-point scale.

Conclusions: This is the first scale to measure the communication partner during TBI interactions. It shows promise in evaluating communication partner training programmes.     

Autistic Adults May Be Erroneously Perceived as Deceptive and Lacking Credibility

Journal of Autism and Developmental Disorders - We hypothesized that autistic adults may be erroneously judged as deceptive or lacking credibility due to demonstrating unexpected and atypical...