Distal biceps section and reinsertion for chronic distal biceps tendinopathy.

BACKGROUND: Surgical reinsertion of the distal biceps tendon for acute and chronic tears is a widely accepted procedure, but little is known about surgical treatment of distal biceps tendinopathy. METHODS: Twenty patients underwent a surgical procedure for distal biceps tendinopathy after failure of conservative treatment. The surgery was performed through a single incision. The biceps tendon was detached, debrided and reinserted using a ToggleLoc (Zimmer Biomet) device. Clinical and radiologic evaluation was performed after a minimum follow-up of 1 year. Quick-Dash score, Liverpool Elbow Score, Mayo Elbow Performance Index, Broberg and Morrey Score and Short HSS Scoring System were used, and isokinetic testing was performed. RESULTS: The outcome of these five clinical elbow scores showed no clinically relevant differences between the affected and non-affected side. Isokinetic testing of peak torque in flexion and supination showed equal strength between both sides. These results indicate good functional outcome and recovery of flexion and supination, compared to the non-operated side and the normal population. CONCLUSION: This study demonstrates that distal biceps tendon debridement and reinsertion is a safe and valid option for patients with distal biceps tendinopathy after failure of conservative treatment. LEVEL OF EVIDENCE: Level 3 retrospective cohort study.

Parental psychological control, adolescent self-criticism, and adolescent depressive symptoms: A latent change modeling approach in Belgian adolescents.

OBJECTIVE: At the level of both between-person differences and within-person changes across time, parental achievement-oriented psychological control may influence the development of adolescent self-criticism, which in turn may increase vulnerability for adolescent depression. METHOD: In a two-wave prospective study of 368 adolescents (age 13-17 years), Latent Change Modeling was used with Belgian adolescents' self-report measures. RESULTS: For mothers and fathers separately, adolescent self-criticism intervened in associations between achievement-oriented psychological control and adolescent depressive symptoms, at the level of both between-person differences and within-person changes. When investigating parents simultaneously, only maternal parenting was related directly and indirectly to adolescent depressive symptoms. CONCLUSIONS: Our results underscore the importance of personality-related vulnerability in associations between the parenting environment and symptoms of psychopathology during adolescent development.

Fear of Hypoglycemia, Parenting Stress, and Metabolic Control for Children with Type 1 Diabetes and Their Parents.

This study sets out to extend current knowledge of parenting stress and fear of hypoglycemia (FoH) in parents of children with type 1 diabetes mellitus (T1DM). We examined if the relationship between parental and children's FoH and metabolic control, as reflected by HbA1c, is mediated by parenting stress. A total of 63 parents and children with T1DM were recruited during their routine physician's appointment. Parents completed questionnaires on parenting stress and FoH. Children eight years and older also completed a questionnaire on FoH. HbA1c values were obtained from all children. Mediation analysis revealed an indirect association between parental FoH and HbA1c values through parenting stress (Sobel's z = 2.42, p = .02), but no indirect association between children's FoH and HbA1c. We concluded that parental FOH has an indirect association with the child's metabolic control that is mediated by parenting stress. More simply, fear of hypoglycemia predicts parent stress, which in turn, predicts metabolic control.

The role of intergenerational similarity and parenting in adolescent self-criticism: An actor-partner interdependence model.

Research investigating the development of adolescent self-criticism has typically focused on the role of either parental self-criticism or parenting. This study used an actor-partner interdependence model to examine an integrated theoretical model in which achievement-oriented psychological control has an intervening role in the relation between parental and adolescent self-criticism. Additionally, the relative contribution of both parents and the moderating role of adolescent gender were examined. Participants were 284 adolescents (M = 14 years, range = 12-16 years) and their parents (M = 46 years, range = 32-63 years). Results showed that only maternal self-criticism was directly related to adolescent self-criticism. However, both parents' achievement-oriented psychological control had an intervening role in the relation between parent and adolescent self-criticism in both boys and girls. Moreover, one parent's achievement-oriented psychological control was not predicted by the self-criticism of the other parent.

Making Sense of Adopted Children's Internal Reality Using Narrative Story Stem Techniques: A Mixed-Methods Synthesis.

Background: Extant research on adopted children has consistently shown that early adverse experiences confer vulnerability to myriad developmental problems, which may be mitigated by the "natural intervention" of adoption itself and/or by treatment efforts. Narrative Story Stems Techniques (NSSTs) have been used in research and clinical practice to assess adopted children's developmental profiles in middle childhood. However, no study to date has systematically reviewed this body of literature. Objectives: This paper presents a systematic review of research using NSSTs to make sense of adopted children's internal reality (i.e., perceptions, experiences, and representations), in terms of exploring theoretical perspectives as well as critically synthesizing findings and discussing implications. Methods: State-of-the-art PRISMA guidelines were followed throughout, resulting in the identification of 18 records, comprising six qualitative, 10 quantitative, and two mixed-methods primary papers, reporting on seven unique studies. All records were assessed with regard to methodological quality. Data were extracted and synthesized narratively using an integrated design for mixed-methods synthesis. Results: The findings suggest that, although NSST research with adopted children is still in its infancy, there is relatively robust evidence supporting the use of these techniques to assess and track developmental change in adopted children's attachment representations. In this regard, the non-verbal (aside from the verbal) approach to children's complex internal reality, as well as a more fine-grained (aside from a categorical or dimensional) perspective on children's NSST responses, are highlighted as particularly valuable in tailoring treatment to a particular child's needs and vulnerabilities. Moreover, several promising avenues for future research and clinical application of NSSTs, including the extension to affect-regulatory and mentalizing perspectives, may further our knowledge and understanding of, and thus treatment efforts toward, these often vulnerable children. However, these findings should be interpreted with caution, due to the limited number of studies characterized by considerable methodological heterogeneity. Conclusions: In light of the findings of the present review, we strongly advocate future studies using NSSTs in theoretically and empirically consistent ways, in order to gain a better understanding of adopted children's internal reality in terms of attachment representations, affect-regulatory strategies, and mentalizing processes, and to track changes therein.

Gene-environment interactions between stress and 5-HTTLPR in depression: A meta-analytic update.

BACKGROUND: Meta-analyses have yielded contradictory findings concerning the role of 5-HTTLPR in interaction with stress (GxE) in depression. The current meta-analysis investigates if these contradictory findings are a result of differences between studies in methodological approaches towards the assessment of stress and depression. METHODS: After performing a systematic database search (February to December 2016), first, a meta-analysis was used to investigate the total effect size and publication bias. Second, stratified meta-analyses were used to investigate the potential moderating influence of different methodological approaches on heterogeneity of study findings. Third, a meta-regression was used to investigate the combined influence of the methodological approaches on the overall effect size. RESULTS: Results showed a small but significant effect of 5-HTTLPR in interaction with stress in the prediction of depression (OR[95%CI] = 1.18[1.09; 1.28], n = 48 effect sizes from 51 studies, totaling 51,449 participants). There was no evidence of publication bias. Heterogeneity of effect sizes was a result of outliers and not due to different methodological approaches towards the assessment of stress and depression. Yet, there was some evidence that studies adopting a categorical and interview approach to the assessment of stress report higher GxE effects, but further replication of this finding is needed. LIMITATIONS: A large amount of heterogeneity (i.e., 46%) was not explained by the methodological factors included in the study and there was a low response rate of invited studies. CONCLUSIONS: The current meta-analysis provides new evidence for the robustness of the interaction between stress and 5-HTTLPR in depression.