Intentional Poisoning in Pediatric Patients: Examining the Risk Factors.

OBJECTIVES: Poisonings in children are common reasons for presentation to the emergency department and can potentially have serious complications. Our research aims to review risk factors leading to intentional self-poisoning. METHODS: A retrospective medical record review of all intentional pediatric poisoning cases presenting to the Children's Emergency at National University Hospital, Singapore between January 2014 and December 2015 was performed. RESULTS: Eighty-seven cases of intentional poisonings were identified, 31 (36.5%) of which were with suicidal intent. The majority of cases were female (85.1%) and adolescents older than 16 years (93.1%). A known psychiatric history was present in 57.5% and 62 (71.3%) had a history of deliberate self-harm. Being diagnosed with a new psychiatric illness during that presentation was associated with a history of self-harm (adjusted odds ratio [Adj OR], 6.74; 95% confidence interval [CI]; 1.04-43.62; P = 0.045). Twenty-seven (31.0%) patients had a history of intentional poisoning, and 15 (17.2%) went on to have subsequent presentations for poisoning. Recurrent poisoning attempts were strongly associated with a known psychiatric history (Adj OR, 5.91; 95% CI, 1.62-21.58; P = 0.007) and a history of deliberate self-harm (Adj OR, 7.49; 95% CI, 1.38-40.66; P = 0.02). Deliberate overdosing on personal long-term medication was seen in 15 (35.7%) of 42, of which 12 (80%) of 15 were psychiatric medications. CONCLUSIONS: Known psychiatric history or a history of deliberate self-harm are risk factors for intentional poisoning. Appropriate risk stratification and preemptive interventions involving closer surveillance or cognitive behavioral programs are possible measures to prevent intentional self-poisoning, especially in these at-risk groups.

A cross-cultural investigation of children's implicit attitudes toward White and Black racial outgroups.

Initial theory and research examining children's implicit racial attitudes suggest that an implicit preference favoring socially advantaged groups emerges early in childhood and remains stable across development (Dunham, Baron, & Banaji, 2008). In two studies, we examined the ubiquity of this theory by measuring non-Black minority and non-White majority children's implicit racial attitudes toward White and Black racial outgroups in two distinct cultural contexts. In Study 1, non-Black minority children in an urban North American community with a large Black population showed an implicit pro-White (versus Black) bias in early childhood. Contrary to previous findings, the magnitude of this bias was lower among older children. In Study 2, Malay (majority) and Chinese (minority) children and adults in the Southeast Asian country of Brunei, with limited contact with White or Black peers, showed an implicit pro-White (versus Black) bias in early childhood. However, the magnitude of bias was greater for adults. Together, these findings support initial theorizing about the early development of implicit intergroup cognition, but suggest that context may affect these biases across development to a greater extent than was previously thought. A video abstract of this article can be viewed at: https://www.youtube.com/watch?v=vgQP8e4MSCk&feature=youtu.be.

Therapist adherence in the strong without anorexia nervosa (SWAN) study: A randomized controlled trial of three treatments for adults with anorexia nervosa.

OBJECTIVE: To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM). METHOD: The SWAN Psychotherapy Rating Scale (SWAN-PRS) was developed, after consultation with the developers of the treatments, and refined. Using the SWAN-PRS, two independent raters initially rated 48 audiotapes of treatment sessions to yield inter-rater reliability data. One rater proceeded to rate a total of 98 audiotapes from 64 trial participants. RESULTS: The SWAN-PRS demonstrated sound psychometric properties, and was considered a reliable measure of therapist adherence. The three treatments were highly distinguishable by independent raters, with therapists demonstrating significantly more behaviors consistent with the actual allocated treatment compared to the other two treatment modalities. There were no significant site differences in therapist adherence observed. DISCUSSION: The findings provide support for the internal validity of the SWAN study. The SWAN-PRS was deemed suitable for use in other trials involving CBT-E, MANTRA, or SSCM.

Microchip capillary electrophoresis.

Microchip capillary electrophoresis (MCE) is gaining popularity due to the developments of simple microfabrication methods under nonstringent laboratory conditions. Moreover, the low material and production costs of polymer-based microchips have further stimulated advances in the applications of MCE in various fields, including clinical analysis, drug screening, biomarker identification, and biosensing. In this chapter, a simple and robust protocol for fabrication of microchips for lab-on-chip testing and microchip electrophoresis is described. The microchips are hybrid poly(dimethylsiloxane) (PDMS)/glass microchips, which are produced by a combination of photolithography and micromolding processes. This type of microchip has been used in a wide range of analyses.

Floating resistivity detector for microchip electrophoresis.

A newly developed conductivity detector, the floating resistivity detector (FRD), for microchip electrophoresis was introduced in this work. The detector design permits decoupling of the detection circuit from the high separation voltage without compromising separation efficiency. This greatly simplifies the integration of microchip electrophoresis systems. Its method of detection relies on platinum electrodes being dipped in two buffer-filled branched detection probe reservoirs on the microchip device. In this way, analytes passing through the detection window will not pass through and subsequently adsorb onto the electrodes, alleviating problems of electrode fouling due to analyte contamination and surface reactions. A customized microchip design was proposed and optimized stepwise for the new FRD system. Each branched detection probe was determined to be 4.50 mm long with a 0.075 mm detection window gap between them. The distance between the detection window and buffer waste reservoir was determined to be 1.50 mm. The optimized microchip design was subsequently used in the analysis of four groups of analytes - inorganic cations, amino acids, aminoglycosides antibiotics, and biomarkers. Based on the preliminary results obtained, the detection limits were in the range of 0.4-0.7 mg/L for the inorganic cations and 1.5-15 mg/L for the amino compounds.

Rapid identification of purified enteropathogenic Escherichia coli by microchip electrophoresis.

In this work, the potential of PDMS-based microchip electrophoresis in the identifications and characterizations of microorganism was evaluated. Enteropathogenic E. coli (EPEC) was selected as the model microorganism. In this study, separation parameters such as applied voltage, concentrations of buffer and buffer modifier, injection voltage, and duration of injection had been investigated and optimized. Determination of EPEC bacteria could be completed within 2 min with good reproducibility. RSDs were less than 0.5 and 5% in migration time and peak area, respectively. Separation efficiency corresponding to plate number of more than 100,000 was achieved. In order to obtain reproducible separations, sample pretreatment was found to be essential. Microchip electrophoresis with LIF detection could potentially revolutionize certain aspects of microbiology involving diagnosis, profiling of pathogens, environmental analysis, and many other areas of study.

Synthetic and X-ray structural and reactivity studies of Cp*RuIV complexes containing bidentate dithiocarbonate, xanthate, carbonate, and phosphinate ligands (Cp* = eta5-C5Me5).

The reaction of [Cp*RuCl2]2 (1; Cp* = eta5-C5Me5) with tetraalkyldithiuram disulfides (R2NC(S)SS(S)CNR2, R = Me, Et), isopropylxanthic disulfide ([iPrOC(S)S]2), and bis(thiophosphoryl) disulfide ([(iPrO)2P(S)S]2) led to the isolation of dark-red crystalline solids of Cp*RuIVCl2(eta2-dithiolate) complexes [dithiolate = S2CNR2, DTCR (2a, R = Me; 2b, R = Et), S2COiPr (3), and S2P(iPrO)2 (4)]. Dichlorido substitution in 2 and 3 with DTCEt and S2COiPr anions yielded RuIV derivatives containing bis(DTC) and mixed DTC-dithiocarbonate ligands. These are the first organoruthenium complexes of such ligands. The reaction of monophosphines with 2a resulted in monochlorido substitution, whereas the analogous reaction with 3 resulted in displacement of both chlorido ligands and reduction of the metal center to RuII. Reduction at Ru was also observed in the reaction of 2a with [CpCr(CO)3]2. Of these complexes, only 2 and 3 are air-stable in the solid state for an extended period. All of the complexes have been spectrally characterized, and selected compounds are also crystallographically characterized.