The use of a radiolucent template to improve bone age X-ray quality (BASIC study).

BACKGROUND: Left hand and wrist X-rays are conventionally used to assess skeletal maturity using methods such as Tanner-Whitehouse 3 (TW3). We noted a number were poor quality, caused by difficulty with hand placement. We introduced a simple radiolucent hand template to assist in hand positioning and assessed changes in X-ray quality and repeat X-ray rates. METHODS: The position of fingers, thumb and overall clarity of bone age X-rays were prospectively scored. In the absence of a validated tool to assess quality a 1-3 scale (poor, borderline, good) was devised. A radiolucent hand template was introduced for use in the intervention group. Need for repeat X-ray was determined by set criteria. RESULTS: The intervention improved scores. More patients scored 3 (good) for positioning of fingers (89.29% and 85.33%, p=0.38), thumb (98.21% and 89.96%, p=0.06) and overall clarity (76.79% and 70.27%, p=0.41) for the intervention (n=56) and control groups (n=259), respectively. No patient required repeat X-ray from the intervention group, compared with 28 in the control group (p=0.007). CONCLUSIONS: Achieving good quality bone age X-rays is more difficult than previously assumed. The use of a radiolucent hand template has been shown to improve hand position and significantly reduce the need for repeat X-ray.

Neurocognitive bases of emotion regulation development in adolescence.

Emotion regulation is the ability to recruit processes to influence emotion generation. In recent years there has been mounting interest in how emotions are regulated at behavioural and neural levels, as well as in the relevance of emotional dysregulation to psychopathology. During adolescence, brain regions involved in affect generation and regulation, including the limbic system and prefrontal cortex, undergo protracted structural and functional development. Adolescence is also a time of increasing vulnerability to internalising and externalising psychopathologies associated with poor emotion regulation, including depression, anxiety and antisocial behaviour. It is therefore of particular interest to understand how emotion regulation develops over this time, and how this relates to ongoing brain development. However, to date relatively little research has addressed these questions directly. This review will discuss existing research in these areas in both typical adolescence and in adolescent psychopathology, and will highlight opportunities for future research. In particular, it is important to consider the social context in which adolescent emotion regulation develops. It is possible that while adolescence may be a time of vulnerability to emotional dysregulation, scaffolding the development of emotion regulation during this time may be a fruitful preventative target for psychopathology.

Influence of water quality and associated contaminants on survival and growth of the endangered Cape Fear shiner (Notropis mekistocholas).

The Cape Fear shiner (Notropis mekistocholas) is a recently described cyprinid species endemic to the Cape Fear River Basin of North Carolina, USA. Only five populations of the fish remain; thus, it is listed as endangered by the U.S. Government. Determining habitat requirements of the Cape Fear shiner, including water quality and physical habitat, is critical to the survival and future restoration of the species. To assess water quality in the best remaining and in the historical habitats, we conducted a 28-d in situ bioassay with captively propagated Cape Fear shiners. Fish were deployed at 10 sites in three rivers, with three cages per site and 20 fish per cage. Water and sediment samples were collected and analyzed for selected metals and organic contaminants. Passive sampling devices also were deployed at each site and analyzed for organic contaminants at test termination. Fish survival, growth (as measured by an increase in total length), and contaminant accumulation were measured on completion of the bioassay. Survival of caged fish averaged 76% (range, 53-100%) and varied significantly among sites and rivers. Caged fish accumulated quantities of cadmium, mercury, polychlorinated biphenyls, and other persistent contaminants over the test duration and grew significantly at only four sites. No apparent relations were observed between exposure to or accumulation of a specific contaminant and reduced growth or survival of fish among all the sites. However, a generalized hazard assessment showed that certain sites exhibited trends in cumulative contaminant presence with reduced fish survival and growth, thereby enabling the identification of the existing riverine habitat most suitable for reintroduction or population augmentation of this endangered fish.