Minimizing habitat conflicts in meeting net-zero energy targets in the western United States.

The scale and pace of energy infrastructure development required to achieve net-zero greenhouse gas (GHG) emissions are unprecedented, yet our understanding of how to minimize its potential impacts on land and ocean use and natural resources is inadequate. Using high-resolution energy and land-use modeling, we developed spatially explicit scenarios for reaching an economy-wide net-zero GHG target in the western United States by 2050. We found that among net-zero policy cases that vary the rate of transportation and building electrification and use of fossil fuels, nuclear generation, and biomass, the "High Electrification" case, which utilizes electricity generation the most efficiently, had the lowest total land and ocean area requirements (84,000 to 105,000 km2 vs. 88,100 to 158,000 km2 across all other cases). Different levels of land and ocean use protections were applied to determine their effect on siting, environmental and social impacts, and energy costs. Meeting the net-zero target with stronger land and ocean use protections did not significantly alter the share of different energy generation technologies and only increased system costs by 3%, but decreased additional interstate transmission capacity by 20%. Yet, failure to avoid development in areas with high conservation value is likely to result in substantial habitat loss.

Psychiatry Match Rates Increase After Exposure to a Medical Student Mentorship Program: A Multisite Retrospective Cohort Analysis.

OBJECTIVE: Since 2002, the Klingenstein Third Generation Foundation (KTGF) has supported a network of medical student mentorship programs (MSMPs) across the USA with the explicit aim of enhancing interest in, and eventual recruitment into the field of child and adolescent psychiatry (CAP). The authors conducted a multisite, retrospective cohort analysis to examine the impact of the program on career selection, as reflected by graduation match rates into psychiatry or pediatrics. METHODS: The authors collected graduating match information (2008-2019) from fourteen participating medical schools (Exposed) and thirteen non-participating schools (Control). Control schools were selected based on region, comparable student body and faculty size, national standing, and rank in NIH funding. Match rates into psychiatry and pediatrics were compared between Exposed and Control groups. RESULTS: Exposed schools had significantly higher match rates into psychiatry as compared to unexposed schools (6.1% and 4.8%, respectively; OR [95%CI] = 1.29 [1.18, 1.40]; X2 = 32.036, p < 0.001). In contrast, during the same time period, exposed schools had significantly lower match rates into pediatrics than unexposed ones (11.6 and 10.5%, respectively; OR [95%CI] = 0.89 (0.83, 0.95); X2 = 12.127, p < 0.001). These findings persisted even after adjustment for secular trends in match rates. CONCLUSIONS: Seventeen years after its inception, the KTGF medical student mentorship program network has had a positive impact on match rates into general psychiatry. Future studies will address whether these results translate to trainees' eventual selection of careers in CAP.

Climate mediates hypoxic stress on fish diversity and nursery function at the land-sea interface.

Coastal ecosystems provide numerous important ecological services, including maintenance of biodiversity and nursery grounds for many fish species of ecological and economic importance. However, human population growth has led to increased pollution, ocean warming, hypoxia, and habitat alteration that threaten ecosystem services. In this study, we used long-term datasets of fish abundance, water quality, and climatic factors to assess the threat of hypoxia and the regulating effects of climate on fish diversity and nursery conditions in Elkhorn Slough, a highly eutrophic estuary in central California (United States), which also serves as a biodiversity hot spot and critical nursery grounds for offshore fisheries in a broader region. We found that hypoxic conditions had strong negative effects on extent of suitable fish habitat, fish species richness, and abundance of the two most common flatfish species, English sole (Parophrys vetulus) and speckled sanddab (Citharichthys stigmaeus). The estuary serves as an important nursery ground for English sole, making this species vulnerable to anthropogenic threats. We determined that estuarine hypoxia was associated with significant declines in English sole nursery habitat, with cascading effects on recruitment to the offshore adult population and fishery, indicating that human land use activities can indirectly affect offshore fisheries. Estuarine hypoxic conditions varied spatially and temporally and were alleviated by strengthening of El Niño conditions through indirect pathways, a consistent result in most estuaries across the northeast Pacific. These results demonstrate that changes to coastal land use and climate can fundamentally alter the diversity and functioning of coastal nurseries and their adjacent ocean ecosystems.

CATEGORICAL DIAGNOSIS OF EXTREME HYPERACTIVITY, IMPULSIVITY, AND INATTENTION IN VERY YOUNG CHILDREN.

Severe hyperactivity and impulsivity are common reasons for referral to infant mental health services. Past versions of ZERO TO THREE's () diagnostic nosology, the Diagnostic Classification of Mental and Developmental Disorders in Infancy and Early Childhood (DC:0-3), did not address this clinical issue because it had been addressed in other nosologies. These general diagnostic nosologies describe attention deficit hyperactivity disorder (ADHD), but with little attention to developmentally specific aspects of the diagnosis in very young children. Categorical diagnosis related to hyperactivity and impulsivity in very young children warrants careful review of existing literature. Explicit attention must be paid to ensure that categorical diagnoses serve to describe syndromes that cause significant impairment to the family to allow children and families to access effective supports and ensure that behaviors typical of the developmental level are not described as pathologic. This article reviews proposed diagnostic criteria for ADHD and overactivity disorder of toddlerhood as well as the rationale for the criteria and evidence supporting validity and reliability of the diagnoses in very young children. Clinical implications also are presented.

DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD DC:0-5: SELECTIVE REVIEWS FROM A NEW NOSOLOGY FOR EARLY CHILDHOOD PSYCHOPATHOLOGY.

The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-5; ZERO TO THREE) is scheduled to be published in 2016. The articles in this section are selective reviews that have been undertaken as part of the process of refining and updating the nosology. They provide the rationales for new disorders, for disorders that had not been included previously in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R; ZERO TO THREE, 2005), and for changes in how certain types of disorders are conceptualized.

Annual research review: Attachment disorders in early childhood--clinical presentation, causes, correlates, and treatment.

BACKGROUND: Though noted in the clinical literature for more than 50 years, attachment disorders have been studied systematically only recently. In part because of the ubiquity of attachments in humans, determining when aberrant behavior is best explained as an attachment disorder as opposed to insecure attachment has led to some confusion. In this selective review, we consider the literature on reactive attachment disorder and disinhibited social engagement disorder and describe an emerging consensus about a number of issues, while also noting some areas of controversy and others where we lack clear answers. We include a brief history of the classification of the disorders, as well as measurement issues. We describe their clinical presentation, causes and vulnerability factors, and clinical correlates, including the relation of disorders to secure and insecure attachment classifications. We also review what little is known and what more we need to learn about interventions. METHODS: We conducted a literature search using PubMed, PsycINFO, and Cochrane Library databases, using search terms 'reactive attachment disorder,' 'attachment disorder,' 'indiscriminate behavior,' 'indiscriminate friendliness,' 'indiscriminate socially disinhibited reactive attachment disorder,' 'disinhibited social engagement disorder,' and 'disinhibited social behavior.' We also contacted investigators who have published on these topics. FINDINGS: A growing literature has assessed behaviors in children who have experienced various types of adverse caregiving environments reflecting signs of putative attachment disorders, though fewer studies have investigated categorically defined attachment disorders. The evidence for two separate disorders is considerable, with reactive attachment disorder indicating children who lack attachments despite the developmental capacity to form them, and disinhibited social engagement disorder indicating children who lack developmentally appropriate reticence with unfamiliar adults and who violate socially sanctioned boundaries. CONCLUSIONS: Although many questions remain to be answered, especially regarding appropriate interventions, we know considerably more about attachment disorders than we did only a decade ago.

Serotonin transporter linked polymorphic region (5-HTTLPR) genotype moderates the longitudinal impact of early caregiving on externalizing behavior.

We examined caregiver report of externalizing behavior from 12 to 54 months of age in 102 children randomized to care as usual in institutions or to newly created high-quality foster care. At baseline no differences by group or genotype in externalizing were found. However, changes in externalizing from baseline to 42 months of age were moderated by the serotonin transporter linked polymorphic region genotype and intervention group, where the slope for short-short (S/S) individuals differed as a function of intervention group. The slope for individuals carrying the long allele did not significantly differ between groups. At 54 months of age, S/S children in the foster care group had the lowest levels of externalizing behavior, while children with the S/S genotype in the care as usual group demonstrated the highest rates of externalizing behavior. No intervention group differences were found in externalizing behavior among children who carried the long allele. These findings, within a randomized controlled trial of foster care compared to continued care as usual, indicate that the serotonin transporter linked polymorphic region genotype moderates the relation between early caregiving environments to predict externalizing behavior in children exposed to early institutional care in a manner most consistent with differential susceptibility.

A transactional and collaborative approach to reducing effects of bottom trawling.

Private-sector financial and legal transactions have long been used to protect terrestrial habitats and working landscapes, but less commonly to address critical threats in marine environments. Transferrable and marketable fishing privileges, including permits and quotas, make it possible to use private-sector transactions as conservation strategies to address some fishery management issues. Abating the effects of bottom trawling on the seafloor and bycatch and discard associated with the practice has proven challenging. On the Central Coast of California, The Nature Conservancy (TNC), Environmental Defense Fund, local fishers and local, state, and federal authorities worked collaboratively to protect large areas of the seafloor from bottom trawling for groundfish while addressing economic impacts of trawl closures. Contingent on the adoption of trawl-closure areas by a federal regulatory agency, TNC used private funds to purchase federal groundfish trawl permits and vessels from willing sellers. Trawl-closure areas were designed collaboratively by combining regional biological diversity and fisheries data with local fishers' knowledge. The private transactional strategy was designed to remedy some deficiencies in previous federal buyouts, to mitigate economic impacts from trawl closures, and to carefully align with a public regulatory process to protect "essential fish habitat" under the Magnuson-Stevens Fishery Conservation and Management Act. This collaborative effort protected 1.5 million ha (3.8 million acres) of seafloor, reduced trawl effort in the area by 50%, and set a precedent for collaborative partnerships between conservation and fishing interests. This is the first time a large conservation organization has taken an ownership position in a fishery and demonstrates how nongovernmental organizations can invest in fisheries to improve environmental and economic performance.

Editorial: It's Not Just a Phase, and We Know What to Do: Children With Early-Onset Mental Health Concerns Deserve Care Now.

Suicide is the 2nd leading cause of death in 10-14 year old and the prevalence of suicidal thoughts and behaviors young children is as high as 7.5%.1 Importantly, children 5 to 11 years old account for 43% of STB-focused emergency department visits in the United States.2 Despite the public health implications of STBs, limited research has focused on the longitudinal development of STBs. In this issue of the Journal, Hennefield et al.3 provide valuable insight into the persistence of preschool-onset major depressive disorder (PO-MDD) and STBs in preadolescents, highlighting opportunities for clinical systems of care.

A Relational Agent Intervention for Adolescents Seeking Mental Health Treatment: Protocol for a Randomized Controlled Trial.

BACKGROUND: Unmet pediatric mental health (MH) needs are growing as rates of pediatric depression and anxiety dramatically increase. Access to care is limited by multiple factors, including a shortage of clinicians trained in developmentally specific, evidence-based services. Novel approaches to MH care delivery, including technology-leveraged and readily accessible options, need to be evaluated in service of expanding evidence-based services to youths and their families. Preliminary evidence supports the use of Woebot, a relational agent that digitally delivers guided cognitive behavioral therapy (CBT) through a mobile app, for adults with MH concerns. However, no studies have evaluated the feasibility and acceptability of such app-delivered relational agents specifically for adolescents with depression and/or anxiety within an outpatient MH clinic, nor compared them to other MH support services. OBJECTIVE: This paper describes the protocol for a randomized controlled trial evaluating the feasibility and acceptability of an investigational device, Woebot for Adolescents (W-GenZD), within an outpatient MH clinic for youths presenting with depression and/or anxiety. The study's secondary aim will compare the clinical outcomes of self-reported depressive symptoms with W-GenZD and a telehealth-delivered CBT-based skills group (CBT-group). Tertiary aims will evaluate additional clinical outcomes and therapeutic alliance between adolescents in W-GenZD and the CBT-group. METHODS: Participants include youths aged 13-17 years with depression and/or anxiety seeking care from an outpatient MH clinic at a children's hospital. Eligible youths will have no recent safety concerns or complex comorbid clinical diagnoses; have no concurrent individual therapy; and, if on medications, are on stable doses, based on clinical screening and as well as study-specific criteria. RESULTS: Recruitment began in May 2022. As of December 8, 2022, we have randomized 133 participants. CONCLUSIONS: Establishing the feasibility and acceptability of W-GenZD within an outpatient MH clinical setting will add to the field's current understanding of the utility and implementation considerations of this MH care service modality. The study will also evaluate the noninferiority of W-GenZD against the CBT-group. Findings may also have implications for patients, families, and providers looking for additional MH support options for adolescents seeking help for their depression and/or anxiety. Such options expand the menu of supports for youths with lower-intensity needs as well as possibly reduce waitlists and optimize clinician deployment toward more severe cases. TRIAL REGISTRATION: ClinicalTrials.gov NCT05372913; https://clinicaltrials.gov/ct2/show/NCT05372913. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44940.

Kelpwatch: A new visualization and analysis tool to explore kelp canopy dynamics reveals variable response to and recovery from marine heatwaves.

Giant kelp and bull kelp forests are increasingly at risk from marine heatwave events, herbivore outbreaks, and the loss or alterations in the behavior of key herbivore predators. The dynamic floating canopy of these kelps is well-suited to study via satellite imagery, which provides high temporal and spatial resolution data of floating kelp canopy across the western United States and Mexico. However, the size and complexity of the satellite image dataset has made ecological analysis difficult for scientists and managers. To increase accessibility of this rich dataset, we created Kelpwatch, a web-based visualization and analysis tool. This tool allows researchers and managers to quantify kelp forest change in response to disturbances, assess historical trends, and allow for effective and actionable kelp forest management. Here, we demonstrate how Kelpwatch can be used to analyze long-term trends in kelp canopy across regions, quantify spatial variability in the response to and recovery from the 2014 to 2016 marine heatwave events, and provide a local analysis of kelp canopy status around the Monterey Peninsula, California. We found that 18.6% of regional sites displayed a significant trend in kelp canopy area over the past 38 years and that there was a latitudinal response to heatwave events for each kelp species. The recovery from heatwave events was more variable across space, with some local areas like Bahía Tortugas in Baja California Sur showing high recovery while kelp canopies around the Monterey Peninsula continued a slow decline and patchy recovery compared to the rest of the Central California region. Kelpwatch provides near real time spatial data and analysis support and makes complex earth observation data actionable for scientists and managers, which can help identify areas for research, monitoring, and management efforts.

Structure of Psychopathology in Romanian Preschool-Aged Children in an Epidemiological and a High-Risk Sample.

Objective: Research on bifactor models of psychopathology in early childhood is limited to community samples with little longitudinal follow-up. We examined general and specific forms of psychopathology within 2 independent samples of preschool-aged Romanian children. Within a sample with children exposed to psychosocial deprivation, we also examined antecedents and longitudinal outcomes of the general factor. Method: One sample consisted of 350 Romanian children (mean age = 39.7 months, SD = 10.9) from an epidemiological study; the second sample consisted of 170 Romanian children (mean age = 55.6 months, SD = 1.9) exposed to severe early-life deprivation, as well as community comparison children, with longitudinal follow-up at 8 and 12 years. Psychopathology symptoms were assessed through caregiver-reported structured clinical interviews. Results: An SI-1 bifactor model of psychopathology was supported in both samples and included specific factors for externalizing, internalizing, and disturbed relatedness symptoms. In the second sample, longer duration of psychosocial deprivation and lower-quality caregiving were associated with higher scores on the general and all specific factors. Higher scores on the general factor were associated with later cognitive function, competence, and psychopathology symptoms. Considering all factors together, only the general factor explained variance in later childhood outcomes and was slightly stronger compared to a total symptom count for some, but not all, outcomes. Conclusion: General psychopathology in early childhood explains meaningful variance in child outcomes across multiple domains of functioning in later childhood. However, important questions remain regarding its clinical utility and usefulness, given complex measurement and limited explanatory power beyond the more accessible approach of a total symptom count. Clinical trial registration information: The Bucharest Early Intervention Project; https://clinicaltrials.gov/; NCT00747396.

Quantity and fate of synthetic microfiber emissions from apparel washing in California and strategies for their reduction.

Synthetic microfibers have been identified as the most prevalent type of microplastic in samples from aquatic, atmospheric, and terrestrial environments across the globe. Apparel washing has shown to be a major source of microfiber pollution. We used California as a case study to estimate the magnitude and fate of microfiber emissions, and to evaluate potential mitigation approaches. First, we quantified synthetic microfiber emissions and fate from apparel washing in California by developing a material flow model which connects California-specific data on synthetic fiber consumption, apparel washing, microfiber generation, and wastewater and biosolid management practices. Next, we used the model to assess the effectiveness of different interventions to reduce microfiber emissions to natural environments. We estimate that in 2019 as much as 2.2 kilotons (kt) of synthetic microfibers were generated by apparel washing in California, a 26% increase since 2008. The majority entered terrestrial environments (1.6 kt), followed by landfills (0.4 kt), waterbodies (0.1 kt), and incineration (0.1 kt). California's wastewater treatment network was estimated to divert 95% of microfibers from waterbodies, mainly to terrestrial environments and primarily via land application of biosolids. Our analysis also reveals that application of biosolids on agricultural lands facilitates a directional flow of microfibers from higher-income urban counties to lower-income rural communities. Without interventions, annual synthetic microfiber emissions to California's natural environments are expected to increase by 17% to 2.1 kt by 2026. Further increasing the microfiber retention efficiency at the wastewater treatment plant would increase emissions to terrestrial environments, which suggests that microfibers should be removed before entering the wastewater system. In our model, full adoption of in-line filters in washing machines decreased annual synthetic microfiber emissions to natural environments by 79% to 0.5 kt and offered the largest reduction of all modeled scenarios.

Epidemiology of psychiatric disorders in very young children in a Romanian pediatric setting.

A growing literature demonstrates that early clinical intervention can reduce risks of adverse psychosocial outcomes. A first step necessary for developing early intervention services is to know the prevalence of clinical disorders, especially in systems that are rebuilding, such as Romania, where the mental health system was dismantled under Ceausescu. No epidemiologic studies have examined prevalence of psychiatric disorders in young children in Romania. The objective of this study was to determine the prevalence of psychiatric disorders in Romanian children 18-60 months in pediatric settings. Parents of 1,003 children 18-60 months in pediatric waiting rooms of two pediatric hospitals completed background information, the Child Behavior Checklist (CBCL). A subgroup over-sampled for high mental health problems were invited to participate in the Preschool Age Psychiatric Assessment. Rates of mental health problems were similar to the US norms on the CBCL. The weighted prevalence of psychiatric disorders in these children was 8.8%, with 5.4% with emotional disorders and 1.4% with behavioral disorders. Comorbidity occurred in nearly one-fourth of the children with a psychiatric disorder and children who met diagnostic criteria had more functional impairment than those without. Of children who met criteria for a psychiatric disorder, 10% of parents were concerned about their child's emotional or behavioral health. This study provides prevalence rates of psychiatric disorders in young Romanian children, clinical characteristic of the children and families that can guide developing system of care. Cultural differences in parental report of emotional and behavioral problems warrant further examination.

The rise in climate change-induced federal fishery disasters in the United States.

Commercial, recreational, and indigenous fisheries are critical to coastal economies and communities in the United States. For over three decades, the federal government has formally recognized the impact of fishery disasters via federal declarations. Despite these impacts, national syntheses of the dynamics, impacts, and causes of fishery disasters are lacking. We developed a nationwide Federal Fishery Disaster database using National Oceanic and Atmospheric Administration (NOAA) fishery disaster declarations and fishery revenue data. From 1989-2020, there were 71 federally approved fishery disasters (eleven are pending), which spanned every federal fisheries management region and coastal state in the country. To date, we estimate fishery disasters resulted in $2B (2019 USD) in Congressional allocations, and an additional, conservative estimate of $3.2B (2019 USD) in direct revenue loss. Despite this scale of impact, the disaster assistance process is largely ad hoc and lacks sufficient detail to properly assess allocation fairness and benefit. Nonetheless, fishery disasters increased in frequency over time, and the causes of disasters included a broad range of anthropogenic and environmental factors, with a recent shift to disasters now almost exclusively caused by extreme environmental events (e.g., marine heatwaves, hurricanes, and harmful algal blooms). Nationwide, 84.5% of fishery disasters were either partially or entirely attributed to extreme environmental events. As climate change drives higher rates of such extreme events, and as natural disaster assistance requests reach an all-time high, the federal system for fisheries disaster declaration and mitigation must evolve in order to effectively protect both fisheries sustainability and societal benefit.

Recognizing young children in need of mental health assessment: Development and preliminary validity of the early childhood screening assessment.

The Early Childhood Screening Assessment (ECSA) is a primary care screening measure developed to identify very young children (1½-5 years old) who need further emotional or behavioral assessment. The ECSA was developed specifically to meet the logistical constraints of primary care settings. This study assessed the preliminary psychometric properties of the ECSA by comparing it with extant validated measures of young children's emotional and behavioral development, comparing it with a diagnostic interview, and measuring test-retest reliability. In the study, 309 mothers in two primary care clinics completed the ECSA and the Child Behavior Checklist (CBCL; T. Achenbach & L. Rescorla, 2000). A subset (n = 69) also completed the Diagnostic Interview for the Preschool Age (DIPA; M. Scheeringa & N. Haslett, 2010). ECSA score correlated significantly and strongly with the CBCL Total Problem T score (Spearman's rho = 0.86, p ⩽ .01). The ECSA was 86% sensitive and 83% specific in identifying DIPA diagnoses. Internal consistency of the ECSA was 0.91. Test-retest reliability at 10 days was excellent (Spearman's rho = 0.81, p ⩽ .01). The ECSA is an easy-to-use screening measure that demonstrates strong convergent validity, criterion validity, and test-retest reliability in the pediatric setting. It shows potential as a feasible and psychometrically strong tool for busy primary care providers to identify preschoolers who need further socioemotional assessment.