Capture of Group A Streptococcus by Open-Microfluidic CandyCollect Device in Pediatric Patients.

Importance: Obtaining high-quality samples to diagnose streptococcal pharyngitis in pediatric patients is challenging due to discomfort associated with traditional pharyngeal swabs. This may cause reluctance to go to the clinic, inaccurate diagnosis, or inappropriate treatment for children with sore throat. Objective: Determine the efficacy of using CandyCollect, a lollipop-inspired open-microfluidic pathogen collection device, to capture Group A Streptococcus (GAS) and compare user preference for CandyCollect, conventional pharyngeal swabs, or mouth swabs among children with pharyngitis and their caregivers. Design: Participants of this cohort study were recruited over a 7-month period in 2022 - 2023. Setting: This study was conducted at an ambulatory care clinic that serves pediatric patients in the Madison, Wisconsin, metropolitan area. Participants: Study participants were diagnosed with GAS pharyngitis using a traditional pharyngeal swab via rapid antigen detection test (RADT); those testing positive were approached or reached out to about participation in the study. A total of 74 caregiver/children dyads were contacted about the study: 23 declined to participate; 21 were not eligible; and 30 willing and eligible participants were admitted into the study. A caregiver provided verbal consent and parental permission, and all children provided verbal assent. Immediately after the standard of care visit in which the throat swab was obtained, a research nurse guided participants through collecting oral samples: CandyCollect device and mouth swab (ESwab TM ). CandyCollect and mouth swab samples were analyzed for GAS by quantitative polymerase chain reaction (qPCR) at the University of Washington. Exposure: Detection of salivary GAS using qPCR analysis of samples obtained from CandyCollect devices and mouth swabs. Main Outcomes and Measures: The proportion of pediatric patients with GAS pharyngitis, as determined by a positive pharyngeal swab tested via a RADT, who were also positive using a CandyCollect and mouth swab analyzed by qPCR. Results: All child participants (30/30) were positive for GAS by qPCR on both the mouth swab and CandyCollect. Caregivers ranked CandyCollect as a good sampling method overall (27/30), and all caregivers (30/30) would recommend the CandyCollect for children 5 years and older. Twenty-three of 30 children "really like" the taste and 24/30 would prefer to use the CandyCollect if a future test was needed. All caregivers (30/30) and most children (28/30) would be willing to use the CandyCollect device at home. Conclusion and relevance: All participants tested positive for GAS on all three collection methods (pharyngeal swab, mouth swab, and CandyCollect). While both caregivers and children like the CandyCollect device, some caregivers would prefer a shorter collection time. Future work includes additional studies with larger cohorts presenting with pharyngitis of unknown etiology and shortening collection time, while maintaining the attractive form of the device. Trial Registration: Registry name: ClinicalTrials.gov ClinicalTrials.gov Identifier: NCT05175196 Weblink: https://classic.clinicaltrials.gov/ct2/show/NCT05175196. Key Points: Question: In pediatric patients with Group A Streptococcus pharyngitis, how do test results and user experience compare across three sampling methods-CandyCollect devices, mouth swabs, and pharyngeal swabs?Findings: In this cohort study of 30 children, aged 5-14 years, saliva samples were collected with CandyCollect devices and mouth swabs and analyzed via qPCR. The results show CandyCollect, a pathogen collection tool preferred by children, had 100% concordance with the results from pharyngeal swabs positive with a rapid antigen detection test performed as part of their clinical care.Meaning: With further development and testing, the CandyCollect device may potentially become an alternative sampling tool for the diagnosis of streptococcal pharyngitis.

The promise of compassion-based therapy as a novel intervention for adolescent PTSD.

In this review, we summarize current evidence for compassion-based approaches for PTSD and the potential for their application to the adolescent PTSD population. Exposure to traumatic events is common in adolescence and PTSD remains a public health crisis. Accessibility, willingness, and engagement are significant barriers to established treatments for PTSD, with attrition rates as high as 50 %. Compassion-based therapies provide potential solutions to treatment obstacles by providing a non-threatening, transdiagnostic option unburdened by aspects of current trauma treatment which may be associated with treatment resistance (e.g., exposure, trauma narrative, induction of fear). Compassion-based approaches are intuitive for trauma treatment, as compassion activates the self-soothing system, thereby disarming the fear system and promoting affect regulation. Compassion-based treatments demonstrate reductions across a substantial range of PTSD symptoms in adults, however, in adolescents extant literature is sparse, with cross-sectional studies suggesting self-compassion is inversely associated with trauma-related psychopathology. Understanding the impact of compassion-based approaches on adolescent PTSD is warranted as the adolescent developmental period may be a particularly opportune time for this approach. Evaluation of the impact of compassion-based treatment on adolescent PTSD in clinical populations via randomized-controlled studies and comparison of its relative efficacy to current evidence-based practices is warranted.

Feasibility of social network analysis to study outcomes of children with medical complexity.

Since most care for children with medical complexity (CMC) is delivered daily in communities by multiple caregiving individuals, that is, caregiving networks, tools to assess and intervene across these networks are needed. This study evaluated the feasibility of applying social network analysis (SNA) to describe caregiving networks. Because hospitalization is among the most frequently used outcomes for CMC, exploratory correlations between network characteristics and CMC hospital use were evaluated. Within 3 weeks, the goal network enrollment was achieved, and all feasibility measures were favorable. Network characteristics correlated with hospital use, that is, smaller, denser networks, with more closed-loop communication correlated with fewer hospital days. Networks with more professional caregivers also correlated with fewer hospital days. SNA is a feasible tool to study CMC caregiving networks. Preliminary data support rigorous hypothesis testing using SNA methods. Network-based interventions to improve CMC health may be an important future direction.

Children and Adolescents with Depression: Perception of Family Caregivers / Crianças e Adolescentes com Depressão: Percepção de Familiares Cuidadores / Niños y Adolescentes con Depresión: Percepción de los Familiares Cuidadores

Abstract Depressive disorder affects people of all ages, including children and adolescents, compromising the family's quality of life. This study aimed to: (1) analyze the perception of family members about the experience of living with and caring for children and adolescents with depressive disorder; (2) identify the resources mobilized by families to respond to the demands of child and adolescent depression. Data, collected by interviews with 26 family members of children/adolescents linked to two Care Centers, were subjected to thematic analysis. The results showed the perception of family caregivers regarding the depressive disorder, to the child and to family life, and suggest religiosity and the nuclear and extended families as resources they use the most. Therefore, there is a need for professionals to expand assistance to all those who live with children/adolescents with depression, since this disorder impacts family life.

Resumo O transtorno depressivo atinge pessoas de todas as idades, incluindo crianças e adolescentes, comprometendo a qualidade de vida da família. Este estudo teve como objetivo: (1) analisar a percepção de familiares sobre a experiência de conviver e cuidar de crianças e adolescentes com transtorno depressivo; (2) identificar os recursos mobilizados pelas famílias para responder às demandas da depressão infantojuvenil. Os dados, coletados através de entrevistas realizadas com 26 familiares de crianças/adolescentes vinculados a dois Centros de Atenção, foram submetidos à análise temática. Os resultados expressam a percepção dos familiares cuidadores em relação ao transtorno depressivo, à criança e à própria vida familiar, e apontam a religiosidade e as famílias nuclear e extensa como os recursos que mais utilizam. Conclui-se pela necessidade de os profissionais ampliarem a assistência para todos que convivem com a depressão infantojuvenil, uma vez que este transtorno impacta na vida familiar como um todo.

Resumen El trastorno depresivo afecta a personas de todas las edades, incluidos niños y adolescentes, comprometiendo la calidad de vida familiar. El objetivo de este estudio fue: (1) analizar la percepción de los familiares sobre la experiencia de convivir y cuidar de niños y adolescentes con trastorno depresivo; (2) identificar los recursos movilizados por las familias para responder a las demandas de la depresión infantil y adolescente. Los datos, recolectados de entrevistas realizadas con 26 familiares de niños/adolescentes vinculados a dos Centros de Atención, se sometieron a análisis temático. Los resultados muestran la percepción de los cuidadores con relación al trastorno depresivo; al niño y a la vida familiar; y apuntan a la religiosidad y a las familias nucleares y extensas como los recursos que más utilizan. Se concluye con la necesidad de que los profesionales amplíen la asistencia a todos los que conviven con la depresión infantil, ya que este trastorno impacta la vida familiar como un todo.

The Internet-Based Conversational Engagement Clinical Trial (I-CONECT) in Socially Isolated Adults 75+ Years Old: Randomized Controlled Trial Protocol and COVID-19 Related Study Modifications.

Background: Increasing social interactions through communication technologies could offer a cost-effective prevention approach that slows cognitive decline and delays the onset of Alzheimer's disease. This paper describes the protocol of an active project named "Internet-based conversational engagement clinical trial (I-CONECT)" (ClinicalTrials.gov: NCT02871921). The COVID-19 pandemic related protocol modifications are also addressed in the current paper. Methods: I-CONECT is a multi-site, assessor-blind, randomized controlled behavioral intervention trial (RCT). We aim to randomize 320 socially isolated adults 75+ years old [160 Caucasian and 160 African American participants, 50:50 split between those with normal cognition and mild cognitive impairment (MCI)] recruited from the community to either the video chat intervention group or the control group (1:1 allocation). Those in the video chat group receive a computer and Internet service for the duration of the study, which they use to video chat with study staff for 30 min/day 4×/week for 6 months (high dose), and then 2×/week for an additional 6 months (maintenance dose). Both video chat and control groups have a brief (about 10 min) telephone check-in with study staff once per week. The primary outcome is the change in global cognitive function measured by Montreal Cognitive Assessment (MoCA) from baseline to 6 months. Secondary outcomes include changes in cognition in memory and executive function domains, emotional well-being measured by NIH Toolbox emotional battery, and daily functional abilities assessed with the Revised Observed Tasks of Daily Living (OTDL-R). Eligible participants have MRIs at baseline and 6 months. Participants contribute saliva for genetic testing (optional consent), and all video chats, weekly check-in calls and neuropsychological assessment sessions are recorded for speech and language analysis. The pandemic halted research activities and resulted in protocol modifications, including replacing in-person assessment with remote assessment, remote deployment of study equipment, and revised targeted sample size. Discussion: This trial provides user-friendly hardware for the conversational-based intervention that can be easily provided at participants' homes. The trial aspires to use age and culture-specific conversational materials and a related platform developed in this trial for enhancing cognitive reserve and improving cognitive function.

Actualización de la prueba general para la evaluación del desarrollo integral del niño entre los 0 meses y 6 años de edad (EDIN) / Update of the general test for evaluation of the integral development of the child between 0 months and 6 years of age (EDIN) / Atualização da prova geral para a avaliação do desenvolvimento integral de crianças entre 0 meses e 6 anos de idade (EDIN)

ResumenIntroducción: En este artículo se presentan los resultados obtenidos en la actualización de la prueba general para la evaluación del desarrollo integral del niño y la niña entre los 0 y 6 años de edad (EDIN).Metodología: la metodología fue de carácter cualitativo, transversal y descriptivo. Se contó con la participación de 14 expertos en el área del desarrollo humano. Los datos fueron recolectados mediante la técnica de juicio de expertos de tipo agregados individuales; la información obtenida fue triangulada con evidencia científica actualizada para determinar la permanencia de los ítems en la propuesta actualizada.Resultados: La prueba juicio de expertos permitió confirmar la inconsistencia de algunos ítems, por lo que fue necesario cambiar, eliminar y adecuar ítems del EDIN. Del total de 456 ítems de esta prueba, 72 (16%) del área de "hábitos", fueron excluidos, por no corresponder a un área del desarrollo, 127 (27.9%) fueron inconsistentes , 257 (56%) fueron consistentes y se crearon 15 nuevos ítems, lo cual da como resultado una prueba actualizada con 287 ítems, distribuidos en seis áreas del desarrollo y 19 grupos de edad, más una lista de cotejo compuesta por 112 recomendaciones sobre los patrones de alimentación, sueño y descanso, eliminación, higiene y vestido y seguridad.Conclusiones: La investigación aporta una prueba actualizada para la población infantil costarricense menor de seis años. El estudio de las pruebas de evaluación del desarrollo es necesario para la atención integral durante la infancia, por lo que es importante que el país cuente con instrumentos de evaluación del desarrollo propios y actualizados.

AbstractIntroduction: In this paper the results in updating the general test for evaluating the development of the child and the child between 0 and 6 years of age (EDIN) are presented.Methodology: The methodology was qualitative, transversal and descriptive. It was attended by 14 experts in the field of human development. Data were collected through technical expert judgment of individual aggregates type. The information obtained was triangulated with updated to determine the permanence of the items in the updated proposal scientific evidence.Results: expert opinion evidence confirmed the inconsistency of some items, so it was necessary to change, delete and adjust items in the EDIN. Of the total of 456 items of this test, 72 (16%) items in the area of "habits" were excluded, not correspond to an area of development, 127 (27.9%) were inconsistent, 257 (56%) were consistent and 15 new items were created, leaving an updated 287 tested, distributed in six areas of development and 19 age groups, plus a checklist consisting of 112 recommendations on eating patterns, sleep and rest, elimination, hygiene and clothing and security.Conclusions: The study provides an updated for minor child population six years Costa Rican test. The study of developmental assessment tests necessary for comprehensive care during childhood, so it is important that the country has own assessment tools development and updated.

ResumoIntrodução: Neste artigo se apresentam os resultados obtidos na atualização da prova geral para a avaliação do desenvolvimento integral de meninos e meninas entre 0 e 6 anos de idade (EDIN).Metodologia: a metodologia foi de tipo qualitativo, transversal e descritiva. Participaram 14 especialistas na área de desenvolvimento humano. ; Os dados foram recoletados mediante a técnica de julgamento de especialistas, de especialistas de tipo agregados individuais; a informação obtida foi triangulada com evidência científica atualizada para determinar a permanência dos ítens na proposta atualizada.Resultados: A prova de julgamento dos especialistas permitiu confirmar a inconsistência de alguns ítens, pelo que foi necessário mudar, eliminar e adequar ítens do EDIN. Do total de 456 ítens desta prova, 72 (16%) ítens da área de "hábitos", foram excluídos, por não corresponder a uma área do desenvolvimento, 127 (27.9%) ítens foram inconsistentes , 257 (56%) ítens foram consistentes e se criaram 15 novos ítens, o qual dá como resultado uma prova atualizada com 287 ítens, distribuídos em 6 seis áreas de desenvolvimento e 19 grupos de idade , mais uma lista de cotejo composta por 112 recomendações sobre os padrões de alimentação, sono e descanso, eliminação, higiene, vestuário e segurança.Conclusões: A pesquisa aporta uma prova atualizada para a população infantil costarriquense menor de 6 (seis) anos. O estudo das provas de avaliação de desenvolvimento é necessário para a atenção integral durante a infância, porque é importante que o país conte com instrumentos de avaliação de desenvolvimento próprios e atualizados.