Does Parental Mental Health Moderate the Association between Parenting Stress and Child Externalizing Behaviors Among Autistic Children?

Parents of autistic children experience significant parenting stress, which is prospectively associated with increases in child externalizing behaviors. However, family factors that place specific families at risk for experiencing the negative impacts of parenting stress on child externalizing behaviors have not been identified. The present study examined whether parental mental health moderates the association between parenting stress and child externalizing behaviors. Parents of 501 autistic children (Mage=5.16yrs) completed the Parenting Stress Index and Eyberg Child Behavior Inventory. Parents reported whether they had ever been diagnosed with a mental health disorder. Parenting stress, parental internalizing diagnosis, and parental externalizing diagnosis all independently predicted child externalizing behavior. However, parenting stress did not interact with any category of parental mental health diagnoses to predict child externalizing. Results implicate high levels of parenting stress as a risk factor for increased child behavior problems among autistic children across parental mental health statuses. Interventions aimed at reducing parenting stress may improve parent outcomes and prevent the development of child externalizing behaviors among families of autistic children.

Stop, in the Name of COVID! Using Social Media Data to Estimate the Effects of COVID-19-Related Travel Restrictions on Migration.

In the wake of the COVID-19 pandemic, the International Organization for Migration has postulated that international migrant stocks fell short of their pre-pandemic projections by nearly 2 million as a result of travel restrictions. However, this decline is not testable with migration data from traditional sources. Key migration stakeholders have called for using data from alternative sources, including social media, to fill these gaps. Building on previous work using social media data to analyze migration responses to external shocks, we test the hypothesis that COVID-related travel restrictions reduced migrant stock relative to expected migration without such restrictions using estimates of migrants drawn from Facebook's advertising platform and dynamic panel models. We focus on four key origin countries in North and West Africa (Côte d'Ivoire, Algeria, Morocco, and Senegal) and on their 23 key destination countries. Between February and June 2020, we estimate that a destination country implementing a month-long total entry ban on arrivals from Côte d'Ivoire, Algeria, Morocco, or Senegal might have expected a 3.39% reduction in migrant stock from the restricted country compared with the counterfactual in which no travel restrictions were implemented. However, when broader societal disruptions of the pandemic are accounted for, we estimate that countries implementing travel restrictions might paradoxically have expected an increase in migrant stock. In this context, travel restrictions do not appear to have effectively curbed migration and could have resulted in outcomes opposite their intended effects.

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder.

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2-6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.

Tele-PCIT: Initial Examination of Internet Delivered PCIT for Young Children with Autism.

PURPOSE: Parent-Child Interaction Therapy (PCIT) is an empirically supported behavioral parenting program for disruptive behavior and has been shown to also be effective for children with autism spectrum disorder (ASD). Telehealth delivery of PCIT (Tele-PCIT) is also supported, but no trials have focused on children with ASD. The purpose of the study was to examine the initial efficacy of a time limited version of Tele-PCIT within an ASD sample. METHODS: Participants included parents of 20 children (ages 2-6) with ASD who received 10 sessions of Tele-PCIT. Parents reported on their parenting stress, parenting practices, and child behavior. A play observation was coded for parent use of treatment skills and for child compliance. RESULTS: 80% of participants completed treatment (n = 16) and results revealed significant improvements across parenting and child outcomes. Parents reported decreases in parenting stress from pre-to-post-treatment, which were maintained at a 3-month follow-up, along with decreases in negative parenting practices (i.e., Laxness and Overactivity) from pre-to-post treatment that were also maintained at follow-up. Significant increases in parent use of positive parenting skills (i.e., "Do" Skills) during child-led play and decreases in negative parenting skills (i.e., "Don't" Skills) were observed. Results also revealed significant reductions in parent rated child externalizing behavior problems from pre-to-post-treatment that were also maintained at follow-up. CONCLUSIONS: Results of the current study support the initial efficacy of Tele-PCIT for treating disruptive behavior in young children with ASD. Findings from this pilot will inform larger examinations of Tele-PCIT for youth with ASD.

Brief Report: Prevalence and Predictors of DSM-Specific and Distinct Anxiety in Cognitively Impaired Autistic Preschool Children.

Autistic individuals are twice as likely to meet criteria for anxiety than neurotypical children; yet we lack understanding of early presentations of anxiety in young autistic children, especially those with cognitive impairment. This study is the first to utilize an autism-specific anxiety diagnostic interview with 28 preschool cognitively impaired, autistic children and 18 neurotypical, age-matched controls. Results indicate that 64% of autistic children met criteria for DSM-specified or "other specified," herein referred to as "distinct," anxiety disorders; 32% met criteria for multiple anxiety disorders, with phobias occurring most often. Results indicate that anxiety is highly prevalent in cognitively-impaired, autistic preschool children, highlighting the need for developmentally-tailored assessment and treatment in early childhood.

Empowering the crowd: feasible strategies for epidemic management in high-density informal settlements. The case of COVID-19 in Northwest Syria.

More than 1 billion people live in informal settlements worldwide, where precarious living conditions pose unique challenges to managing a COVID-19 outbreak. Taking Northwest Syria as a case study, we simulated an outbreak in high-density informal Internally Displaced Persons (IDP) camps using a stochastic Susceptible-Exposed-Infectious-Recovered model. Expanding on previous studies, taking social conditions and population health/structure into account, we modelled several interventions feasible in these settings: moderate self-distancing, self-isolation of symptomatic cases and protection of the most vulnerable in 'safety zones'. We considered complementary measures to these interventions that can be implemented autonomously by these communities, such as buffer zones, health checks and carers for isolated individuals, quantifying their impact on the micro-dynamics of disease transmission. All interventions significantly reduce outbreak probability and some of them reduce mortality when an outbreak does occur. Self-distancing reduces mortality by up to 35% if contacts are reduced by 50%. A reduction in mortality by up to 18% can be achieved by providing one self-isolation tent per eight people. Protecting the most vulnerable in a safety zone reduces the outbreak probability in the vulnerable population and has synergistic effects with the other interventions. Our model predicts that a combination of all simulated interventions may reduce mortality by more than 90% and delay an outbreak's peak by almost 2 months. Our results highlight the potential for non-medical interventions to mitigate the effects of the pandemic. Similar measures may be applicable to controlling COVID-19 in other informal settlements, particularly IDP camps in conflict regions, around the world.

Instrumenting Polyodon spathula (Paddlefish) Rostra in Flowing Water with Strain Gages and Accelerometers.

The prominent rostrum of the North American Paddlefish, supported by a lattice-like endoskeleton, is highly durable, making it an important candidate for bio-inspiration studies. Energy dissipation and load-bearing capacity of the structure from extreme physical force has been demonstrated superior to that of man-made systems, but response to continuous hydraulic forces is unknown and requires special instrumentation for in vivo testing on a live fish. A single supply strain gage amplifier circuit has been combined with a digital three-axis accelerometer, implemented in a printed circuit board (PCB), and integrated with the commercial-off-the-shelf Adafruit Feather M0 datalogger with a microSD card. The device is battery powered and enclosed in silicon before attachment around the rostrum with a silicon strap "watch band." As proof-of-concept, we tested the instrumentation on an amputated Paddlefish rostrum in a water-filled swim tunnel and successfully obtained interpretable data. Results indicate that this design could work on live swimming fish in future in vivo experiments.

Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease.

Coronary artery bypass grafting (CABG) decreases mortality in patients with significant left main (LM) coronary artery disease and for years remained the therapy of choice for patients with this ominous lesion. Advances in percutaneous coronary intervention (PCI) have enabled it to become an alternative to CABG. The results of observational registries and randomized comparisons have shown the safety and efficacy of PCI in appropriately selected patients with low or intermediate angiographic risk scores. Furthermore, the use of physiological measures of flow limitation and the use of intracoronary imaging techniques has added benefit and improved outcomes. The use of fractional flow reserve to more accurately evaluate the significance of intermediate lesions and guide the extent of revascularization has been an important refinement. Intravascular ultrasound and optical coherence tomography assessment of optimal stent deployment has led to reductions in restenosis. Newer generation stents, combined with improvements in specific techniques, especially at the LM bifurcation have extended PCI to more complex anatomic scenarios. The availability of left ventricular support devices in patients with complex coronary anatomy and severely depressed left ventricular function has added a margin of safety to LM and multivessel intervention. Randomized comparisons of CABG with PCI in carefully selected patients, using contemporaneous surgical and interventional techniques and optimal medical therapy, will further aid heart teams in the decision-making process. In conclusion, this review will give a concise overview of the management of unprotected LM disease.

Immunohistochemical localization of AMPA-type glutamate receptor subunits in the nucleus of the Edinger-Westphal in embryonic chick.

The Edinger-Westphal nucleus (EW) in birds is responsible for the control of pupil constriction, accommodation, and choroidal blood flow. The activation of EW neurons is mediated by the neurotransmitter glutamate, in large part through AMPA-type glutamate receptors (GluRs), whose behavior varies according to the subunit composition. We investigated the developmental expression of the GluR subunits in EW of the chick (Gallus gallus) using immunohistochemistry on tissue from embryonic days 10 through 20 (E10-E20). Of the three antibodies used, one recognized the GluR1 subunit, another the GluR4 subunit, and the third recognized a sequence common to GluR2 and GluR3 subunits. No immunolabeling of EW neurons for any GluR subunits was observed prior to E12, although immunolabeling was seen in somatic oculomotor prior to E12. At E12, immunoreactivity for each of the three antibodies was in only approximately 2% of EW neurons. By E14, the abundance of GluR1+ perikarya in EW had increased to 13%, and for GluR2/3 had increased to 48%. The perikaryal abundance of the immunoreactivity for GluR1 and GluR2/3 declined to 3% and 23%, respectively, by E16. At E14, 33% of EW neurons immunolabeled for GluR4, and their frequency increased to 43% by E16, and remained at that approximate percentage through hatching. The increased expression of GluR1 and GluR4 in EW at E14 coincides with the reported onset of the expression of the calcium-binding protein parvalbumin, and the calcium currents associated with AMPA receptors formed by these two subunits may play a role in the occurrence of parvalbumin expression.