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1.
J Int Neuropsychol Soc ; 30(1): 18-26, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37057871

RESUMEN

OBJECTIVES: The developmental absence (agenesis) of the corpus callosum (AgCC) is a congenital brain malformation associated with risk for a range of neuropsychological difficulties. Inhibitory control outcomes, including interference control and response inhibition, in children with AgCC are unclear. This study examined interference control and response inhibition: 1) in children with AgCC compared with typically developing (TD) children, 2) in children with different anatomical features of AgCC (complete vs. partial, isolated vs. complex), and 3) associations with white matter volume and microstructure of the anterior (AC) and posterior commissures (PC) and any remnant corpus callosum (CC). METHODS: Participants were 27 children with AgCC and 32 TD children 8-16 years who completed inhibitory control assessments and brain MRI to define AgCC anatomical features and measure white matter volume and microstructure. RESULTS: The AgCC cohort had poorer performance and higher rates of below average performance on inhibitory control measures than TD children. Children with complex AgCC had poorer response inhibition performance than children with isolated AgCC. While not statistically significant, there were select medium to large effect sizes for better inhibitory control associated with greater volume and microstructure of the AC and PC, and with reduced volume and microstructure of the remnant CC in partial AgCC. CONCLUSIONS: This study provides evidence of inhibitory control difficulties in children with AgCC. While the sample was small, the study found preliminary evidence that the AC (f2=.18) and PC (f2=.30) may play a compensatory role for inhibitory control outcomes in the absence of the CC.


Asunto(s)
Cuerpo Calloso , Sustancia Blanca , Niño , Humanos , Cuerpo Calloso/diagnóstico por imagen , Agenesia del Cuerpo Calloso/complicaciones , Agenesia del Cuerpo Calloso/diagnóstico por imagen , Imagen por Resonancia Magnética , Neuroimagen , Sustancia Blanca/diagnóstico por imagen
2.
Am J Perinatol ; 41(8): 969-974, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38290557

RESUMEN

OBJECTIVE: We aimed to evaluate uptake of the glucose tolerance test performed during delivery hospitalization as part of routine clinical care. STUDY DESIGN: This is a retrospective cohort study of people with GDM at a tertiary center. We collected 9 months of postimplementation data after the in-hospital ("early") glucose tolerance test was adopted as a routine screening option. Adherence was compared between those who elected early glucose tolerance testing versus those who deferred testing to the standard postpartum period. Bivariable statistics including demographics, care team, and postpartum testing/visit attendance were compared between those who received early testing and those who did not using chi-square, Fisher's exact, and t-tests. RESULTS: A total of 681 patients with GDM delivered during the study period. Of those who had an early glucose tolerance test ordered (n = 408), 340 (83.3%) completed the test. Among those who did not complete an early glucose tolerance test (ordered and not completed or never ordered), only 104/341 (30.5%) completed any postpartum glucose testing in the first 12 months of postpartum. There were significant differences in characteristics in terms of race/ethnicity, insurance, type of gestational diabetes (A1GDM vs. A2GDM), diabetes medications, obstetric care provider, and delivery mode. Among those who completed early testing, 43.7% of participants had impaired glucose metabolism and 6.5% had values concerning for overt diabetes mellitus. Among those who deferred testing to the standard 6- to 12-week period, 24.0% had impaired glucose metabolism and none had overt diabetes. Those who completed an early glucose tolerance test had a lower rate of postpartum visit attendance compared with those who deferred (75.6 vs. 91.5%, p < 0.01). CONCLUSION: In this cohort, when the early glucose tolerance test is offered in clinical practice, adherence rates are higher than when the test is deferred until the postpartum visit. KEY POINTS: · Adherence rates with the early glucose tolerance test (GTT) are higher than if the testing is deferred.. · Those who completed an early GTT had a lower rate of postpartum visit attendance compared with those who deferred.. · Offering an in-hospital postpartum GTT can help address low rates of glucose testing postpartum..


Asunto(s)
Diabetes Gestacional , Prueba de Tolerancia a la Glucosa , Periodo Posparto , Humanos , Femenino , Diabetes Gestacional/diagnóstico , Embarazo , Estudios Retrospectivos , Adulto , Hospitalización/estadística & datos numéricos , Tamizaje Masivo , Glucemia/análisis
3.
J Int Neuropsychol Soc ; 29(3): 257-265, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-35388789

RESUMEN

OBJECTIVES: Children born very preterm (VP) are susceptible to a range of cognitive impairments, yet the effects of VP birth on long-term, episodic, and prospective memory remains unclear. This study examined episodic and prospective memory functioning in children born VP compared with their term-born counterparts at 13 years. METHOD: VP (n = 81: born <30 weeks' gestation) and term (n = 26) groups were aged between 12 and 14 years. Children completed: (i) standardized verbal and visuospatial episodic memory tests; and (ii) an experimental time- and event-based prospective memory test that included short-term (within assessment session) and long-term (up to 1-week post-session) tasks. Parents completed a questionnaire assessing memory functions in everyday life. RESULTS: The VP group performed worse on all measures of verbal and visuospatial episodic memory than the term group. While there were no group differences in event-based or long-term prospective memory, the VP group performed worse on time-based and short-term prospective memory tasks than term-born counterparts. Parents of children born VP reported more everyday memory difficulties than parents of children born at term, with parent-ratings indicating significantly elevated rates of everyday memory challenges in children born VP. CONCLUSIONS: Children born VP warrant long-term surveillance, as challenges associated with VP birth include memory difficulties at 13 years. This study highlights the need for greater research and clinical attention into childhood functional memory outcomes.


Asunto(s)
Recien Nacido Extremadamente Prematuro , Memoria Episódica , Recién Nacido , Humanos , Niño , Adolescente , Memoria a Corto Plazo , Edad Gestacional , Atención
4.
J Pediatr Psychol ; 48(3): 293-304, 2023 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-36655518

RESUMEN

OBJECTIVES: To investigate the longitudinal associations between parental mental health symptoms within 4 weeks of birth, parenting behaviors at 1 year, and child general cognitive ability at 4.5-5 years in a sample of children born very preterm (VP). This study also examined whether these associations differed based on level of family social risk. METHODS: Participants were 143 children born <30 weeks' gestation and their parents. Within 4 weeks of birth, mothers' and fathers' depressive and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and Hospital Anxiety Depression Scale-Anxiety Subscale. Parents' sensitive and structuring parenting behaviors were assessed at 1 year using the Emotional Availability Scales. Child general cognitive ability was assessed at 4.5-5 years using the Wechsler Preschool & Primary Scale of Intelligence-Fourth Edition. RESULTS: Higher maternal depressive symptoms were associated with lower levels of sensitive and structuring parenting behavior, while higher maternal anxiety symptoms were associated with higher levels of structuring parenting behavior. There was weak evidence for positive associations between mothers' sensitive parenting behavior and fathers' structuring parenting behavior and child general cognitive ability. There was also weak evidence for stronger associations between mothers' mental health symptoms, parenting behaviors, and child general cognitive ability, in families of higher compared with lower social risk. CONCLUSIONS: Depressive and anxiety symptoms experienced by mothers in the initial weeks following VP birth can have long-term effects on their parenting behaviors. Enquiring about parents' mental health during their child's hospitalization in the neonatal intensive care unit is crucial.


Asunto(s)
Madres , Nacimiento Prematuro , Masculino , Femenino , Niño , Humanos , Recién Nacido , Preescolar , Madres/psicología , Responsabilidad Parental/psicología , Padre/psicología , Salud Mental , Padres/psicología , Cognición
5.
J Pediatr ; 241: 90-96.e2, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34699907

RESUMEN

OBJECTIVES: To compare the parenting environment and the relationships between parenting behaviors and concurrent child neurobehavioral outcomes at 2 years of corrected age between children born moderate-to-late preterm (MLP; 32-36 weeks of gestation) and at term (≥37 weeks of gestation). STUDY DESIGN: Participants were 129 children born MLP and 110 children born at term and their mothers. Mothers' parenting behaviors (sensitivity, structuring, nonintrusiveness, nonhostility) were assessed at 2 years of corrected age using the Emotional Availability Scales. Child cognitive and language development were assessed using the Bayley Scales of Infant and Toddler Development, and social-emotional competence using the Infant Toddler Social and Emotional Assessment. RESULTS: Mothers of children born MLP and at term displayed similar parenting behaviors overall, with slightly lower nonintrusiveness in mothers of children born MLP (adjusted mean difference -0.32 [-0.60, -0.04]; P = .03). In both groups of children, greater maternal sensitivity was associated with better cognitive development (P < .001 MLP; P = .02 term), increased maternal structuring was associated with better social-emotional competence (P = .02 MLP; P = .03 term), and higher maternal nonintrusiveness was associated with better cognitive, language, and social-emotional outcomes (all P < .04). Greater maternal sensitivity and structuring were associated with better language development in children born MLP but not in children born at term. CONCLUSIONS: Parenting behaviors are important for neurobehavioral outcomes in children born MLP and at term. Language development may be more strongly influenced by select parenting behaviors in children born MLP compared with children born at term.


Asunto(s)
Desarrollo Infantil , Madres , Responsabilidad Parental , Nacimiento Prematuro , Nacimiento a Término , Preescolar , Cognición , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Desarrollo del Lenguaje , Estudios Longitudinales , Masculino , Estudios Prospectivos
6.
J Pediatr ; 246: 80-88.e4, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35304169

RESUMEN

OBJECTIVE: To evaluate 13-year outcomes of a randomized controlled trial of preventive care (VIBeS Plus) for infants born very preterm and their parents and examine whether possible effects of intervention varied by family social risk. STUDY DESIGN: Families were randomized to an intervention arm (n = 61) or a standard care arm (n = 59). The intervention was delivered at home by psychologists and physiotherapists over the infants' first year, focusing on infant development and parental mental health. At 13 years corrected age, cognitive, motor, and behavioral outcomes, and parental mental health were assessed. Primary estimands were between-group mean differences, estimated using multiple imputed regression models. RESULTS: Follow-up included 81 surviving children (69%). There was little evidence of benefits of the intervention for IQ, attention, executive functioning, working memory, and academic skills regardless of level of social risk. Specifically, mean differences in adolescent cognitive outcomes ranged from -2.0 units (95% CI, -9.9 to 5.9) in favor of standard treatment to 5.1 units (95% CI, -2.3 to 12.5) favoring the intervention. A group-by-social risk interaction was observed only for adolescent motor outcomes, with mean differences favoring the intervention for those at higher social risk (balance, 4.9; 95% CI, 1.3-8.5; total motor, 3.2; 95% CI, 0.3-6.2), but not those at lower social risk (balance, -0.3; 95% CI, -2.4 to 1.9; total motor, 0.03; 95% CI, -1.9 to 2.0). Mean differences in adolescent behavior and parental mental health ranged from -6.6 (95% CI -13.8, 0.5) to -0.2 (95% CI, -1.9 to 1.4) and -1.8 (95% CI, -4.1 to 0.6) to -1.7 (95% CI, -4.3 to 1.0), respectively, indicating a pattern of fewer symptoms in the intervention group. CONCLUSIONS: Benefits of the intervention persisted for adolescent behavior, with better motor outcomes observed in those from socially disadvantaged families. Replication with larger samples, multiple informant reports, and assessment of quality of life-related outcomes is warranted. TRIAL REGISTRATION: http://www.anzctr.org.au/: ACTRN12605000492651.


Asunto(s)
Enfermedades del Prematuro , Recien Nacido Prematuro , Adolescente , Niño , Desarrollo Infantil , Femenino , Retardo del Crecimiento Fetal , Humanos , Lactante , Recién Nacido , Enfermedades del Prematuro/prevención & control , Padres/psicología , Calidad de Vida
7.
Cereb Cortex ; 31(2): 1227-1239, 2021 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-33108795

RESUMEN

The corpus callosum is the largest white matter pathway in the brain connecting the two hemispheres. In the context of developmental absence (agenesis) of the corpus callosum (AgCC), a proposed candidate for neuroplastic response is strengthening of intrahemispheric pathways. To test this hypothesis, we assessed structural and functional connectivity in a uniquely large cohort of children with AgCC (n = 20) compared with typically developing controls (TDC, n = 29), and then examined associations with neurobehavioral outcomes using a multivariate data-driven approach (partial least squares correlation, PLSC). For structural connectivity, children with AgCC showed a significant increase in intrahemispheric connectivity in addition to a significant decrease in interhemispheric connectivity compared with TDC, in line with the aforementioned hypothesis. In contrast, for functional connectivity, children with AgCC and TDC showed a similar pattern of intrahemispheric and interhemispheric connectivity. In conclusion, we observed structural strengthening of intrahemispheric pathways in children born without corpus callosum, which seems to allow for functional connectivity comparable to a typically developing brain, and were relevant to explain neurobehavioral outcomes in this population. This neuroplasticity might be relevant to other disorders of axonal guidance, and developmental disorders in which corpus callosum alteration is observed.


Asunto(s)
Agenesia del Cuerpo Calloso/fisiopatología , Conducta Infantil/fisiología , Cuerpo Calloso/fisiología , Red Nerviosa/fisiología , Plasticidad Neuronal/fisiología , Adolescente , Agenesia del Cuerpo Calloso/diagnóstico por imagen , Niño , Conducta Infantil/psicología , Estudios de Cohortes , Cuerpo Calloso/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Red Nerviosa/diagnóstico por imagen
8.
J Perinat Med ; 50(7): 970-976, 2022 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-36027908

RESUMEN

OBJECTIVES: The US preterm birth rate varies dramatically by race and ethnicity yet the racial and ethnic representation within studies evaluating 17-hydroxprogesterone caproate (17-P) for preterm birth prevention is unknown. The objectives of our study were to 1) examine the racial and ethnic representation of participants in 17-P preterm birth prevention studies, 2) evaluate adherence to the NIH race and ethnicity reporting guidelines and 3) compare racial and ethnic representation in research studies to national preterm birth incidence. METHODS: We systematically reviewed US studies published between January 2000 and December 2019. Study participant's race and ethnicity were reported using descriptive statistics then compared to US 2017//2018 preterm birth data using Pearson's chi-square. RESULTS: Eighteen studies met the inclusion criteria, 17 studies reported race, 11 studies reported ethnicity, and yet none of the studies followed the NIH criteria. Compared to 2017/2018 US preterm births, the proportion of black/African American study participants was significantly higher whereas the proportions of all other race categories were lower. CONCLUSIONS: More detailed reporting of race and ethnicity is needed in 17-P literature. Black women appear to be well represented while other racial and ethnic groups may be understudied.


Asunto(s)
Etnicidad , Nacimiento Prematuro , Caproato de 17 alfa-Hidroxiprogesterona , 17-alfa-Hidroxiprogesterona , Caproatos , Femenino , Humanos , Recién Nacido , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/etiología , Nacimiento Prematuro/prevención & control
9.
Neuroimage ; 243: 118471, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34455063

RESUMEN

In the human brain, the corpus callosum is the major white-matter commissural tract enabling the transmission of sensory-motor, and higher level cognitive information between homotopic regions of the two cerebral hemispheres. Despite developmental absence (i.e., agenesis) of the corpus callosum (AgCC), functional connectivity is preserved, including interhemispheric connectivity. Subcortical structures have been hypothesised to provide alternative pathways to enable this preservation. To test this hypothesis, we used functional Magnetic Resonance Imaging (fMRI) recordings in children with AgCC and typically developing children, and a time-resolved approach to retrieve temporal characteristics of whole-brain functional networks. We observed an increased engagement of the cerebellum and amygdala/hippocampus networks in children with AgCC compared to typically developing children. There was little evidence that laterality of activation networks was affected in AgCC. Our findings support the hypothesis that subcortical structures play an essential role in the functional reconfiguration of the brain in the absence of a corpus callosum.


Asunto(s)
Agenesia del Cuerpo Calloso/diagnóstico por imagen , Lateralidad Funcional/fisiología , Adolescente , Cerebelo/diagnóstico por imagen , Niño , Conectoma , Cuerpo Calloso/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Plasticidad Neuronal , Sustancia Blanca
10.
J Neurosci Res ; 99(10): 2340-2350, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33624327

RESUMEN

Children born extremely preterm (EP, <28 weeks' gestation) or extremely low birth weight (ELBW, <1,000 g) are a vulnerable population at high risk of working memory impairments. We aimed to examine changes in the brain structural connectivity networks thought to underlie working memory performance, after completion of a working memory training program (Cogmed) compared with a placebo program in EP/ELBW children. This was a double-blind, placebo-controlled randomized trial (the Improving Memory in a Preterm Randomised Intervention Trial). Children born EP/ELBW received either the Cogmed or placebo program at 7 years of age (n = 91). A subset of children had magnetic resonance imaging of the brain immediately pre- and 2 weeks post-training (Cogmed n = 28; placebo n = 27). T1 -weighted and diffusion-weighted images were used to perform graph theoretical analysis of structural connectivity networks. Changes from pre-training to post-training in structural connectivity metrics were generally similar between randomized groups. There was little evidence that changes in structural connectivity metrics were related to changes in working memory performance from pre- to post-training. Overall, our results provide little evidence that the Cogmed working memory training program has training-specific effects on structural connectivity networks in EP/ELBW children.


Asunto(s)
Encéfalo/crecimiento & desarrollo , Conectoma/tendencias , Recien Nacido con Peso al Nacer Extremadamente Bajo/crecimiento & desarrollo , Recien Nacido Extremadamente Prematuro/crecimiento & desarrollo , Aprendizaje/fisiología , Memoria a Corto Plazo/fisiología , Encéfalo/diagnóstico por imagen , Niño , Estudios de Cohortes , Método Doble Ciego , Femenino , Humanos , Recién Nacido , Imagen por Resonancia Magnética/tendencias , Masculino , Factores de Riesgo
11.
Dev Sci ; 24(6): e13126, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34060677

RESUMEN

The corpus callosum is the largest white matter pathway connecting homologous structures of the two cerebral hemispheres. Remarkably, children and adults with developmental absence of the corpus callosum (callosal dysgenesis, CD) show typical interhemispheric integration, which is classically impaired in adult split-brain patients, for whom the corpus callosum is surgically severed. Tovar-Moll and colleagues (2014) proposed alternative neural pathways involved in the preservation of interhemispheric transfer. In a sample of six adults with CD, they revealed two homotopic bundles crossing the midline via the anterior and posterior commissures and connecting parietal cortices, and the microstructural properties of these aberrant bundles were associated with functional connectivity of these regions. The aberrant bundles were specific to CD and not visualised in healthy brains. We extended this study in a developmental cohort of 20 children with CD and 29 typically developing controls (TDC). The two anomalous white-matter bundles were visualised using tractography. Associations between structural properties of these bundles and their regional functional connectivity were explored. The proposed atypical bundles were observed in 30% of our CD cohort crossing via the anterior commissure, and in 30% crossing via the posterior commissure (also observed in 6.9% of TDC). However, the structural property measures of these bundles were not associated with parietal functional connectivity, bringing into question their role and implication for interhemispheric functional connectivity in CD. It is possible that very early disruption of embryological callosal development enhances neuroplasticity and facilitates the formation of these proposed alternative neural pathways, but further evidence is needed.


Asunto(s)
Cuerpo Calloso , Sustancia Blanca , Adulto , Agenesia del Cuerpo Calloso , Encéfalo , Niño , Humanos , Vías Nerviosas
12.
Hum Brain Mapp ; 41(3): 684-696, 2020 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-31713952

RESUMEN

This study in children born extremely preterm (EP; <28 weeks' gestational age) or extremely low birth weight (ELBW; <1,000 g) investigated whether adaptive working memory training using Cogmed® is associated with structural and/or functional brain changes compared with a placebo program. Ninety-one EP/ELBW children were recruited at a mean (standard deviation) age of 7.8 (0.4) years. Children were randomly allocated to Cogmed or placebo (45-min sessions, 5 days a week over 5-7 weeks). A subset had usable magnetic resonance imaging (MRI) data pretraining and 2 weeks posttraining (structural, n = 48; diffusion, n = 43; task-based functional, n = 18). Statistical analyses examined whether cortical morphometry, white matter microstructure and blood oxygenation level-dependent (BOLD) signal during an n-back working memory task changed from pretraining to posttraining in the Cogmed and placebo groups separately. Interaction analyses between time point and group were then performed. There was a significant increase in neurite density in several white matter regions from pretraining to posttraining in both the Cogmed and placebo groups. BOLD signal in the posterior cingulate and precuneus cortices during the n-back task increased from pretraining to posttraining in the Cogmed but not placebo group. Evidence for group-by-time interactions for the MRI measures was weak, suggesting that brain changes generally did not differ between Cogmed and placebo groups. Overall, while some structural and functional MRI changes between the pretraining and posttraining period in EP/ELBW children were observed, there was little evidence of training-induced neuroplasticity, with changes generally identified in both groups. Trial registration Australian New Zealand Clinical Trials Registry, anzctr.org.au; ACTRN12612000124831.


Asunto(s)
Remediación Cognitiva , Giro del Cíngulo/fisiología , Recien Nacido con Peso al Nacer Extremadamente Bajo/fisiología , Recien Nacido Extremadamente Prematuro/fisiología , Memoria a Corto Plazo/fisiología , Lóbulo Parietal/fisiología , Práctica Psicológica , Sustancia Blanca/anatomía & histología , Mapeo Encefálico , Niño , Femenino , Giro del Cíngulo/diagnóstico por imagen , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Plasticidad Neuronal/fisiología , Evaluación de Resultado en la Atención de Salud , Lóbulo Parietal/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagen
13.
Environ Sci Technol ; 54(11): 6900-6907, 2020 06 02.
Artículo en Inglés | MEDLINE | ID: mdl-32374592

RESUMEN

We have developed a new class of sodium carbonate/silicone composite sorbents that selectively capture carbon dioxide (CO2) and can purify biogas to natural gas pipeline-quality biomethane. These nontoxic composites can be three-dimensionally printed or extruded at low costs, can have high specific CO2 sorption rates (in excess of 5 µmol s-1 g-1 bar-1) and high selectivity due to their chemical mechanism, and can be regenerated with low-energy air stripping. Therefore, these composite sorbents combine the high selectivity of liquid sorbents with the high specific sorption rates and low regeneration energies found in many solid sorbents. We characterized these composite sorbents with X-ray computed tomography, scanning electron microscopy (SEM), and X-ray diffraction (XRD). Furthermore, we measured composite sorption capacities of up to 0.62 mol CO2 kg-1 and recorded breakthrough curves in a flow-through, fixed-bed reactor using both simulated biogas and locally sourced industrial biogas. Additional tests of the composite sorbent were carried out with pure CO2 in a sealed pressure drop apparatus. This experimental data was used to validate a numerical model of the setup and to simulate an industrial-scale biogas upgrading process. Finally, we performed a preliminary technoeconomic analysis for this upgrading process and found that this composite sorbent can upgrade biogas at a lower cost (∼$0.97 per GJ) than other currently implemented techniques.


Asunto(s)
Biocombustibles , Carbonatos , Dióxido de Carbono , Gas Natural
14.
J Pediatr Psychol ; 45(7): 725-735, 2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-32514578

RESUMEN

OBJECTIVE: Mothers of infants born very preterm (VPT) are at high risk of mental health difficulties. However, less is known about the course of fathers' depressive and anxiety symptoms over time, and the implications this may have for early parenting behaviors. METHODS: In total, 100 fathers of 125 infants born VPT (<30 weeks' gestation) completed questionnaires assessing depressive and anxiety symptoms shortly after their infant's birth, and when their infant reached term-equivalent age, 3 months, 6 months, and 12 months' corrected age. At 12 months' corrected age, fathers' parenting behaviors were assessed using the Emotional Availability Scales. Longitudinal latent class analysis was used to identify trajectories of fathers' depressive and anxiety symptoms, and linear regression equations examined relationships between these trajectories and fathers' parenting behaviors. RESULTS: For both depressive and anxiety symptoms, two distinct trajectories were identified. For depression, most fathers were assigned to the persistently low symptom trajectory (82%), while the remainder were assigned to the persistently high symptom trajectory (18%). For anxiety, 49% of fathers were assigned to the persistently low symptom trajectory, while 51% were assigned to the trajectory characterized by moderate symptoms over the first postnatal year. There were no significant differences in parenting behaviors between fathers assigned to the different depressive and anxiety symptom trajectories. CONCLUSIONS: Fathers of infants born VPT are at risk of chronic depressive and anxiety symptoms over the first postnatal year, highlighting the need for screening and ongoing support.


Asunto(s)
Ansiedad/psicología , Depresión/psicología , Padre/psicología , Recién Nacido de muy Bajo Peso , Salud Mental/estadística & datos numéricos , Responsabilidad Parental/psicología , Conducta Paterna , Nacimiento Prematuro , Ansiedad/diagnóstico , Ansiedad/etiología , Depresión/diagnóstico , Depresión/etiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Madres , Relaciones Padres-Hijo , Embarazo
15.
J Pediatr ; 205: 195-201, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30448013

RESUMEN

OBJECTIVES: To examine factors associated with fathers' early parenting behaviors (including very preterm [VPT] birth, familial social risk, child sex, and child medical risk), and the relationship between fathers' early parenting behaviors and later child development. STUDY DESIGN: Participants were 81 VPT (born <30 weeks of gestation) and 39 full-term father-child dyads. Parenting behaviors (sensitivity, structuring, nonintrusiveness, nonhostility) were assessed at 12 months of corrected age using the Emotional Availability Scales, with scores ranging from 1 (low) to 7 (high). At 24 months of corrected age, child cognitive, language, motor, and social-emotional development were assessed. Results are presented as (regression coefficients; 95% CIs). RESULTS: There was little evidence that VPT birth, familial social risk, or child medical risk were associated with fathers' parenting behaviors. Fathers of girls tended to be more sensitive (0.42; 0.18, 0.65), less intrusive (0.36; 0.04, 0.70), and less hostile (0.26; 0.01, 0.50) compared with fathers of boys. Higher structuring was associated with more optimal cognitive (3.29; 1.25, 5.34), and language development (4.69; 2.26, 7.14). Higher sensitivity was associated with more optimal language development 3.35 (0.95, 5.75), and more intrusive behavior was associated with more externalizing symptoms (-1.68; -3.06, -0.31). CONCLUSIONS: Early parenting did not differ between fathers with VPT and full-term children, but fathers' parenting did vary according to child sex. Fathers' early parenting was associated with future neurodevelopment, reinforcing the need to support fathers' parenting, and include fathers in early intervention programs.


Asunto(s)
Conducta Infantil/psicología , Emociones/fisiología , Relaciones Padre-Hijo , Padre/psicología , Recien Nacido Extremadamente Prematuro/psicología , Responsabilidad Parental/psicología , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Estudios Prospectivos
17.
J Pediatr ; 202: 92-97.e4, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30177350

RESUMEN

OBJECTIVE: To assess the effectiveness of Cogmed Working Memory Training compared with a placebo program in improving academic functioning 24 months post-training in extremely preterm/extremely low birth weight 7-year-olds. STUDY DESIGN: A multicenter double-blind, placebo-controlled randomized controlled trial was conducted across all tertiary neonatal hospitals in the state of Victoria, Australia. Participants were 91 extremely preterm/extremely low birth weight 7-year-old children born in Victoria in 2005. Children were randomly assigned to either the Cogmed or placebo arm and completed the Cogmed or placebo program (20-25 sessions of 35-40 minutes duration) at home over 5-7 weeks. Academic achievement (word reading, spelling, sentence comprehension, and mathematics) was assessed 24 months post-training, as well as at 2 weeks and 12 months post-training, via standardized testing inclusive of working memory, attention, and executive behavior assessments. Data were analyzed using an intention-to-treat approach with mixed-effects modeling. RESULTS: There was little evidence of any benefits of Cogmed on academic functioning 24 months post-training, as well as on working memory, attention, or executive behavior at any age up to 24 months post-training compared with the placebo program. CONCLUSIONS: We currently do not recommend administration of Cogmed for early school-aged children born extremely preterm/extremely low birth weight to improve academic functioning. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12612000124831.


Asunto(s)
Éxito Académico , Instrucción por Computador , Recien Nacido Extremadamente Prematuro , Memoria a Corto Plazo , Atención , Niño , Método Doble Ciego , Evaluación Educacional , Función Ejecutiva , Femenino , Humanos , Recién Nacido , Masculino
18.
J Int Neuropsychol Soc ; 24(5): 445-455, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29510770

RESUMEN

OBJECTIVES: Agenesis of the corpus callosum (AgCC), characterized by developmental absence of the corpus callosum, is one of the most common congenital brain malformations. To date, there are limited data on the neuropsychological consequences of AgCC and factors that modulate different outcomes, especially in children. This study aimed to describe general intellectual, academic, executive, social and behavioral functioning in a cohort of school-aged children presenting for clinical services to a hospital and diagnosed with AgCC. The influences of age, social risk and neurological factors were examined. METHODS: Twenty-eight school-aged children (8 to 17 years) diagnosed with AgCC completed tests of general intelligence (IQ) and academic functioning. Executive, social and behavioral functioning in daily life, and social risk, were estimated from parent and teacher rated questionnaires. MRI findings reviewed by a pediatric neurologist confirmed diagnosis and identified brain characteristics. Clinical details including the presence of epilepsy and diagnosed genetic condition were obtained from medical records. RESULTS: In our cohort, ~50% of children experienced general intellectual, academic, executive, social and/or behavioral difficulties and ~20% were functioning at a level comparable to typically developing children. Social risk was important for understanding variability in neuropsychological outcomes. Brain anomalies and complete AgCC were associated with lower mathematics performance and poorer executive functioning. CONCLUSIONS: This is the first comprehensive report of general intellectual, academic, executive social and behavioral consequences of AgCC in school-aged children. The findings have important clinical implications, suggesting that support to families and targeted intervention could promote positive neuropsychological functioning in children with AgCC who come to clinical attention. (JINS, 2018, 24, 445-455).


Asunto(s)
Agenesia del Cuerpo Calloso/diagnóstico , Conducta Infantil , Escolaridad , Función Ejecutiva , Adolescente , Factores de Edad , Agenesia del Cuerpo Calloso/fisiopatología , Agenesia del Cuerpo Calloso/psicología , Niño , Conducta Infantil/fisiología , Conducta Infantil/psicología , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas
19.
J Int Neuropsychol Soc ; 24(4): 372-381, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29145913

RESUMEN

OBJECTIVES: Preterm children demonstrate deficits in executive functions including inhibition, working memory, and cognitive flexibility; however, their goal setting abilities (planning, organization, strategic reasoning) remain unclear. This study compared goal setting abilities between very preterm (VP: <30 weeks/<1250 grams) and term born controls during late childhood. Additionally, early risk factors (neonatal brain abnormalities, medical complications, and sex) were examined in relationship to goal setting outcomes within the VP group. METHODS: Participants included 177 VP and 61 full-term born control children aged 13 years. Goal setting was assessed using several measures of planning, organization, and strategic reasoning. Parents also completed the Behavior Rating Inventory of Executive Function. Regression models were performed to compare groups, with secondary analyses adjusting for potential confounders (sex and social risk), and excluding children with major neurosensory impairment and/or IQ<70. Within the VP group, regression models were performed to examine the relationship between brain abnormalities, medical complications, and sex, on goal setting scores. RESULTS: The VP group demonstrated a clear pattern of impairment and inefficiency across goal setting measures, consistent with parental report, compared with their full-term born peers. Within the VP group, moderate/severe brain abnormalities on neonatal MRI predicted adverse goal setting outcomes at 13. CONCLUSIONS: Goal setting difficulties are a significant area of concern in VP children during late childhood. These difficulties are associated with neonatal brain abnormalities, and are likely to have functional consequences academically, socially and vocationally. (JINS, 2018, 24, 372-381).


Asunto(s)
Encéfalo/anomalías , Disfunción Cognitiva/patología , Disfunción Cognitiva/fisiopatología , Función Ejecutiva/fisiología , Objetivos , Recien Nacido Extremadamente Prematuro/fisiología , Adolescente , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Masculino
20.
Proc Natl Acad Sci U S A ; 110(25): 10095-100, 2013 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-23729814

RESUMEN

We experimentally demonstrate the direct coupling of silicate mineral dissolution with saline water electrolysis and H2 production to effect significant air CO2 absorption, chemical conversion, and storage in solution. In particular, we observed as much as a 10(5)-fold increase in OH(-) concentration (pH increase of up to 5.3 units) relative to experimental controls following the electrolysis of 0.25 M Na2SO4 solutions when the anode was encased in powdered silicate mineral, either wollastonite or an ultramafic mineral. After electrolysis, full equilibration of the alkalized solution with air led to a significant pH reduction and as much as a 45-fold increase in dissolved inorganic carbon concentration. This demonstrated significant spontaneous air CO2 capture, chemical conversion, and storage as a bicarbonate, predominantly as NaHCO3. The excess OH(-) initially formed in these experiments apparently resulted via neutralization of the anolyte acid, H2SO4, by reaction with the base mineral silicate at the anode, producing mineral sulfate and silica. This allowed the NaOH, normally generated at the cathode, to go unneutralized and to accumulate in the bulk electrolyte, ultimately reacting with atmospheric CO2 to form dissolved bicarbonate. Using nongrid or nonpeak renewable electricity, optimized systems at large scale might allow relatively high-capacity, energy-efficient (<300 kJ/mol of CO2 captured), and inexpensive (<$100 per tonne of CO2 mitigated) removal of excess air CO2 with production of carbon-negative H2. Furthermore, when added to the ocean, the produced hydroxide and/or (bi)carbonate could be useful in reducing sea-to-air CO2 emissions and in neutralizing or offsetting the effects of ongoing ocean acidification.


Asunto(s)
Dióxido de Carbono/química , Secuestro de Carbono , Electrólisis/métodos , Hidrógeno/química , Silicatos/química , Cloruro de Sodio/química , Ácidos/química , Bicarbonatos/química , Compuestos de Calcio/química , Cloro/química , Electrólitos/química , Calentamiento Global , Minerales/química , Océanos y Mares , Agua de Mar/química , Termodinámica
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