Behavioral Scale Research Articles

Effects of Gestational Diabetes Mellitus on Offspring’s Neurobehavioral Development: A Retrospective Cohort Study

Objective: To evaluate the association between gestational diabetes mellitus (GDM) and offspring neurobehavioral development. Methods: A total of 280 infants born to mothers with or without GDM were recruited, and their neurobehavioral development was assessed using the Children’s Neuropsychological and Behavioral Scale (CNBS). Results: Infants born to mothers with GDM exhibited significantly lower development quotient (DQ) scores at the 1st, 3rd, 6th, 8th, and 12th months after birth. Conclusion: GDM may adversely affect offspring neurobehavioral development, with this effect persisting despite interventions implemented during pregnancy.

The role of perfusion, grey matter volume and behavioural phenotypes in the data-driven classification of cognitive syndromes

BackgroundThe use of structural and perfusion brain imaging in combination with behavioural information in the prediction of cognitive syndromes using a data-driven approach remains to be explored. Here, we thus examined the contribution of brain structural and perfusion imaging and behavioural features to the existing classification of cognitive syndromes using a data-driven approach.MethodsStudy participants belonged to the community-based Biomarker and Cognition Cohort Study in Singapore who underwent neuropsychological assessments, structural-functional MRI and blood biomarkers. Participants had a diagnosis of cognitively normal (CN), subjective cognitive impairment (SCI), mild cognitive impairment (MCI) and dementia. Cross-sectional structural and cerebral perfusion imaging, behavioural scale data including mild behaviour impairment checklist, Pittsburgh Sleep Quality Index and Depression, Anxiety and Stress scale data were obtained.ResultsThree hundred seventy-three participants (mean age 60.7 years; 56% female sex) with complete data were included. Principal component analyses demonstrated that no single modality was informative for the classification of cognitive syndromes. However, multivariate glmnet analyses revealed a specific combination of frontal perfusion and temporo-frontal grey matter volume were key protective factors while the severity of mild behaviour impairment interest sub-domain and poor sleep quality were key at-risk factors contributing to the classification of CN, SCI, MCI and dementia (p < 0.0001). Moreover, the glmnet model showed best classification accuracy in differentiating between CN and MCI cognitive syndromes (AUC = 0.704; sensitivity = 0.698; specificity = 0.637).ConclusionsBrain structure, perfusion and behavioural features are important in the classification of cognitive syndromes and should be incorporated by clinicians and researchers. These findings illustrate the value of using multimodal data when examining syndrome severity and provide new insights into how cerebral perfusion and behavioural impairment influence classification of cognitive syndromes.

Premature Infant Gut Microbiome relationships with childhood behavioral scales: preliminary insights.

Very Low Birth Weight (VLBW) infants, born weighing less than 1,500 grams, are at risk for both gut dysbiosis and later neuropsychological developmental deficits. Behavioral effects, while related to neurodevelopment, are often more subtle and difficult to measure. The extent of later neurobehavioral consequences associated with such microbial dysbiosis has yet to be determined. We explored associations between the infants' gut microbiome and early childhood behavior at 4 years of age and identified the bacterial taxa through a multivariate analysis by linear models. Parents completed the Child Behavior Checklist (CBCL) focused on different DSM diagnostic categories: affective, anxiety, pervasive developmental, attention deficit/hyperactivity, and oppositional defiant. All the CBCL scores were corrected for gender, delivery method, gestational age, infant birth weight, occurrence of sepsis, and days on antibiotics prior statistical analyses. Canonical correlation analysis (CCA) was performed to determine the relationship between early life gut microbiome and the adjusted CBCL scores. The association of bacterial Amplicon sequence Variants (ASVs) to the CBCL scores were tested with multivariate analysis by linear models (MaAsLin). Nineteen children who were previously born with very low birth weight and studied while hospitalized in the Neonatal Intensive Care Unit (NICU) were included in this study. Statistically significant associations were observed between early life gut bacteria such as Veillonella dispar, Enterococcus, Escherichia coli, and Rumincococcus to later behavior at 4 years. No significant association could be observed with early-life gut microbiome alpha diversity and behavioral measures at 4 years. These preliminary observational data provide insight into the relationships between VLBW gut microbiome dysbiosis and childhood behavior. This study contributes to the literature on gut microbiome analysis by examining various behavioral domains using a standardized tool linked to the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Breaking ground on ADHD diagnosis in Pakistan.

Madam, Attention-deficit hyperactivity disorder – better known as ADHD - is a prevalent childhood behavioural disorder, estimated to have a prevalence between 2-7% globally [1]. Despite this high prevalence and its rising number of annual cases, ADHD underdiagnosed, especially in adolescent females and older children [1]. Undiagnosed ADHD has adverse effects on many aspects of a person’s life, including, but not limited to, social skills, time perception, stress management, and mood disorders. Meta-analysis evidence shows that childhood ADHD confers an elevated risk for depression across clinic-referred and community-based samples (Meinzer, Pettit, &amp; Viswesvaran, 2014) [2]. Consequently, these patients face academic underachievement, hindrance in employment, relationships troubles and in extreme cases, criminality. A study published in PLOS One established that despite early onset and greater prevalence of ADHD in young males, symptoms tend to diminish compared to that of females [3]. It is proposed that ADHD in adult males is characterised by a lesser recognised form that does not include hyperactive-impulsive symptoms and, therefore, has more chance of going undiagnosed and unrecorded. This explains why it seems as if ADHD symptoms tend to diminish in males [3]. Newer research also speculates that a subset of women might be presenting with an adult-onset form of ADHD [3], contradicting historical concepts that ADHD is a neurodevelopmental disorder that always emerges in childhood. That being said, a possibility remains that the increased number of cases in adult women might just be undiagnosed women 'catching up', supported by a review study that concluded increased ADHD identification in adult women compared to during childhood [2]. Pakistan has a severe lack of research and awareness regarding neurodivergence and ADHD. This explains why diagnosis and therapy for these patients using standardized behavioural rating scales and complete psychological evaluation is highly uncommon. The medical community of Pakistan needs to combat this by breaking the stigma surrounding neurodivergence and raising awareness about what ADHD is and what challenges it poses to undiagnosed patients. Early-on primary school screening of children can increase diagnosis and promote the provision of better opportunities to neurodivergent individuals to improve their standard of educational and work life.

The Behavioral Dysregulation Scale: Initial psychometric properties of a self-report measure of behavioral emotion dysregulation

The role of emotion dysregulation in the development and maintenance of transdiagnostic psychopathology is well established. Although behavioral acts often serve a regulatory function, there have been few systematic attempts to reliably measure multiple, functionally similarly forms of behavioral dysregulation via self-report. Using student (N = 776) and community (N = 494) samples, we examined the initial psychometric properties of a measure of behavioral emotion dysregulation, the Behavioral Dysregulation Scale (BDRS). Internal consistency was examined, and confirmatory factor analysis was used to confirm the presence of a rationally derived one-factor structure of the BDRS in both samples. Construct validity was assessed using bivariate correlations. We obtained a unidimensional, 13-item measure of behavioral dysregulation with adequate factor structure and good construct validity. Across both samples, a one-factor solution fit the data with acceptable to strong factor loadings. The BDRS was correlated with theoretically related but distinct constructs, including strong negative associations with measures of maladaptive cognitive emotion regulation and small to moderate positive associations with measures of adaptive cognitive emotion regulation. The results demonstrate preliminary support for the BDRS as a reliable and valid measure of behavioral emotion dysregulation with implications for better assessing the regulatory function of common maladaptive behaviors.

A biochemical description of postsynaptic plasticity—with timescales ranging from milliseconds to seconds

Synaptic plasticity [long-term potentiation/depression (LTP/D)], is a cellular mechanism underlying learning. Two distinct types of early LTP/D (E-LTP/D), acting on very different time scales, have been observed experimentally-spike timing dependent plasticity (STDP), on time scales of tens of ms; and behavioral time scale synaptic plasticity (BTSP), on time scales of seconds. BTSP is a candidate for a mechanism underlying rapid learning of spatial location by place cells. Here, a computational model of the induction of E-LTP/D at a spine head of a synapse of a hippocampal pyramidal neuron is developed. The single-compartment model represents two interacting biochemical pathways for the activation (phosphorylation) of the kinase (CaMKII) with a phosphatase, with ion inflow through channels (NMDAR, CaV1,Na). The biochemical reactions are represented by a deterministic system of differential equations, with a detailed description of the activation of CaMKII that includes the opening of the compact state of CaMKII. This single model captures realistic responses (temporal profiles with the differing timescales) of STDP and BTSP and their asymmetries. The simulations distinguish several mechanisms underlying STDP vs. BTSP, including i) the flow of [Formula: see text] through NMDAR vs. CaV1 channels, and ii) the origin of several time scales in the activation of CaMKII. The model also realizes a priming mechanism for E-LTP that is induced by [Formula: see text] flow through CaV1.3 channels. Once in the spine head, this small additional [Formula: see text] opens the compact state of CaMKII, placing CaMKII ready for subsequent induction of LTP.

Exploring the relationship between physical literacy levels, engagement and emotionality in physical education classes

For the researchers, physical literacy (AFi) is the objective to be achieved in Physical Education, for seeking competent subjects, capable of adhering to physical activity throughout their lives, with continuous personal, social, affective, and physical development. Quantitative, descriptive-correlational research was carried out, with a non-experimental design and a non-probabilistic sample of 322 subjects, students from 12 to 18 years old from private, public, and subsidized schools in Talca, Chile. The aim was to relate the level of AFi, engagement and perceived emotionality. Data were collected by the Perceived Physical Literacy Instrument (PPLI), Behavioral Engagement Questionnaire (BEQ) and Scale for Mood Assessment (EVEA). A positive relationship was identified with a higher level of physical literacy, higher levels of happiness (r=0.37) and emotional engagement (r=0.54), decreasing the indexes of hostility (r=-0.25) and the private establishments reach the highest levels of anxiety (X̅=3.2). It is concluded that the higher the level of AFi, the greater the commitment and the greater the regulation of emotional factors.

Exploratory genetic analysis in children with autism spectrum disorder and other developmental disorders using whole exome sequencing.

Developmental disorders (DDs), such as autism spectrum disorder (ASD), incorporate various conditions; once identified, further diagnostics are necessary to specify their type and severity. The aim of this exploratory study was to identify genetic variants that can help differentiate ASD early from other DDs. We selected 36 children (mean age 60.1 months) with DDs using Developmental Behavioral Scales (DBS) through "EDUS-Education for All", an organization providing services for children with developmental disorders in Bosnia and Herzegovina. We further rated children's autistic traits with the preschool version of the Childhood Autism Rating Scale, second edition (CARS-II). We defined ASD if scores were >25.5 and other DDs if scores were <25.5. Diagnosis of ASD and DD were independently confirmed by child psychiatrists. Whole exome sequencing (WES) was performed by Veritas Genetics, USA, using Illumina NovaSeq 6000 (Illumina Inc., San Diego, CA, USA) next-generation sequencing (NGS) apparatus. We tested genetic association by applying SKAT-O, which optimally combines the standard Sequence Kernel Association Test (SKAT) and burden tests to identify rare variants associated with complex traits in samples of limited power. The analysis yielded seven genes (DSE, COL10A1, DLK2, CSMD1, FAM47E, PPIA, PYDC2) to potentially differentiate observed phenotypic characteristics between our cohort participants with ASD and other DDs. Our exploratory study in a small sample of participants with ASD and other DDs contributed to gene discovery in differentiating ASD from DDs. A replication study is needed in a larger sample to confirm our results.

Comparison of the Effectiveness of EMLA Cream, 2% Lidocaine Gel, and Ice Bag on Pain Intensity Caused by Venipuncture in Children Aged 6-12 Years

Background and Objectives Intravenous catheter placement is one of the most common invasive care measures performed by nurses. Considering the contradictory results obtained regarding the effect of local analgesic techniques, the present study was conducted to compare the effect of EMLA cream vs. 2% lidocaine gel vs. ice bag on pain intensity caused by venipuncture in children aged 6-12 years. Subjects and Methods In this clinical trial, 160 children undergoing elective surgery were selected according to the inclusion and exclusion criteria and were divided into 4 groups of 40 using block randomization method. In this study, pain intensity was measured based on patient self-report and by nurses during venipuncture while applying EMLA cream, 2% lidocaine gel, and ice bag using the numeric analog scale (NAS) and the FLACC scale which included 5 criteria for child behavior. The range of scores in both scales is recorded from 0 to 10, where 0 indicates absence of pain. The data were collected using dispersion indices. Kruskal-Wallis test and chi-square test were used to compare the numerical scale of pain and behavior between groups using SPSS-16 statistical software. Results The mean age of the participants was 7.79±1.79 years, and 80 (50%) were male. The results showed that the mean values of pain intensity based on the numerical scale in the control, EMLA cream, lidocaine gel, and ice bag group were 4±0.78, 0.9±0.75, 2.80±0.18, and 2.60±0.67, respectively. Moreover, there was a statistically significant difference between the groups according to numerical scale and behavioral scale (P&lt;0.001), with the EMLA cream group expressing a lower level of pain based on both scales. Conclusion The results of the present study showed that the use of all three methods of EMLA cream, lidocaine gel, and ice bag reduced pain during venipuncture. The EMLA cream was associated with a higher amount of pain reduction compared to the other two methods. Therefore, EMLA cream could be recommended to be used routinely in the target area one hour before catheter placement.

Evolution of Severe Closed Head Injury: Assessing Ventricular Volume and Behavioral Measures at 30 and 90 Days Post-Injury

Background: Assessing functional outcomes in Severe Closed Head Injury (SCHI) is complex due to brain parenchymal changes. This study examines the Ventricles to Intracranial Volume Ratio (VBR) as a metric for these changes and its correlation with behavioral scales. Methods: Thirty-one SCHI patients were included. VBR was derived from CT scans at 3, 30, and 90 days post-injury and compared with Levels of Cognitive Functioning (LCF), Disability Rating Scale (DRS), and Early Rehabilitation Barthel Index (ERBI) assessments at 30 and 90 days. Results: Ten patients were excluded post-decompressive craniectomy or ventriculoperitoneal shunt. Findings indicated a VBR decrease at 3 days, suggesting acute phase compression, followed by an increase from 30 to 90 days, indicative of post-acute brain atrophy. VBR correlated positively with the Marshall score in the initial 72 h, positioning it as an early indicator of subsequent brain atrophy. Nevertheless, in contrast to the Marshall score, VBR had stronger associations with DRS and ERBI at 90 days. Conclusions: VBR, alongside behavioral assessments, presents a robust framework for evaluating SCHI progression. It supports early functional outcome correlations informing therapeutic approaches. VBR’s reliability underscores its utility in neurorehabilitation for ongoing SCHI assessment and aiding clinical decisions.

A comparative analysis of oropharyngeal functions in preterm and term children with cerebral palsy

This study aims to compare term and preterm children with Cerebral Palsy (CP) in terms of their oropharyngeal functions. A total of 50 children with CP participated in the study, and were divided into two groups according to their birth history including preterm group (gestational age below 37 weeks; 60 % female; mean age = 6.86 ± 4.35 years) and term group (gestational age between 37 and 41 weeks; 60 % female; mean age = 6.48 ± 4.86 years). Chewing and swallowing functions were evaluated in terms of oropharyngeal functions. Chewing evaluation was performed by using the Karaduman Chewing Performance Scale (KCPS) and the Turkish version of the Mastication Observation and Evaluation Instrument (T-MOE). The pediatric version of the Eating Assessment Tool (PEDI-EAT-10) was used to evaluate swallowing performance of children. In addition, the Behavioral Pediatric Feeding Assessment Scale (BPFAS) was used to assess feeding behaviors of children. There were significant differences between groups in terms of KCPS (p = 0.03), T-MOE (p = 0.01), and PEDI-EAT-10 scores (p = 0.04). There was a significant difference between groups in terms of the parental frequency score from the BPFAS (p = 0.04). Oropharyngeal functions of preterm children with CP were more adversely affected than term children with CP. Clinicians working with children with CP should be aware of the risks of preterm birth on oropharyngeal functions, and take precautions for oropharyngeal dysfunction in the early period in preterm children with CP.

Psychometric Properties of the Hindi Version of the Behavioral Inhibition System/Behavioral Activation System Scale

Abstract: Aim: The Behavioral Inhibition and Activation Scale is a popular instrument that assesses an individual's responsiveness to reward and punishment. It is widely translated and validated in different languages. However, the Hindi version of this scale is not yet available. The present study aimed to adapt the BIS/BAS scale into Hindi and examine its psychometric properties and factor structure. Method: The original BIS/BAS scale was translated into Hindi using the translation and back-translation method. The translated Hindi version along with the NEO-FFI and HADS was administered on 200 participants. Psychometric properties, i.e., reliability, validity, and factor structure, were estimated. Result: Cronbach’s α coefficient ranged between .68 and .80, while test–retest reliability ranges between .85 and .92. The validity is also adequate. The findings support the five-factor structure of the BIS/BAS scale. Limitations: The present study has a relatively small sample, which is drawn from only one Hindi-speaking region of India. Conclusion: It was found that the Hindi version of the BIS/BAS scale is a reliable and valid tool with good psychometric properties.

Effect of antenatal micronutrient or antidepressant exposure on Brazelton neonatal behavioral assessment scale (NBAS) performance within one-month of birth

BackgroundAntenatal depression is a risk factor for poor infant outcomes. Broad-spectrum-micronutrients (vitamins and minerals) have shown efficacy in treating psychiatric symptoms in non-pregnant populations and are associated with reduced incidence of adverse birth outcomes, and improvements in neonatal development. We investigated the effects of treatment of antenatal depression with micronutrients above the Recommended Dietary Allowance on infant development compared to treatment with antidepressant medications and controls. MethodOne-hundred-and-three infants were assessed using the Brazelton Neonatal Behavioral Assessment Scale (NBAS) within 28 days of birth: 37 exposed to micronutrients in-utero (50–182 days exposure), 18 to antidepressants in-utero (exposure for full gestation), and 48 controls whose mothers received neither treatment nor experienced depressive symptoms. ResultsControlling for gestational age and parity, there were significant group differences on habituation, orientation, motor, state regulation, autonomic stability and reflexes (p < .05). Micronutrient-exposed performed better than antidepressant-exposed and controls on habituation, motor and autonomic stability (p < .05), effect sizes ranged 1.0–1.7 and 0.5–1.0, respectively. Antidepressant-exposed performed significantly worse on orientation and reflexes compared to micronutrient-exposed and controls. Micronutrient-exposed had significantly better state regulation compared to antidepressant-exposed. There was an association between micronutrient exposure length and better habituation (r = 0.41, p = .028). Micronutrient exposure was generally identified as a stronger predictor of neonatal performance over maternal depression, social adversity, gestational age and infant sex. ConclusionIn-utero micronutrient exposure appears to mitigate risks of depression on infant outcomes showing positive effects on infant behavior, on par with or better than typical pregnancies and superior to antidepressants. Limitations include differential exposure to micronutrients/antidepressants and lack of group blinding.

Musical experience influences socio-emotional functioning in behavioural variant frontotemporal dementia.

On phenotypic and neuroanatomical grounds, music exposure might potentially affect the clinical expression of behavioural variant frontotemporal dementia (bvFTD). However, this has not been clarified. 14 consecutive patients with bvFTD fulfilling consensus diagnostic criteria were recruited via a specialist cognitive clinic. Earlier life musical experience, current musical listening habits and general socio-emotional behaviours were scored using a bespoke semi-quantitative musical survey and standardised functional scales, completed with the assistance of patients' primary caregivers. Associations of musical scores with behavioural scales were assessed using a linear regression model adjusted for age, sex, educational attainment and level of executive and general cognitive impairment. Greater earlier life musical experience was associated with significantly lower Cambridge Behavioural Inventory (Revised) scores (β ± SE = -17.2 ± 5.2; p = 0.01) and higher Modified Interpersonal Reactivity Index (MIRI) perspective-taking scores (β ± SE = 2.8 ± 1.1; p = 0.03), after adjusting for general cognitive ability. Number of hours each week currently spent listening to music was associated with higher MIRI empathic concern (β ± SE = 0.7 ± 0.21; p = 0.015) and MIRI total scores (β ± SE = 1.1 ± 0.34; p = 0.014). Musical experience in earlier life and potentially ongoing regular music listening may ameliorate socio-emotional functioning in bvFTD. Future work in larger cohorts is required to substantiate the robustness of this association, establish its mechanism and evaluate its clinical potential.

Maternal singing reduced pain indexes in 2-month-old infants and increased proximity during vaccinations.

Immunisation is a global health priority, but methods of non-pharmacological pain relief are not widely used in routine clinical practice. In this study, we set out to investigate the effects of maternal singing during the routine vaccination of infants. We recruited 67 mother-infant pairs at Health Centres in the Aosta Region of Italy. Infants aged 2-4 months were randomly allocated to a singing intervention group or to a control group whose injections were administered following standard practice. Pre- and post-immunisation pain was blindly assessed using the Modified Behavioural Pain Scale, and mother-infant proximity indexes were assigned based on muted video-tracks. When assessed for pain, the infants in the maternal singing group were assigned significantly lower movement indexes (p = 0.032) and marginally significantly lower cry indexes (p = 0.076). A higher frequency of mother-to-infant gaze (p < 0.005) was observed in the singing group dyads. Finally, the intervention group mothers' self-perceived ease in singing was correlated with their previous singing experience and with lower anxiety following the vaccination procedure (p < 0.05). Maternal singing during immunisation procedures benefits both mothers and babies. The practice of singing is a biologically rooted and adaptive form of intuitive parental communication that should be encouraged, especially in at-risk populations.

Comparison of intravenous ketamine and fentanyl sedation in duration of mechanical ventilation in intensive care unit

Background and aims: To compare the duration of mechanical ventilation in patients receiving ketamine compared to fentanyl for sedation in mechanically ventilated patients in intensive care unit. Methods: One hundred and six patients requiring mechanical ventilation were randomized to receive continuous intravenous infusion of either ketamine (1 mg/kg bolus followed by 0.4 to 0.8 mg/kg/h) or fentanyl (1mcg/kg bolus followed by 0.3-0.5 mcg/kg/min) with the dose titrated to achieve Richmond Agitation Sedation Scale (RASS) score of 0 to -1 and Behavioral Pain Scale (BPS) score of 3 to 7. The primary outcome was the duration of mechanical ventilation. Secondary outcomes were sedation score, analgesia score and need of vasopressors. Results: The mean duration of ventilation was 2.5±0.6 days and 2.2±1.0 days (p=0.1) in patients receiving ketamine and fentanyl respectively. More patients required vasopressors: 27 (50.9%) vs 9 (17%) in patients receiving fentanyl compared to ketamine (p&lt;0.05). There were no significant changes in hemodynamic variables after the initiation of the study drug in both the groups. Infusion was discontinued for adverse effects in seven (13%) patients in both the groups. Conclusion: When compared with fentanyl, continuous ketamine infusion was tolerated similarly by critically ill adults, with similar duration of mechanical ventilation. Ketamine sedation was associated with decreased requirement for vasopressors.

Empowering Community Health Workers in Japan: Determinants of Non-Communicable Disease Prevention Competency

Background: Community health workers (CHWs), hailing from the general populace, play a pivotal role in fortifying healthcare systems, with a primary focus on mitigating non-communicable diseases (NCDs) and elevating overall life expectancy. To assess the aptitude of CHWs in NCD prevention, we introduced the Community Health Workers Perceptual and Behavioral Competency Scale for preventing non-communicable diseases (COCS-N). This study examines the multifaceted interplay of individual and community factors that influence CHWs’ COCS-N scores. Methods: The research design is a secondary analysis using data from a self-administered questionnaire survey of 6480 CHWs residing in municipalities across Japan, which obtained 3120 valid responses, between September to November 2020. The COCS-N was employed as the dependent variable, while the independent variables were individual-related factors, including years of community health work, health literacy, and community-related factors, such as CHWs’ sense of community. To ascertain the significance of associations between individual and community factors and CHWs’ competency, an analysis of covariance (ANCOVA) was utilized to compare the three groups Q1/Q2/Q3 by low, medium, and high scores on the COCS-N scale. Statistical significance was considered to be indicated by a p-value of less than 0.05. Results: The ANCOVA analysis revealed that three factors were significantly linked to CHWs’ competence. These comprised individual factors: “years of CHWs” (mean ± SD Q1: 6.0 ± 6.0, Q2: 7.8 ± 7.0, Q3: 8.2 ± 7.7, p &lt; 0.001) and “health literacy” (Q1: 27.7 ± 6.6, Q2: 30.4 ± 6.9, Q3: 33.8 ± 7.8, p &lt; 0.001), as well as a community factor: “Sense of community” (Q1: 14.8 ± 3.7, Q2: 16.5 ± 3.5, Q3: 18.2 ± 3.6, p &lt; 0.001). Conclusions: Our finding is that a positive association was derived between COCS-N scores and certain determinants. Notably, “years of CHWs” and “health literacy” in the individual domain, along with the “Sense of community” in the communal context, were firmly established as being significantly associated with CHWs’ competency. Consequently, CHWs need training to increase their “health literacy” and “sense of community”, to acquire high competency in NCD prevention, which will lead to the empowerment of CHWs and maintain their motivation to continue.

Clinical phenotypic spectrum of CTNNB1 neurodevelopmental disorder.

Pathogenic heterozygous loss of function variants in CTNNB1 are associated with CTNNB1 neurodevelopmental disorder. We report the clinical phenotype of individuals with CTNNB1 neurodevelopmental disorder using both caregiver-reported data (medical history, adaptive function, quality of life, and behavior issues) and in-person clinical assessments (neurological, motor, and cognitive function) in 32 individuals with likely pathogenic or pathogenic CTNNB1 variants. Most individuals had truncal hypotonia, muscle weakness, hypertonia, dystonia, microcephaly, and many had a history of tethered cord. Visual problems included strabismus, hyperopia, and familial exudative vitreoretinopathy. Half of individuals walked without an assistive device. The mean Gross Motor Functional Measure-66 score was 56.6 (SD = 14.8). Average time to complete Nine-Hole Peg Test was slower than norms. Mean general conceptual ability composite scores from Differential Ability Scales Second Edition were very low (M = 58.3, SD = 11.3). Fifty-five percent of individuals had low adaptive functioning based on the Vineland Adaptive Behavioral Scales. Based upon the Child Behavior Checklist total problems score, the majority (65%) of individuals had behavioral challenges. The mean overall Quality of Life Inventory-Disability score was 81.7 (SD = 11.9). These data provide a detailed characterization of clinical features in individuals with CTNNB1 neurodevelopmental disorder.

Parent and Child-Reported Strengths of Children With ADHD

A strength-based approach to childhood attention-deficit/hyperactivity disorder (ADHD) research highlights children’s positive attributes that can support their areas of difficulty. However, research on perceptions of a child’s positive attributes is understudied. Specifically, there is little research that examines strength-based perceptions of children with ADHD, and only one known article addresses parent perceptions of their children with ADHD. As such, this study analyzed parent and child-reported strengths in children with ADHD. Parent and child-reported strengths were measured using the Behavioral and Emotional Rating Scale—Second edition, Parent Form and Child Form (BERS-2). Results indicated that parents and children perceived strengths in the interpersonal, intrapersonal, and affective domains to be similar, falling in the Average range. However, children indicated their family involvement and school functioning fell within the Average range, whereas parents rated these domains below average. Positive parental perspectives of their children may promote positive parent-child interactions and serve as an overall protective factor for children with ADHD. Domains which parents and children see as strengths should be utilized to support areas of weakness. Strength-based research for children with ADHD and positive interventions utilizing strengths may benefit families with ADHD, as well as classroom teachers and school psychologists.

The indirect effects of self-regulation on the association of social support with increased protective drinking behavior and decreased alcohol problems in a predominantly Hispanic college student sample.

Research suggests that self-regulation, which refers to one's ability to manage a behavior, and social support are related to alcohol use. Other research suggests that social support may serve as a precursor to self-regulation and health-promoting behaviors. We examined whether self-regulation has an indirect effect on the association between social support and both protective drinking behaviors and alcohol problems. A random sample of students at a Hispanic Serving Institution completed an online survey, which included sociodemographic questions, the Multidimensional Perceived Social Support Scale, the Short Self-Regulation Questionnaire, the Protective Behavioral Strategies (PBS) Scale, and the Rutgers Alcohol Problem Index. Undergraduate students (n = 192) who reported drinking in the last month were included in the analysis. A path analysis using Mplus8 was conducted to investigate the relationships among social support, self-regulation, PBS, and alcohol-related problems. The sample was mostly female (58.9) and of Hispanic ethnicity (89.6). Analyses showed that social support had a significant positive association with PBS and a significant negative association with alcohol-related problems. When self-regulation was added to the models, these associations were no longer significant, and self-regulation had a significant indirect effect on the relationship between social support and both PBS and alcohol-related problems. The results of the current cross-sectional study suggest that a viable hypothesis in future longitudinal studies is that self-regulation is a mechanism by which social support increases PBS and reduces alcohol problems. Future research should assess longitudinally both the mediating effects of self-regulation between social support and drinking outcomes and potential moderators, such as ethnicity.