High hsCRP concentration is associated with acute pancreatitis in multifactorial chylomicronemia syndrome.

BACKGROUND: Multifactorial chylomicronemia syndrome (MCS) is a severe form of hypertriglyceridemia (hyperTG) associated with an increased risk of acute pancreatitis (AP). However, the risk of AP is very heterogenous in MCS. Previous studies suggested that inflammation might promote disease progression in hyperTG-induced AP. OBJECTIVE: To determine if low-grade inflammation is associated with AP in MCS. METHODS: This study included 102 subjects with MCS for which high-sensitivity C-reactive protein (hsCRP) concentration was measured at their first visit at the Montreal Clinical Research Institute. RESULTS: MCS subjects with a previous history of AP had a significant higher hsCRP concentration (4.62 mg/L vs. 2.61 mg/L; p=0.003) and high hsCRP concentration (≥3mg/L) was independently associated with AP prevalence (p<0.05). Up to 64% of the variability in AP prevalence was explained by the maximal TG concentration, hsCRP concentration, the presence of rare variants in TG-related genes, and fructose intake based on a stepwise multivariate regression model (p<0.0001). CONCLUSION: This retrospective study showed for the first time that hsCRP concentration is strongly associated with AP prevalence in MCS. It also suggests that low-grade inflammation may be a driver of AP in severe hypertriglyceridemia. Prospective studies could help determine the causality of this association and assess whether medication known to reduce low-grade inflammation could help prevent AP in individuals with severe hypertriglyceridemia.

A latent class analysis of adolescent dating violence: Associations with daily conflict management.

BACKGROUND: Adolescent dating violence (ADV) is a major public health concern experienced by more than half of adolescents. Previous studies have found considerable diversity in patterns of ADV and suggest that its various forms often occur concurrently and reciprocally within adolescent dating relationships. While multiple robust distal correlates of ADV have already been established, research on situational factors, such as conflict-related variables, is still sparse. OBJECTIVE: This study aimed to identify patterns of ADV based on the co-occurrence of different types of ADV victimization and perpetration. Multiple correlates of these ADV patterns were examined, including daily conflict-related factors (e.g., occurrence, resolution). METHODS: A sample of 216 adolescents (M = 17.03 years; SD = 1.49) who were currently involved in a dating relationship completed a baseline assessment followed by 14 consecutive daily diaries. RESULTS: Latent class analysis revealed five classes, including Low violence (21.8 %), Emotional violence (50.9 %), Emotional and sexual violence (13 %), Psychological violence and control (7.9 %), and Multiple violence (6.5 %). Demographic, relationship, distal, and daily conflict-related indicators differentiated the classes. Findings indicated that youth in the Psychological violence and control and Multiple violence classes were involved in longer-lasting relationships and displayed higher externalized problems and emotion dysregulation, more frequent experiences of childhood traumas, and, notably, more difficulties in managing daily conflicts. CONCLUSION: Adolescence is a crucial time to reduce the onset, persistence, and adverse consequences of ADV. By identifying situational conflict-related factors associated with ADV victimization and perpetration, this study can inform important prevention efforts.

Dietary recommendations for dysbetalipoproteinemia: A need for better evidence.

The increased risk of cardiovascular disease in patients with dysbetalipoproteinemia (DBL) is well documented and is associated with the dysfunctional metabolism of remnant lipoproteins. Although these patients are known to respond well to lipid-lowering medication including statins and fibrates, the best dietary approach to lower remnant lipoprotein accumulation and to prevent cardiovascular outcomes remain unclear. Indeed, current evidence is based on studies published mainly in the 1970s, which comprise small sample sizes and methodological limitations. This review aims to summarize nutritional studies performed in DBL patients to date and to discuss potential avenues in this field and future areas of research.

"I felt imprisoned": A qualitative exploration of controlling behaviors in adolescent and emerging adult dating relationships.

INTRODUCTION: First dating relationships can elicit intense emotions that youth may attempt to alleviate by using control tactics that negatively impact the quality of their relationship and their partner's well-being. Despite the breadth of research on dating violence, studies examining control tactics in youth relationships are limited. The current qualitative study documented control tactics from the perspective of youth who are currently in dating relationships. METHOD: Individual semistructured interviews were conducted with 39 participants aged 15-22 years old to gather information regarding conflict management strategies used in their dating relationships. The participants were recruited from high schools and junior colleges across the province of Quebec, Canada. RESULTS: Direct content analysis revealed three categories of control tactics, including, isolation, domination, and emotional manipulation. These findings highlight the importance of further examining control dynamics in adolescent and emerging adult dating relationships to improve dating violence prevention programs. CONCLUSIONS: Educational programs can help prevent control from escalating to more direct forms of violence by supporting youth in identifying unhealthy relationship dynamics and providing them with tools to either safely end the relationship or communicate their concerns with their partner.

The Associations between Self-Silencing and Delinquency in Adolescent Who Experienced Child Sexual Abuse.

A large body of research reveals that child sexual abuse is an adverse experience associated with many negative socioemotional and behavioral consequences during adolescence. Notably, adolescent victims of child sexual abuse are more likely to engage in delinquent behavior, which has importance for their adaptation later in life. While research on the psychological antecedents of delinquent behavior has independently considered each core feature of silencing the self (i.e., low assertiveness and self-expression, conflict avoidance, presenting a non-authentic self, anger, and hostility), it has failed to jointly consider these as potential predictors of delinquent behaviors in adolescent victims of child sexual abuse. The purpose of this study was to examine the associations between the two dimensions of self-silencing (i.e., divided self and silencing the self) and delinquency in adolescent victims of child sexual abuse. A sample of 110 adolescents seeking services following child sexual abuse completed self-reported questionnaires, and case files were analyzed to gather information regarding child sexual abuse severity. Hierarchical regression analyses revealed that, after controlling for the effect of age, gender, parental monitoring, and child sexual abuse severity, self-silencing was positively associated with delinquent behaviors, affiliation with delinquent peers, as well as alcohol and drug use. Divided self contributed to the prediction of aggressive behaviors. Implementing interventions aimed at increasing adolescents' assertiveness, conflict management skills, and emotion regulation and promoting congruence between their behaviors and authentic selves may lower their involvement in delinquency.

Relationship quality among dating adolescents: Development and validation of the Relationship Quality Inventory for Adolescents.

Relationship quality has implications for individuals' and couples' wellbeing, such as higher couple functioning and perceived quality of life. In adolescence, low relationship quality has been associated with poor mental health and relational outcomes. However, given the lack of instruments to assess satisfaction in dating relationships, most studies have relied on measures of marital satisfaction. The current study aimed to address this gap by elaborating and validating the Relationship Quality Inventory for Adolescents (RQI-A). Exploratory and confirmatory factor analyses were conducted among two samples of French-speaking dating adolescents (n 1 = 310; n 2 = 335). The two-factor structure (Connectedness and Commitment) was cross-validated, and dimensions showed high internal consistency coefficients (ω = 0.86-0.89). Results also provide evidence of convergent validity of the scale with related measures. The RQI-A may help study predictors and correlates of dating relationship quality.

The Interplay of Perceptions and Conflict Behaviors during Disagreements: A Daily Study of Physical Teen Dating Violence Perpetration.

Physical dating violence (DV) is a widespread problem among adolescents. A growing body of literature demonstrates that physical DV often occurs during disagreements when partners use destructive conflict management strategies, such as conflict engagement (e.g., losing control, criticizing) or withdrawal (e.g., acting cold, being distant). However, little is known regarding how the individual daily variability on the use of destructive conflict management strategies can influence the probability of perpetrating day-to-day physical DV, especially if the other partner is also perceived as using destructive behaviors. Using an intensive longitudinal approach, the current study first aimed to examine the daily associations between the use of various conflict management strategies and physical DV perpetration in adolescent dating relationships. A second objective was to investigate if perceived partner's conflict behaviors moderated the relation between self-reported conflict management strategies and day-to-day physical DV perpetration. A sample of 216 adolescents (Mage = 17.03, SD = 1.49) involved in a dating relationship, completed a baseline assessment followed by 14 daily diaries. Results of multilevel logistic analyses revealed that using conflict engagement strategies significantly increased the probability of day-to-day physical DV perpetration. Furthermore, the probability of perpetrating physical DV was significantly higher on days in which teens reported using high levels of conflict engagement while also perceiving their partner as using high levels of conflict engagement or withdrawal. These findings yield new insights on the daily context in which disagreements might escalate into aggression. Evidence from this study further supports the conflict escalation pattern and the demand/withdraw communication pattern in the context of adolescent dating relationships. Preventive initiatives should address the interplay of perceptions and conflict behaviors concerning physical DV perpetration.

Development and validation of the Relational Skills Inventory for Adolescents.

INTRODUCTION: Dating violence prevention initiatives are intended, not only to reduce the occurrence of violent behaviors, but also to promote the development of positive dating relational skills starting in adolescence. However, despite the growing interest in examining adolescent relational skills in adolescents, no specific measure is yet available to assess post program gains relative to dating violence prevention and intervention. The current study addressed this important gap in dating relationships research by developing and validating a new measure of relational skills for adolescents. METHODS: Exploratory and confirmatory factor analyses were conducted on two samples of French-speaking dating adolescents from Quebec, Canada (n1= 384; n2= 687). RESULTS: Exploratory factor analysis revealed a three-factor structure reflecting constructs of Assertiveness, Support and Individuality (α = 0.69-0.81). Results also support evidence of convergent validity with related measures. The three-factor structure was cross-validated among a second sample (α = 0.74-0.79). Two-way ANCOVAs were also conducted to examine differences in levels of relational skills as a function of sex and previous dating violence perpetration. Results indicated that girls reported higher levels of assertiveness than boys, and that adolescents who reported the use of dating violence also reported lower levels of all relational skills. CONCLUSION: The validation of the Relational Skills Inventory for Adolescents (RSI-A) will help researchers assess the effectiveness of interventions aimed at promoting the development of positive dating relationships during adolescence.

Symptom patterns of sexually abused teenage girls seeking services.

Child sexual abuse (CSA) is associated with a host of negative repercussions. Yet, scholarly reports highlight the diversity of symptom presentation in survivors of CSA. Relying on the complex posttraumatic stress disorder (C-PTSD) framework, this study aimed to identify symptom profiles in teenage girls seeking services following disclosure of CSA. Participants included 207 teenage girls aged 12-18. They completed questionnaires on PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and domains of impairments of the C-PTSD (i.e., interpersonal difficulties, biology, affect and behavioral regulation, dissociation, cognition, and self-concept). A latent profile analysis identified three profiles: PTSD, Complex PTSD, and Resilient. Results support the validity of the C-PTSD model with a subgroup reporting classic PTSD symptoms as well as alterations in several domains of functioning. Our second aim was to explore potential correlates of the resulting symptom profiles. Both personal and family factors were found to distinguish profiles, with teens in the Resilient group reporting fewer associations with delinquent peers, less use of avoidance coping strategies, and more maternal support than the two other profiles. Furthermore, CSA severity did not differ between the Complex PTSD and the Resilient profiles. The current findings argue in favor of a more individualized approach to treatment taking into consideration differences in presentation of symptoms among profile teenage survivors of CSA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Comparison of two carbohydrate intake strategies to improve glucose control during exercise in adolescents and adults with type 1 diabetes.

BACKGROUND AND AIMS: During aerobic physical activity (PA), hypoglycemia is common in people with type 1 diabetes (T1D). Few studies have compared the effectiveness of different carbohydrate (CHO) intake strategies to prevent PA-induced hypoglycemia. Our objective was to compare the efficacy of two CHO intake strategies, same total amount but different CHO intake timing, to maintain glucose levels in the target range (4.0-10.0 mmol/L) during PA in people with T1D. METHODS AND RESULTS: An open-label, randomized, crossover study in 33 participants (21 adults; 12 adolescents). Participants practiced 60 min PA sessions (ergocyle) at 60% VO2peak 3.5 h after lunch comparing an intake of 0.5 g of CHO per kg of body weight applied in a pre-PA single CHO intake (SCI) or in a distributed CHO intake (DCI) before and during PA. The percentage of time spent in glucose level target range during PA was not different between the two strategies (SCI: 75 ± 35%; DCI: 87 ± 26%; P = 0.12). Hypoglycemia (<4.0 mmol/L) occurred in 4 participants (12%) with SCI compared to 6 participants (18%) with DCI (P = 0.42). The SCI strategy led to a higher increase (P = 0.01) and variability of glucose levels (P = 0.04) compared with DCI. CONCLUSIONS: In people living with T1D, for a 60 min moderate aerobic PA in the post-absorptive condition, a 0.5 g/kg CHO intake helped most participants maintain acceptable glycemic control with both strategies. No clinically significant difference was observed between the SCI and DCI strategies. ClinicalTrials.gov Identifier: NCT03214107 (July 11, 2017).

Practices, perceptions and expectations for carbohydrate counting in patients with type 1 diabetes - Results from an online survey.

AIMS: Characterize adult patients with diabetes on intensive insulin therapy in terms of: (a) practices and perceived difficulties relative to carbohydrate counting (CC) and diabetes treatment, and (b) their perceptions and expectations relative to CC. METHODS: Participants completed a 30-question web-based questionnaire. RESULTS: Participants with type 1 diabetes (T1D) and using CC as part of their treatment plan (n=180) were included in this analysis. Participants were predominantly women (64%), aged 42±13years old and had diabetes for 22±13years. A large proportion of participants reported being confident in applying CC (78%) and considered precise CC as being important for glycemic control (91%), while only 17% reported finding CC difficult. Despite the low perceived difficulty associated with CC, many specific difficulties were encountered by patients such as the perception that glycemia fluctuates even with appropriate CC and that CC complicates the management of diabetes. A larger proportion of participants with a lower level of education (