A transdisciplinary team approach to scoping reviews: the case of pediatric polypharmacy.

BACKGROUND: Polypharmacy can be either beneficial or harmful to children. We conducted a scoping review to examine the concept of pediatric polypharmacy: its definition, prevalence, extent and gaps in research. In this manuscript, we report our transdisciplinary scoping review methodology. METHODS: After establishing a transdisciplinary team, we iteratively developed standard operating procedures for the study's search strategy, inclusion/exclusion criteria, screening, and data extraction. We searched eight bibliographic databases, screened abstracts and full text articles, and extracted data from included studies using standardized forms. We held regular team meetings and performed ongoing internal validity measurements to maintain consistent and quality outputs. RESULTS: With the aid of EPPI Reviewer collaborative software, our transdisciplinary team of nine members performed dual reviews of 363 included studies after dual screening of 4398 abstracts and 1082 full text articles. We achieved overall agreement of 85% and a kappa coefficient of 0.71 (95% CI 0.68-0.74) while screening full text articles. The screening and review processes required about seven hours per extracted study. The two pharmacists, an epidemiologist, a neurologist, and a librarian on the review team provided internal consultation in these key disciplines. A stakeholder group of 10 members with expertise in evidence synthesis, research implementation, pediatrics, mental health, epilepsy, pharmacoepidemiology, and pharmaceutical outcomes were periodically consulted to further characterize pediatric polypharmacy. CONCLUSIONS: A transdisciplinary approach to scoping reviews, including internal and external consultation, should be considered when addressing complex cross-disciplinary questions.

Queer Athlete, Non-Biological Mothers: Competing, Marginalized, Identities.

While athletes must be tough and dedicated to sport, many mothers feel pressured to commit to caregiving. A small but growing body of literature has examined how female athletes negotiate these seemingly conflicting roles of mother and athlete. However, the current literature has predominantly focused on heterosexual, cisgender, White women. In this paper, we examine the subject position of the queer athlete, non-biological mother by drawing on the literature on queer parenthood, motherhood in sport, and discourse analysis. Specifically, we use stories from mainstream media to understand ways that queer athlete, non-biological mothers simultaneously are re/produced within dominant discourses and expand our understanding of motherhood.

School Administrators' Experiences in a 6-Month Health and Wellness Community of Practice.

BACKGROUND: A statewide 6-month school administrator health and wellness program encouraged participants to use a fitness tracker to self-monitor their physical activity and sleep patterns. The purpose of this study was to examine participants' experience in a school administrator health and wellness program and their perceptions of the impact on health-related behaviors, including activity/movement, nutrition, and sleep. METHODS: Each of the 45 participants completed a semi-structured interview at three points in the program. Questions were designed to discern school administrators' perceptions of their ideal health and wellness balance at home and work. RESULTS: School administrators reported new insights into their own well-being, benefits of social supports in their personal wellness journey, an expanded understanding of their ideal health and wellness balance at home and work, and a stronger sense of serving as a role model who needs to take care of him/herself. CONCLUSIONS: Although the program was helpful in establishing an ideal health and wellness balance at home and work for some school administrators, future programs should better emphasize nutrition and scaffold opportunities to maintain new habits following program completion.

Generalized Periodic Discharges With and Without Triphasic Morphology.

PURPOSE: Generalized periodic discharges (GPDs) with a triphasic morphology have been associated with nonepileptic encephalopathies. We conducted the study to assess the reliability in which electroencephalographers can differentiate triphasic from nontriphasic periodic discharges and to evaluate for the presence of electroencephalogram and clinical characteristics that are associated with a higher risk of seizures. METHODS: We studied prospectively 92 patients between May 2016 and February 2017. Each pattern was analyzed by two readers, who were blinded to clinical data. RESULTS: The interrater agreement was "substantial" (Kappa 0.67). The following features significantly increased the risk of developing seizures: the absence of triphasic morphology, focality on electroencephalogram, interburst suppression, a history of epilepsy, and an abnormal scan. The "GPD score" includes a history of epilepsy, focality on electroencephalogram, and the absence of triphasic morphology. A GPD score of 0 has 13% risk of seizures, whereas a score of 5 to 6 has a 94% risk. CONCLUSIONS: Triphasic morphology GPDs confer less risk of seizures when compared with patients with GPDs without triphasic morphology. Features with a higher risk of seizures include focality on electroencephalogram, interburst suppression, a history of epilepsy, and an abnormal scan. The GPD score can be used to assess the risk of developing seizures in patients with GPDs.

Defining pediatric polypharmacy: A scoping review.

OBJECTIVES: Lack of consensus regarding the semantics and definitions of pediatric polypharmacy challenges researchers and clinicians alike. We conducted a scoping review to describe definitions and terminology of pediatric polypharmacy. METHODS: Medline, PubMed, EMBASE, CINAHL, PsycINFO, Cochrane CENTRAL, and the Web of Science Core Collection databases were searched for English language articles with the concepts of "polypharmacy" and "children". Data were extracted about study characteristics, polypharmacy terms and definitions from qualifying studies, and were synthesized by disease conditions. RESULTS: Out of 4,398 titles, we included 363 studies: 324 (89%) provided numeric definitions, 131 (36%) specified duration of polypharmacy, and 162 (45%) explicitly defined it. Over 81% (n = 295) of the studies defined polypharmacy as two or more medications or therapeutic classes. The most common comprehensive definitions of pediatric polypharmacy included: two or more concurrent medications for ≥1 day (n = 41), two or more concurrent medications for ≥31 days (n = 15), and two or more sequential medications over one year (n = 12). Commonly used terms included polypharmacy, polytherapy, combination pharmacotherapy, average number, and concomitant medications. The term polypharmacy was more common in psychiatry literature while epilepsy literature favored the term polytherapy. CONCLUSIONS: Two or more concurrent medications, without duration, for ≥1 day, ≥31 days, or sequentially for one year were the most common definitions of pediatric polypharmacy. We recommend that pediatric polypharmacy studies specify the number of medications or therapeutic classes, if they are concurrent or sequential, and the duration of medications. We propose defining pediatric polypharmacy as "the prescription or consumption of two or more distinct medications for at least one day". The term "polypharmacy" should be included among key words and definitions in manuscripts.

Relationship of personalized jerseys and aggression in women's ice hockey.

The present study examined the relationship between aggression and players' names on uniforms in collegiate women's ice hockey. Aggression was defined as mean penalty minutes per game. Information, i.e., win/loss record, penalties, and names on uniforms, about the 2002-2003 season women's ice hockey team was obtained via e-mail from 53 of 72 (74% return rate) sports information directors (Division I = 23, Division II = 2, Division III = 28). Analysis indicated that teams with personalized jerseys had significantly more penalty minutes per game than teams without personalized jerseys. However, as the majority of the teams with personalized jerseys were Division I teams and the majority of the teams without personalized jerseys were Division III teams, it is unclear whether results were due to personalized jersey or competition level of play.

Development and validation of the Brazilian Weight Teasing during Physical Activity Scale / Desenvolvimento e validação da Escala Brasileira de Provocações Referente ao Peso durante Atividade Física

Weight-related teasing is associated with loneliness, depression, eating disorders, and less physical activity. The purpose of the study was to develop the Brazilian Weight Teasing during Physical Activity scale (WTPAS-BR) and gather validity evidence to support its use in Brazilian adolescents. In phase 1, the prototype scale was adjusted. In phase 2, the prototype scale was cross-culturally adapted into the WTPAS-BR. In phase 3, the WTPAS-BR was psychometrically assessed. Adjustments to the prototype scale qualified items to measure weight-related teasing. A rigorous and systematic cross-cultural adaptation process translated, and assessed the content and adequacy of the WTPAS-BR among Brazilian adolescents. Based on the factorial assessment of WTPAS-BR, a one-factor model with four items was adopted. The WTPAS-BR showed adequate internal consistency, convergent validity, and test-retest reliability. Strong validity evidence supports the use of the WTPAS-BR to measure weight-related teasing occurring during physical activity in Brazilian adolescents...(AU)

A provocação relacionada ao peso corporal está associada com solidão, depressão, distúrbios alimentares e baixa atividade física. O objetivo deste estudo foi desenvolver a Escala Brasileira de Provocação relacionada ao Peso Corporal durante a Atividade Física (PPCAF-BR) e reunir evidências de validade para apoiar seu uso em adolescentes brasileiros. Na fase 1, ajustes foram feitos em uma escala protótipo. Na fase 2, esta escala foi adaptada culturalmente para a PPCAF-BR. Na fase 3, a PPCAF-BR foi avaliada psicometricamente. As adaptações realizadas na escala protótipo qualificaram os itens para a avaliação de provocações referentes ao peso corporal. A tradução e a adequação da PPCAF-BR em adolescentes brasileiros foi obtida através de uma rigorosa e sistemática adaptação transcultural. Baseado na análise fatorial, foi adotado um modelo de um fator com quatro itens. A PPCAF-BR apresentou consistência interna, validade convergente e reprodutibilidade teste-reteste adequadas. Fortes evidências de validade suportam a utilização da PPCAF-BR para medir a provocação relacionada ao peso corporal ocorrida durante a atividade física em adolescentes brasileiros...(AU)

Crossing the line: rites of passage, team aspects, and ambiguity of hazing.

Framed within the psychosocial context of the sport ethic and social-approval goal orientation, 10 female and 11 male current collegiate or former high school athletes participated in individual interviews about their hazing experiences. Data analysis resulted in seven lower order themes and two higher order themes. The higher order theme of the general aspects of hazing included types of factors influencing, reasons for and the effects of hazing. The higher order theme of hazing as deviant overconformity included rites of passage, hazing and the team, and the ambiguity of hazing. Results indicated that athletes reported engaging in risky, hazing behaviors and that both the values of sport as well as the desire to be accepted by teammates encouraged hazing.

Visual processing of social context during mental state perception in schizophrenia.

OBJECTIVE: To examine schizophrenia patients' visual attention to social contextual information during a novel mental state perception task. METHOD: Groups of healthy participants (n = 26) and schizophrenia patients (n = 24) viewed 7 image pairs depicting target characters presented context-free and context-embedded (i.e., within an emotion-congruent social context). Gaze position was recorded with the EyeLink I Gaze Tracker while participants performed a mental state inference task. Mean eye movement variables were calculated for each image series (context-embedded v. context-free) to examine group differences in social context processing. RESULTS: The schizophrenia patients demonstrated significantly fewer saccadic eye movements when viewing context-free images and significantly longer eye-fixation durations when viewing context-embedded images. Healthy individuals significantly shortened eye-fixation durations when viewing context-embedded images, compared with context-free images, to enable rapid scanning and uptake of social contextual information; however, this pattern of visual attention was not pronounced in schizophrenia patients. In association with limited scanning and reduced visual attention to contextual information, schizophrenia patients' assessment of the mental state of characters embedded in social contexts was less accurate. CONCLUSION: In people with schizophrenia, inefficient integration of social contextual information in real-world situations may negatively affect the ability to infer mental and emotional states from facial expressions.

Influence of involvement in the girls on track program on early adolescent girls' self-perceptions.

The Model of Competence Motivation (Harteg 1978) higlights how self-perceptions are influenced by individual and socialization fac tors. Using this model the present study investigated, quantitatively with a pretest and posttest design (N=34) and qualitatively via individual interviews (N=8), how involvement in the Girls on Track pogram (GOT) influenced the perceived competence and self-worth of sixth-grade girls. GOT is a program that uses training for a 5-km race as a means to teach life skills. The self-perceptions of the particapants showed increasing trends from pre- to posttest. Interviewed girls discussed their acquisition of interpersonal skills and ofpositive feelings about themselves. The discussion emphasizes how program involvement can influence the development of self-perceptions in early adolescent girls.

Emotional context processing is impaired in schizophrenia.

INTRODUCTION: Following considerable evidence for impaired context processing and facial emotion recognition in schizophrenia, this study examined the ability of schizophrenia patients to utilise contextual information when judging the meaning of facial expressions. METHODS: 22 healthy and 20 schizophrenia participants completed the "vignette-face" task (Carroll & Russell, 1996) in which target facial expressions are preceded by vignettes describing situational information that is discrepant in affective valence; judgements reflect either the dominance of the emotional context or the facial expression. Measures of basic facial emotion recognition and executive function were also obtained. RESULTS: On the vignette-face task, schizophrenia patients did not utilise contextual information for specific story-face pairs, whereas controls more commonly judged the emotion in line with contextual information. Most consistently, the responses of schizophrenia patients reflected neither situational nor facial cues when contextual cues suggested a complex mental state paired with a negative or threat-related expression (e.g., anger, fear, sadness). Facial affect processing ability was a significant predictor of the successful social context integration in the vignette-face task. CONCLUSION: The reduced influence of context upon threat-related expressions in schizophrenia may contribute to the misperception of threat in situations where contextual information should appease such an interpretation.