Association of apolipoprotein E4 to the number of cerebral microbleeds in patients recovered from COVID-19

Background: COVID-19 has been associated with cerebral microbleeds (CMB). Previously, an association of ApoE4 with COVID-19 severity and CMBs in autopsy was found. In this study, we investigated if carrying the Apoe4 allele relates to the number of CMBs in magnetic resonance imaging (MRI) in patients recovered from COVID-19. Material(s) and Method(s): Adult patients recovered from COVID-19 and a control group without a history of COVID-19 was recruited. Exclusion criteria were major neurologic disease, developmental disability or pregnancy. The participants underwent brain MRI 6 months after infection, and a blinded neuroradiologist analyzed the findings. ApoE was genotyped using a microarray. Statistical analysis was performed using the statistical software R. A negative binomial model was chosen based on the distribution of CMBs. Result(s): Of the 216 subjects that underwent MRI, 168 consented to genetic testing, additionally 2 patients were excluded due to extensive CMBs and 1 due to diffuse axonal injury. We included 113 COVID-19 patients (49 ICU-treated, 29 ward-treated and 35 home-isolated) and 52 controls. The most prevalent comorbidities were hypertension, asthma and diabetes. CMBs was found in 47 subjects, with the number of CMBs ranging from 0 to 26. The ApoeE4 allele was carried by 37%, equally distributed among the groups. After adjustment, age (aRR = 1.06, p = 0.007) and COVID-19 (aRR = 2.59, p = 0.038) were independently associated with CMBs. The ApoE4 allele (aRR = 2.16, p = 0.07, CI = 0.94-5.10) was not significant. Conclusion(s): Age and previous COVID-19, but not possession of the ApoeE4 allele, were independently associated with the number of CMBs.

Impact of Modality on Workload among Engineering Undergraduates during the COVID-19 Pandemic

The COVID-19 pandemic created unprecedented disruptions in models for engineering student training. At The Citadel, an undergraduate-focused college in the Southeastern United States, a variety of modalities were implemented following the onset of the pandemic, including emergency online and Hyflex learning. We conducted a longitudinal study to analyze the cognitive load among our undergraduate engineering students throughout changing modalities. Using data from the NASA Task Load Index (TLX) and open-ended reflections on student challenges, we found that total workload (a surrogate for cognitive load) was generally highest during emergency online learning in the second half of Spring 2020 semester, with experiences possibly varying across different demographic and academic groups. Emergency online challenges were often related to time management, personal organization, and responsibility for learning. In contrast, HyFlex challenges were often related to technology and communication challenges. While emergency online learning was a cognitive load disruption, that disruption was often associated with personal and/or academic development. HyFlex learning mediated cognitive load disruption;although, student challenges may have been simple nuisances rather than mediators of developmental change. © 2023 American Society of Civil Engineers.

Engagement during post-acute care transition: Perceptions and experiences of family caregivers of older adults with dementia

Older adults with dementia experience hospitalizations and post-acute care transitions more than people without dementia and rely on family caregivers for support. Family caregivers of older adults with dementia, therefore, play a crucial role during care transitions, and caregiver engagement is acknowledged as a critical factor in promoting quality of care. Despite this, "engagement" has been exclusively defined from the perspective of clinical care providers in other settings, and little is known about the post-acute care experiences and perceptions of family caregivers. The purpose of this dissertation was to describe the meaning of engagement to family caregivers navigating post-acute care transition, to elucidate their perspectives on barriers and facilitators of engagement, and to explore their support needs.Following an interpretive descriptive approach and guided by Meleis's Middle Range transition theory, semi-structured interviews were conducted with a purposive sample of 15 family caregivers of older adults with dementia. Using an inductive coding process, similar codes were categorized by grouping codes that describe similar concepts related to the caregiver experiences and perceptions. The process helped to develop themes from the categories and a conceptual framework that described the meaning of engagement.Thematic findings revealed family caregivers' descriptions of the meaning of engagement during post-acute care transitions is linked to being there, having meaningful connection with professional care providers, and having communication with the person with dementia. Limited communication and not being able to be there were seen as barriers to engagement. Nine family caregivers' level of engagement was impacted by the COVID-19 pandemic new visitation policies. Facilitator to engagement were linked to having good communication with professional care providers and having past post-acute care transition experience. The support needs of family caregivers were also related to their relationship with healthcare providers and receiving support from family and friends. The study supports highlighting communication as an integral part of transition and makes an argument to expanding the Meleis's Middle Range transition theory. Findings of the study contribute to the dementia caregiving literature and make an appeal to healthcare providers and policymakers to include family caregivers as part of the care team. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Sleep across childhood during the COVID-19 pandemic: A narrative review of the literature and clinical case examples

Without the structure and schedule of traditional activities such as in-person school and socialization, evidence is emerging of pediatric sleep changes during the COVID-19 pandemic. A narrative review was conducted of the sleep literature during the pandemic for preschoolers, school-aged children, and adolescents. Changes in sleep and risk and protective factors for sleep heath during the COVID-19 pandemic are reviewed along with real-life clinical case examples for each developmental period. Given the high rates of pediatric sleep disturbance, clinicians, researchers, and policymakers should refine screening strategies and facilitate referrals for behavioral interventions to support sleep health during pandemics and other natural disasters. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Learning to combat social isolation in senior living communities during COVID-19 and beyond

Social isolation has been a growing concern since the onset of the COVID-19 pandemic, disproportionately impacting older adults. Social isolation can impact the physical, mental, and emotional health of older adults. The purpose of this study was to examine coping strategies of older adults living in senior living communities, as well as the supportive efforts of the team members working in such communities, to determine best practices for combating social isolation for older adults. This qualitative study was guided by the research question: How do older adults perceive loneliness, social isolation, and social connectedness living in senior living communities? Guided by the theoretical frameworks of socioemotional selectivity theory (SST) and strength and vulnerability integration model (SAVI), this study explored how diminished time horizons impact the prioritization of social connections. This qualitative study collected data through semi-structured interviews from older adults living in senior living communities in the United States. Several themes emerged from the data including Parameters of Social Connection, Dining Room as a Hub of Socialization, Time Horizon Awareness and Compensation, Strategies of Connection, and Loss of Spouse. Several implications for best practices are also discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Experiences of accumulated stress among aging parent caregivers of adults with autism spectrum disorder

With the continuing increased incidence rate of autism spectrum disorder over the decades, there are increasing numbers of adults with autism who require varying levels of lifelong care, typically from parents. It is necessary to understand parents' lived experience of lifelong caregiving, and how their own aging process further impacts life quality. Furthermore, greater understanding of stressors, resources, appraisals, and coping among parent caregivers of children with "high functioning autism" who are transitioning into young adulthood is particularly necessary as services, needs, and experiences for both are nuanced due to functional status, deficits in the service system, and demographic disparities. Given lifespan aspects past research has not addressed, the study focused on development of a measure of parent accumulated stressors, and on interrelations of stressors, perceived social support, future time perspective, burden, satisfaction, and coping on health-related quality of life and meaning in life among 28 parents of young adults with autism. Although proposed quantitative analyses were not completed due to sample size, qualitative analyses on parent experiences and stressors revealed common themes of concern for child's future quality of life, complicated dynamics of providing help to their child overtime, and increased stress related to others' lack of understanding of their child. In total, 10 themes and multiple subthemes were identified in relation to aspects of accumulated stressors. Findings suggest parent stress with this specific population is complex, manifesting in nuanced ways at different life stages. Impacts of the COVID-19 pandemic are also explored, and implications for scientific advancement and clinical services are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Adult learners with learning disabilities' motivation to succeed in higher education online learning during Covid-19

Many students had to transition to online learning due to the COVID-19 pandemic while other students were already enrolled in online education. Online study may hold additional struggles for students with learning disabilities. The problem addressed in this qualitative, phenomenological study was the motivating factors of online higher education students who have a learning disability during the COVID-19 pandemic. The theoretical foundation was Maslow's hierarchy of needs. Data were gathered through 10 semistructured interviews and then analyzed through the thematic analysis yielding five themes: (a) lack of professional support, (b) resources, (c) support system, (d) consistent motivation, and (e) low motivation. These findings showed that students needed support within families and educational institutions to continue to be successful in their schooling and motivated. Additionally, it showed that students needed resources to better help them succeed in their assignments. Implications for positive social change include better understanding of how students are motivated when doing online school despite the different challenges they may be experiencing. Additionally, this study may also contribute to social change by informing other students that they are not alone during the process of their education and that there are ways to continue to be motivated. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

What about the baby? Infancy and parenting in the COVID-19 pandemic

This article reviews the evolution of a newborn through the first year of life and the potential impacts of COVID-19 on the infant, parent, and the parent-infant relationship. Babies grow in the context of relationships, and the quality of those relationships affects the physiological and psychological organization of the baby. Precisely because each baby is a being with unique biology, temperament, and ways of experiencing, feeling, and learning, much is to be discovered and understood about them. The baby's wordless communications require their parents to intuit, infer, hypothesize, and experiment as parents come to know the needs of their baby. As we walk alongside parents who struggle to come to know their infant-even as the infant is coming to know them-we are required to have conceptual knowledge of how a newborn becomes a fully awakened infant. Under typical conditions, the birth of a firstborn baby presents a caregiving challenge and developmental opportunity for the emerging parent. Environmental context can serve to support or interfere in the success of the adjustment. This paper will explore some theoretical underpinnings that contribute to infant and parent well-being and the possible impact of being born during the COVID-19 pandemic. Also considered will be the undue burden of families bearing the weight of economic inequities, oppression, and structurally supported racism. This article will explore the influence of parental perception, the development of attachment relationships, and how that is influenced by and influences infant communication. Finally, it will suggest ways that psychotherapists seeing individuals who are parents can hold the infant in mind as they work to understand and respond to their adult clients navigating the impacts of this pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Primary immunodeficiency associated with a SAMD9L mutation

Background: SAMD9L is a tumor suppressor involved in regulating the proliferation and maturation of cells, particularly those derived from the bone marrow, and appears to play an important role in cerebellar function. It can be activated in hematopoietic stem cells by type I and type II interferons. It has been hypothesized to act as a critical antiviral gatekeeper regulating interferon dependent demand driven hematopoiesis. Gain of function mutations can present with an immunodeficiency due to transient severe cytopenias during viral infection. Case presentation: We report a 3-year-old boy born full term with a history of severe thrombocytopenia requiring transfusions, developmental delay, ataxia, seizure disorder, and recurrent severe respiratory viral infections. His infectious history was significant for respiratory syncytial virus with shock requiring extracorporeal membrane oxygenation complicated by cerebral infarction and a group A streptococcus empyema, osteomyelitis requiring a left below the knee amputation, and infections with rhinovirus, COVID-19, and parainfluenza requiring hospitalizations for respiratory support. Initial immunologic evaluation was done during his hospitalization for parainfluenza. His full T cell subsets was significant for lymphopenia across all cell lines with CD3 934/microL, CD4 653/microL, CD8 227/microL, CD19 76/microL, and CD1656 61/microL. His mitogen stimulation assay to phytohemagglutinin and pokeweed was normal. Immunoglobulin panel showed a mildly decreased IgM of 25 mg/dL, but normal IgA and IgG. Vaccine titers demonstrated protective titers to 12/22 pneumococcus serotypes, varicella, diphtheria, mumps, rubella, and rubeola. Repeat full T cell subsets 6 weeks later revealed marked improvement in lymphocyte counts with CD3 3083/microL, CD4 2101/microL, CD8 839/microL, CD19 225/microL, and CD1656/microL. A primary immunodeficiency genetic panel was ordered and positive for a heterozygous SAMD9L c.1549T>C (p.Trp517Arg) mutation classified as a variant of unknown significance. Discussion(s): This patient's history of severe viral infections, ataxia, thrombocytopenia, and severe transient lymphopenia during infection is suggestive of a SAM9DL gain of function mutation. Protein modeling done by the laboratory suggests this missense mutation would affect protein structure. The mutation found has been observed in individuals with thrombocytopenia. This case highlights the importance of immunophenotyping both during acute illness and once recovered.Copyright © 2023 Elsevier Inc.

Socioemotional functioning as a moderator of the predictive ability of the DIAL-4 on academic achievement

Student performance on kindergarten screening measures and level of kindergarten-entry skills have been shown to be predictive of subsequent academic achievement, thus making kindergarten screening measures a useful tool that guides the monitoring of student progress over time. Though a commonly used tool to assist in kindergarten placement considerations by educators nationwide, the literature is lacking in studies that demonstrate the predictive ability of the Developmental Indicators for the Assessment of Learning - Fourth Edition (DIAL-4) on later academic achievement. Related, behavioral and emotional functioning has been demonstrated to significantly impact student achievement. While the literature supports the predictive ability of kindergarten screening measures on academic performance, research is limited on how behavioral functioning moderates this predictive relationship. The present study aimed to examine the predictive ability of the DIAL-4 on later academic achievement and identify whether behavioral and emotional functioning impacts upon, and to what degree, the relationship between academic achievement and the DIAL-4. Additionally, this study examined the impact of the pause of in-person learning, as caused by the COVID-19 pandemic on student achievement and behavioral and emotional functioning through within-samples comparisons of student functioning in 2019 and 2021 to identify change amongst individual students. The results support the predictive ability of the DIAL-4 on subsequent academic achievement with significant correlations between DIAL-4 scores obtained before kindergarten with subsequent measures of academic achievement. The was no evidence found for a moderation effect of behavioral and emotional functioning on the prediction of academic achievement. Lastly, when controlling for scores on the DIAL-4, the data suggest a decrease in rate of student academic achievement and an increase in emotional and behavioral dysregulation following the onset of the COVID-19 pandemic demonstrated by statistically significant differences in BERI scores as well as significant decreases in rates of growth in reading ability within some cohorts. These findings provide educators with empirical evidence for the utility of the DIAL-4 in predicting academic achievement as well as insight into how the COVID-19 pandemic impacted students' functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Individual differences in patterns of developmental opportunity and constraint during covid-19: Implications for longitudinal well-being

Individual differences in sociodemographic characteristics and trait-like perceptions of opportunities and constraints may shape how people respond to adversities such as the COVID-19 pandemic. However, little is known about how these factors combine to form multifaceted profiles of developmental opportunity and constraint or the implications of such profiles for longitudinal well-being following major life stressors. Using 1-year data from a national sample of U.S. adults (n = 293), we identified profiles based on relevant sociodemographic characteristics (age, socioeconomic status, chronic conditions, functional status) and trait-like perceptions of opportunity and constraints (perceived mastery, perceived constraints). Results of latent profile analyses showed that three common profiles emerged at pandemic onset (veridical opportunity, perceived constraints, perceived opportunity). Subsequent latent growth models showed that, despite reporting more sociodemographic constraints, the perceived opportunity profile exhibited better 1-year emotional well-being (positive and negative affect) during the pandemic than the perceived constraints profile. Findings advance the literature by identifying multifaceted individual differences in profiles of developmental opportunity and constraint and by showing these profiles have consequences for longitudinal well-being following the pandemic onset. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Health-related quality of life, mental health and caregiver burden in children with autosomal recessive polycystic kidney disease (ARPKD)

Objective: To examine whether established patient-reported outcome measures are suitable for capturing the impact of ARPKD in children and their families. Method(s): We assessed 44 children with ARPKD (40 families) with respect to patients' health-related quality of life ((hr- QOL) using PedsQLTM ESRD module) and mental health (strength and difficulties questionnaire (SDQ)) as well as family and caregiver burden (Impact on family score (IFS) und Ulm inventory of parental caregiver QOL (ULQIE)) and compared them to published data and 36 healthy control children matched for age and time. Result(s): Patients were aged 9.5 +/- 5.9 years (vs. controls 8.8 +/- 5.0, p = ns) and 21 (48%) were female (vs. 19 controls (53%), p = ns). Mean eGFR was 81 ml/min*1.73m2 (range 4 - 165);7 received dialysis and 11 had functioning kidney transplants (KTX, 2 combined with liver transplants). Eight patients had developmental delay secondary to medical complications, while chronic illness was an exclusion criterion for healthy controls. 61 caregivers of affected children had same gender-distribution (61% vs. 60% mothers) and age (both 42 +/- 7 years) and number of dependent children (1.8 +/- 0.9 vs. 2.0 +/- 0.8) as 57 caregivers of healthy children. The mean proxy reported PedsQL Total score was 77.5 +/- 10.6 (range 59 - 96). It correlated significantly to eGFR (r = 0.5, p < 0.01, (also within the subpopulations pre- and post-KTX)). Parents reported greater mental health problems in affected than in control children with a higher SDQ total score mainly due to higher scores in the hyperactivity and peerinteraction subscales. ULQIE revealed that parents of affected children had significantly lower levels of physical functioning, self-fulfillment and general QOL, but despite higher emotional burden scores they indicated similar satisfaction with family life. Impact on family scores were in a similar range to those of children with moderate to severe disabilities. Conclusion(s): The good spread of PedsQLTM ESRD-scores and their correlation to renal function indicates that it captures significant aspects of ARPKD, however, it may need further adjustment to include liver complications. All four chosen instruments revealed significant impact of ARPKD on hrQOL and mental health of affected children as well as family life and parental wellbeing in comparison to healthy controls. More problems with peer-interactions may also be due to more stringent shielding of chronically ill children from social contacts during the COVID pandemic compared to healthy children.

Effect of COVID-19 lockdown on sleep behavior and screen exposure time: An observational study among Indian school children

Lockdown is an important measure that has been globally adopted to reduce the spread of the contagious disease caused by SARS CoV-2. The imposed schedule and confinement led to extensive use of digital media and rise in sedentary activity drastically. The escalated duration of screen exposure causes disruption in sleep behavior. An online survey was conducted to comprehend the effect of lockdown on sleep behavior and screen exposure time on school children. Screen exposure time involved with various electronic gadgets was also analyzed. It was observed that the social jet lag and sleep debt were significantly less during lockdown than before it. Inertia during lockdown significantly increased. The difference between screen exposure time on weekdays before lockdown and weekends during lockdown was identified to be the highest. Three clusters based on sleep behavior and duration of screen time were identified of which Cluster 2 revealed simultaneous existence of high sleep duration and screen time. These baseline data on sleep parameters and duration of exposure to the screen will help us in devising approaches to mitigate the evident disruption this unprecedented phase has brought about. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Consumer attitudes and sociodemographic profiles in purchasing organic food products: evidence from a Greek and Swedish survey

PurposeThis study explores Greek and Swedish consumers' attitude towards organic food consumption in order to demonstrate possible differences that can be identified based on health and ecological consciousness beliefs rather than demographic factors. The examination of an emerging and a more mature market allow the authors to provide more targeted marketing strategies that possibly increase organic food consumption in both countries.Design/methodology/approachThe authors adopt an econometric approach to the analysis of consumer behavior in relation to organic food consumption in Sweden and Greece. More specifically, the authors examine the motivations and postexperiences of organic food consumers of different socioeconomic profiles in these two countries, one in northern and one in southern Europe. The authors apply an ordered logistic regression analysis model to map out the interaction between consumer attitudes and sociodemographic variables.FindingsThe authors results show that consumers in Sweden more frequently purchase organic foods than consumers in Greece. Environmental protection and ethical values increase the odds for Swedish organic food consumers to buy organic food products. Health consciousness and family well-being are perceived as factors that increase the odds for Greek organic food consumers to buy organic foods. Sociodemographic factors do not play a pivotal role for consumer behavior in relation to organic food in both countries.Originality/valueThis study distinguishes between organic food consumers in two countries with different levels of organic food production and export activity, size of organic market, national organic labeling system and legal definition and standards of organic food. Within these differences, the organic food industry could align its marketing efforts better rather focus on simplistic demographics. The current view unfolds the fact that there are limited studies comparing two European markets at different stages of development and the factors that influence organic food consumer behavior.

Nobody's child: Managing mental trauma of children with mental health issues

The world has not yet seen the end of COVID-19 or SARS-CoV-2. However, as the spate of infection, hospitalization, and death abates, we are limping back to what we used to know as being normal. A new world is emerging, and more of this newness is yet waiting to be discovered. Children are developing differently, parents are unable to provide the necessary psychological and social support, there is hardly any peer interaction yet, and adults in their lives are too preoccupied with their own distresses to give the kind of support a growing child needs. In many situations, children are being allowed to almost fend for themselves in social and familial areas and in the area of cognitive development and these will surely show their true colors in the years to come. On a positive note, the nearly-post-COVID-19 world has witnessed children displaying an array of coping mechanisms leading to post-traumatic growth (PTG). It is heartening to note that the human psyche has the ability to overcome distress and disaster and forge ahead in a positive manner. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Preschool teacher practices and beliefs about digital technology use in classrooms

The focus of this dissertation centers around the beliefs that early education teachers hold regarding the role digital technology plays in the learning and development of young children and how those beliefs are implemented in the classroom. Although there is some previous research on this topic not enough is known about digital technology beliefs and practices at the preschool level. Thus, the focus of this dissertation centers around including the "voices of preschool teachers."Using a mixed methods approach via survey and selected follow-up interviews;100 preschool teachers expressed their beliefs and practices about digital technology use. Three groupings emerged;one group that favored using technology with young children, one group that favored technology use but with limitations, and a final group that did not see any benefit in using technology with young children. Preschool teachers also related the role technology may play in the learning and development of young children and levels of technology access. Almost all teachers reported that they had access to at least one electronic device;children's access, however, was much more limited.Lived experiences as teachers worked through the COVID-19 pandemic were also reported. Many teachers found that they were able to form better connections with parents and families via an electronic format, often at times that were more convenient for parents to talk. Teachers also reported learning how to use various types of digital technology during the COVID-19 pandemic and they reported continuing to implement what they had learned. Teachers' beliefs about technology use in classrooms by teacher demographics were tested to detect whether there were differences between the three belief groupings. The results indicated that when teachers received technology support they were more likely to have favorable beliefs about technology use. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A collective strange situation: COVID-19 and children's developmental lines

Emerging findings have demonstrated the adverse effects of the COVID-19 pandemic on the well-being of children and families through abrupt and ongoing changes in routine due to social distancing measures, school closures, financial stress, fears of infection, and the loss of loved ones. Research has provided insight into the diverse ways that children and families react to heightened stressors in their environment, both through evidence of increased risk of developing symptoms of post-traumatic stress disorder (Xie et al. 2020), and through protective factors, such as seeking support within a secure family system (Schofield et al. 2013). This paper will review the current literature about the impact of COVID-19 related stressors on children and families and then revisit literature and theories that developed in the context of previous widespread crises, which continue to inform our understanding of human development and resilience following shared traumatic experiences. For example, Bowlby's theory of attachment was honed by observing the effects of children's separations from their parents during WW2. Additionally, Victor Frankl's meaning-focused work, developed after surviving Nazi concentration camps during the Holocaust, provides a framework for understanding resilience and shaped the elaboration and applications of existential therapies (Frankl 1946/1984). Based on a review of both the historical and more recent literature, as well as our own observations of children and parents in our clinical practice, we offer some suggestions for how psychoanalytic theories and therapies can support children and adolescents' emotional development and resilience during and following this crisis. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Heart Rate Variability and Pregnancy Complications: Systematic Review.

BACKGROUND: The autonomic nervous system (ANS) is known as a critical regulatory system for pregnancy-induced adaptations. If it fails to function, life-threatening pregnancy complications could occur. Hence, understanding and monitoring the underlying mechanism of action for these complications are necessary. OBJECTIVE: We aimed to systematically review the literature concerned with the associations between heart rate variability (HRV), as an ANS biomarker, and pregnancy complications. METHODS: We performed a comprehensive search in the PubMed, Medline Completion, CINAHL Completion, Web of Science Core Collection Classic, Cochrane Library, and SCOPUS databases in February 2022 with no time span limitation. We included studies concerned with the association between any pregnancy complications and HRV, with or without a control group. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used for the review of the studies, and Covidence software was used for the study selection process. For data synthesis, we used the guideline by Popay et al. RESULTS: Finally, 12 studies with 6656 participants were included. Despite the methodological divergency that hindered a comprehensive comparison, our findings suggest that ANS is linked with some common pregnancy complications including fetal growth. However, existing studies do not support an association between ANS and gestational diabetes mellitus. Studies that linked pulmonary and central nervous system disorders with ANS function did not provide enough evidence to draw conclusions. CONCLUSIONS: This review highlights the importance of understanding and monitoring the underlying mechanism of ANS in pregnancy-induced adaptations and the need for further research with robust methodology in this area.

Developmental Manifestations of Grief in Children and Adolescents: Caregivers as Key Grief Facilitators.

The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief.

A Qualitative Investigation on COVID-19 Vaccine Hesitancy in Neurodivergent Communities.

Vaccine hesitancy is a major barrier to vaccination, hindering the success of vaccine efforts and thereby increasing public health risk to viral diseases, including COVID-19. Neurodivergent (ND) individuals, including individuals with an intellectual and/or developmental disability, have demonstrated a heightened risk of hospitalization and death due to COVID-19, highlighting the need for further research specifically on ND communities. We conducted a qualitative analysis using in-depth interviews with medical professionals, non-medical health professionals and communicators, and ND individuals or their caregivers. Using a thematic coding analysis methodology, trained coders identified major themes according to 24 distinct codes spanning across the categories of (1) barriers to vaccination; (2) facilitators to vaccination; and (3) suggestions for improving vaccine confidence. Qualitative findings identify misinformation, perception of vaccine risk, sensory sensitivities, and structural hardship as the most significant barriers to COVID-19 vaccination. We highlight the importance of accommodations to vaccination for the ND community alongside coordinated efforts by healthcare leaders to direct their communities to accurate sources of medical information. This work will inform the direction of future research on vaccine hesitancy, and the development of programs specific to the ND community's access to vaccines.