Social isolation continued: Covid-19 shines a light on what self-advocates know too well.

Covid-19 has been an unprecedented time for social work as a profession and even more so for marginalized communities. This paper shares the reflections of three self-advocates (persons labelled/with intellectual disabilities engaged in advocacy and activism), a social worker, and a social work educator and researcher. It is intended as a rallying cry for social work to rethink how we deliver services to ensure that people who have already been made vulnerable through oppressive ableist practices and assumptions are not put at greater disadvantage at times like Covid-19. Hearing directly from self-advocates, we learn of their exclusion from pandemic planning, and of the ways that physical and social distancing protocols have worked to exacerbate the isolation, marginalization and inequities that people labelled/with intellectual disabilities have experienced over the years. We are called upon to more actively focus on advocacy efforts with people labelled/with intellectual disabilities to increase their involvement in planning, as well as access to supports, and to ensure that they do not remain "the left behind of the left behind" .

Prenatal Maternal Stress, Child Cortical Thickness, and Adolescent Depressive Symptoms.

Prenatal maternal stress predicts subsequent elevations in youth depressive symptoms, but the neural processes associated with these links are unclear. This study evaluated whether prenatal maternal stress is associated with child brain development, and adolescent depressive symptoms using a prospective design with 74 mother child pairs (40 boys). Maternal stress was assessed during pregnancy, child cortical thickness at age 7, and depressive symptoms at age 12. Prenatal maternal stress was associated with less cortical thickness primarily in frontal and temporal regions and with elevated depressive symptoms; child cortical thickness additionally correlated with adolescent depressive symptoms. The observed associations are consistent with the possibility that cortical thickness in superior frontal regions links associations between prenatal maternal stress and adolescent depressive symptoms.

Cortical Thinning and Neuropsychiatric Outcomes in Children Exposed to Prenatal Adversity: A Role for Placental CRH?

OBJECTIVE: The authors sought to assess associations among early-life exposure to adversity, the development and maturation of neurons and brain circuits, and neurodevelopmental outcomes. Specifically, they examined whether fetal exposure to placental corticotropin-releasing hormone (CRH), a molecule conveying maternal signals to the fetus, predicts brain growth and neuropsychiatric outcomes in school-age children. METHOD: In a large, well-characterized prospective cohort, concentrations of placental CRH (pCRH) in maternal plasma were determined during five intervals during gestation. When the children reached school age, their brain structures were examined using MRI, and emotional and cognitive tests assessing internalizing and externalizing behaviors and attention were administered (N=97, 49 of them girls). RESULTS: Levels of pCRH during gestation predicted structural and functional brain outcomes in children. Specifically, fetal exposure to elevated pCRH levels was associated with thinning of selective cortical regions and with commensurate cognitive and emotional deficits. The relations among fetal exposure to pCRH, cortical thinning, and childhood function were sex specific. CONCLUSIONS: In view of the established effects of CRH on maturation and arborization of cortical neurons, and the major contribution of dendrites to cortical volume, these findings position pCRH as an important mediator of the consequences of early-life adversity on neuropsychiatric outcomes.

Distinct patterns of reduced prefrontal and limbic grey matter volume in childhood general and internalizing psychopathology.

Reduced grey matter volume (GMV) is widely implicated in psychopathology, but studies have found mostly overlapping areas of GMV reduction across disorders rather than unique neural signatures, potentially due to pervasive comorbidity. GMV reductions may be associated with broader psychopathology dimensions rather than specific disorders. We used an empirically supported bifactor model consisting of common psychopathology and internalizing- and externalizing-specific factors to evaluate whether latent psychopathology dimensions yield a clearer, more parsimonious pattern of GMV reduction in prefrontal and limbic/paralimbic areas implicated in individual disorders. A community sample of children (n=254, ages 6-10) was used to to evaluate whether GMV reductions could constitute early neural risk factors. The common psychopathology factor was associated with reduced GMV in prefrontal areas (dorsal, orbitofrontal, ventrolateral). The internalizing-specific factor was related to reduced GMV in limbic/paralimbic areas (hippocampus, amygdala, insula). No significant associations were found between GMV and the externalizing-specific factor after accounting for common psychopathology.

Prenatal maternal cortisol concentrations predict neurodevelopment in middle childhood.

Glucocorticoids (cortisol in humans) are the end product of the hypothalamic-pituitary-adrenocortical (HPA) axis and are proposed as a key mechanism for programming fetal brain development. The present prospective longitudinal study evaluates the association between prenatal maternal cortisol concentrations and child neurodevelopment. Participants included a low risk sample of 91 mother-child pairs. Prenatal maternal plasma cortisol concentrations were measured at 19 and 31 gestational weeks. Brain development and cognitive functioning were assessed when children were 6-9 years of age. Structural magnetic resonance imaging scans were acquired and cortical thickness was determined. Child cognitive functioning was evaluated using standardized measures (Wechsler Intelligence Scale for Children IV and Expressive Vocabulary Test, Second Edition). Higher maternal cortisol concentrations during the third trimester were associated with greater child cortical thickness primarily in frontal regions. No significant associations were observed between prenatal maternal cortisol concentrations and child cortical thinning. Elevated third trimester maternal cortisol additionally was associated with enhanced child cognitive performance. Findings in this normative sample of typically developing children suggest that elevated maternal cortisol during late gestation exert lasting benefits for brain development and cognitive functioning 6-9 years later. The benefits of fetal exposure to higher maternal cortisol during the third trimester for child neurodevelopment are consistent with the role cortisol plays in maturation of the human fetus. It is plausible that more extreme elevations in maternal cortisol concentrations late in gestation, as well as exposure to pharmacological levels of synthetic glucocorticoids, may have neurotoxic effects on the developing fetal brain.

Hippocampus and amygdala volumes from magnetic resonance images in children: Assessing accuracy of FreeSurfer and FSL against manual segmentation.

The volumetric quantification of brain structures is of great interest in pediatric populations because it allows the investigation of different factors influencing neurodevelopment. FreeSurfer and FSL both provide frequently used packages for automatic segmentation of brain structures. In this study, we examined the accuracy and consistency of those two automated protocols relative to manual segmentation, commonly considered as the "gold standard" technique, for estimating hippocampus and amygdala volumes in a sample of preadolescent children aged between 6 to 11 years. The volumes obtained with FreeSurfer and FSL-FIRST were evaluated and compared with manual segmentations with respect to volume difference, spatial agreement and between- and within-method correlations. Results highlighted a tendency for both automated techniques to overestimate hippocampus and amygdala volumes, in comparison to manual segmentation. This was more pronounced when using FreeSurfer than FSL-FIRST and, for both techniques, the overestimation was more marked for the amygdala than the hippocampus. Pearson correlations support moderate associations between manual tracing and FreeSurfer for hippocampus (right r=0.69, p<0.001; left r=0.77, p<0.001) and amygdala (right r=0.61, p<0.001; left r=0.67, p<0.001) volumes. Correlation coefficients between manual segmentation and FSL-FIRST were statistically significant (right hippocampus r=0.59, p<0.001; left hippocampus r=0.51, p<0.001; right amygdala r=0.35, p<0.001; left amygdala r=0.31, p<0.001) but were significantly weaker, for all investigated structures. When computing intraclass correlation coefficients between manual tracing and automatic segmentation, all comparisons, except for left hippocampus volume estimated with FreeSurfer, failed to reach 0.70. When looking at each method separately, correlations between left and right hemispheric volumes showed strong associations between bilateral hippocampus and bilateral amygdala volumes when assessed using manual segmentation or FreeSurfer. These correlations were significantly weaker when volumes were assessed with FSL-FIRST. Finally, Bland-Altman plots suggest that the difference between manual and automatic segmentation might be influenced by the volume of the structure, because smaller volumes were associated with larger volume differences between techniques. These results demonstrate that, at least in a pediatric population, the agreement between amygdala and hippocampus volumes obtained with automated FSL-FIRST and FreeSurfer protocols and those obtained with manual segmentation is not strong. Visual inspection by an informed individual and, if necessary, manual correction of automated segmentation outputs are important to ensure validity of volumetric results and interpretation of related findings.

Fetal exposure to maternal depressive symptoms is associated with cortical thickness in late childhood.

BACKGROUND: Maternal depression is one of the most common prenatal complications. The consequences of fetal exposure to maternal depression are poorly understood. The aim of this study is to examine the association between fetal exposure to maternal depressive symptoms and cortical thickness in children 6-9 years old. METHODS: A prospective, longitudinal study of maternal depressive symptoms at 19, 25, and 31 weeks' gestation was followed by acquisition of a structural magnetic resonance imaging scan in 81 children (age, 86.1 ± 9.9 months). RESULTS: Significant (p < .01) cortical thinning in children primarily in the right frontal lobes was associated with exposure to prenatal maternal depression. The strongest association was at 25 weeks' gestation; exposure to maternal depression at 25 gestational weeks was associated with cortical thinning in 19% of the whole cortex and 24% of the frontal lobes, primarily in the right superior, medial orbital, and frontal pole regions of the prefrontal cortex (p < .01). The significant association between prenatal maternal depression and child externalizing behavior (p < .05) was mediated by cortical thinning in prefrontal areas of the right hemisphere. CONCLUSIONS: The pattern of cortical thinning in children exposed to prenatal maternal depression is similar to patterns in depressed patients and in individuals with risk for depression. Exposure to prenatal depression coupled with subsequent cortical thinning was associated with presence of externalizing behavior in preadolescent children and may be prodromal markers of risk for dysphoria. Vulnerability to prenatal influences at 25 gestational weeks may result from the enormous growth and dramatic structural changes in the nervous system.

Shape of the basal ganglia in preadolescent children is associated with cognitive performance.

Current studies support the belief that high levels of performance and intellectual abilities are associated with increased brain size or volume. With few exceptions, this conclusion is restricted to studies of post-adolescent subjects and to cerebral cortex. There is evidence that "bigger is better" may not pertain to children and further, that there are areas of the brain in which larger structures are associated with cognitive deficits. In 50 preadolescent children (21 girls) a structural survey of the brain (VBM) was conducted to determine and locate areas in which gray matter volume was associated with poor cognitive performance. Only increased gray matter volume in particular areas of the basal ganglia and specifically the putamen was significantly associated with poor performance on tests of memory, response speed and a general marker and subtests of intelligence. Based on the VBM findings, volumetric analysis of basal ganglia structures was performed using FSL/FIRST. However, no significant changes in total volume of putamen or other basal ganglia structures were detected with this analysis. The disagreement between measures of localized gray matter differences and volumetric analysis suggested that there might be local regional deformity rather than widespread volumetric changes of the putamen. Surface analysis with FSL/FIRST demonstrated that bilateral outward deformation of the putamen, but especially the left, was associated with poor performance on several cognitive tests. Expansion of the globus pallidus and caudate nucleus also was associated with poor performance. Moreover a significant association was detected between a reliable test of language-free intelligence and topographically distinct outward and inward deformation of the putamen. Expansion and contraction of the putamen as a predictor of intelligence may explain why this association was not observed with measures of total volume. These results suggest that deformity is a sensitive measure of function, and that distortion of the basal ganglia may be a neurophenotype for risk of developmental impairment.

The personal development tutor role: an exploration of student and lecturer experiences and perceptions of that relationship.

This exploratory study formed part of the Leadership in Compassionate Care Programme (LCCP) that considered embedding the principles of person-centred compassionate care within an undergraduate nursing curriculum. Currently, there is a lack of literature regarding compassionate care in relation to the student-personal development tutor (PDT) relationship. The aim of the study was to explore the current personal development tutor role, within a pre-registration adult nursing programme, in relation to the support provided to students by PDTs and from this, establish what was important in the role from the student and lecturer perspectives, within the context of the LCCP. A qualitative approach utmilising participant interviews was employed. Six undergraduate nursing students on a Bachelor of Nursing adult programme and five PDTs participated in the study and Emotional Touchpoint technique was used to elicit participant experiences. Data were analysed using an adapted version of the Senses Framework, originally proposed by Nolan et al. (2006). The results demonstrate the importance that students and their PDTs attach to the relationship and how elements of care arising from the Senses Framework are fundamental to developing and sustaining this relationship. Further, it is apparent that role modelling in relation to care is considered an important element of the PDT role which has relevance to nurse education and practice. In light of these findings a range of strategies are proposed to enhance the PDT relationship by utilising a modified version of the Senses Framework as a model for PDT and student interaction.

Developmental changes in hippocampal shape among preadolescent children.

It is known that the largest developmental changes in the hippocampus take place during the prenatal period and during the first two years of postnatal life. Few studies have been conducted to address the normal developmental trajectory of the hippocampus during childhood. In this study shape analysis was applied to study the normal developing hippocampus in a group of 103 typically developing 6- to 10-year-old preadolescent children. The individual brain was normalized to a template, and then the hippocampus was manually segmented and further divided into the head, body, and tail sub-regions. Three different methods were applied for hippocampal shape analysis: radial distance mapping, surface-based template registration using the robust point matching (RPM) algorithm, and volume-based template registration using the Demons algorithm. All three methods show that the older children have bilateral expanded head segments compared to the younger children. The results analyzed based on radial distance to the centerline were consistent with those analyzed using template-based registration methods. In analyses stratified by sex, it was found that the age-associated anatomical changes were similar in boys and girls, but the age-association was strongest in girls. Total hippocampal volume and sub-regional volumes analyzed using manual segmentation did not show a significant age-association. Our results suggest that shape analysis is sensitive to detect sub-regional differences that are not revealed in volumetric analysis. The three methods presented in this study may be applied in future studies to investigate the normal developmental trajectory of the hippocampus in children. They may be further applied to detect early deviations from the normal developmental trajectory in young children for evaluating susceptibility for psychopathological disorders involving hippocampus.

Fetal glucocorticoid exposure is associated with preadolescent brain development.

BACKGROUND: Glucocorticoids play a critical role in normative regulation of fetal brain development. Exposure to excessive levels may have detrimental consequences and disrupt maturational processes. This may especially be true when synthetic glucocorticoids are administered during the fetal period, as they are to women in preterm labor. This study investigated the consequences for brain development and affective problems of fetal exposure to synthetic glucocorticoids. METHODS: Brain development and affective problems were evaluated in 54 children (56% female), aged 6 to 10, who were full term at birth. Children were recruited into two groups: those with and without fetal exposure to synthetic glucocorticoids. Structural magnetic resonance imaging scans were acquired and cortical thickness was determined. Child affective problems were assessed using the Child Behavior Checklist. RESULTS: Children in the fetal glucocorticoid exposure group showed significant and bilateral cortical thinning. The largest group differences were in the rostral anterior cingulate cortex (rACC). More than 30% of the rACC was thinner among children with fetal glucocorticoid exposure. Furthermore, children with more affective problems had a thinner left rACC. CONCLUSIONS: Fetal exposure to synthetic glucocorticoids has neurologic consequences that persist for at least 6 to 10 years. Children with fetal glucocorticoid exposure had a thinner cortex primarily in the rACC. Our data indicating that the rACC is associated with affective problems in conjunction with evidence that this region is involved in affective disorders raise the possibility that glucocorticoid-associated neurologic changes increase vulnerability to mental health problems.

Development of white matter pathways in typically developing preadolescent children.

The first phase of major neuronal rearrangements in the brain takes place during the prenatal period. While the brain continues maturation throughout childhood, a critical second phase of synaptic overproduction and elimination takes place during the preadolescent period. Despite the importance of this developmental phase, few studies have evaluated neural changes taking place during this period. In this study, MRI diffusion tensor imaging data from a normative sample of 126 preadolescent children (59 girls and 67 boys) between the ages of 6 and 10 years were analyzed in order to characterize age-relationships in the white matter microstructure. Tract Based Spatial Statistics (TBSS) method was used for whole brain analysis of white matter tracts without a priori assumption about the location of age associated differences. Our results demonstrate significant age-associated differences in most of the major fiber tracts bilaterally and along the whole body of the tracts. In contrast, developmental differences in the cingulum at the level of the parahippocampal region were only observed in the right hemisphere. We suggest that these age-relationships with a widespread distribution seen during the preadolescent years maybe relevant for the implementation of cognitive and social behaviors needed for a normal development into adulthood.

Maternal cortisol over the course of pregnancy and subsequent child amygdala and hippocampus volumes and affective problems.

Stress-related variation in the intrauterine milieu may impact brain development and emergent function, with long-term implications in terms of susceptibility for affective disorders. Studies in animals suggest limbic regions in the developing brain are particularly sensitive to exposure to the stress hormone cortisol. However, the nature, magnitude, and time course of these effects have not yet been adequately characterized in humans. A prospective, longitudinal study was conducted in 65 normal, healthy mother-child dyads to examine the association of maternal cortisol in early, mid-, and late gestation with subsequent measures at approximately 7 y age of child amygdala and hippocampus volume and affective problems. After accounting for the effects of potential confounding pre- and postnatal factors, higher maternal cortisol levels in earlier but not later gestation was associated with a larger right amygdala volume in girls (a 1 SD increase in cortisol was associated with a 6.4% increase in right amygdala volume), but not in boys. Moreover, higher maternal cortisol levels in early gestation was associated with more affective problems in girls, and this association was mediated, in part, by amygdala volume. No association between maternal cortisol in pregnancy and child hippocampus volume was observed in either sex. The current findings represent, to the best of our knowledge, the first report linking maternal stress hormone levels in human pregnancy with subsequent child amygdala volume and affect. The results underscore the importance of the intrauterine environment and suggest the origins of neuropsychiatric disorders may have their foundations early in life.

Evaluation of the personal development portfolio in higher education: an explorative study.

Personal Development Profiles (PDPs) have been an important and necessary feature of United Kingdom (UK) Higher Education for more than a decade. There is significant agreement as to their core purpose and their key features are of relevance to higher education institutions internationally, irrespective of whether an equivalent formal system or process is in place. The aim of this exploratory study was to evaluate the use of PDPs within a Child Health Nursing Programme in a UK University, looking at the experiences of both teaching staff and of students coming to the end of their three year programme of study. A convenience sample of final year pre-registration Child Health Nursing students and their lecturers was used for the purposes of this study with mixed methods of collection used to generate the required data. A survey was conducted with questionnaires. Following the analysis of the questionnaires, a discussion group was undertaken with the students. A series of questions was developed to guide this discussion. The structure offered by the system of PDPs evaluated here was seen to offer much in the way of potential value. Staff saw it as offering direction, a tool for discussion and a clear time and reason for meeting their students. Students similarly appreciated the structure it provided, but did describe it as somewhat repetitive. These findings were clearly of use in terms of evaluating this ongoing work, but also offer the potential to inform the work of other educational institutions.

Magnetic resonance imaging demonstrates long-term changes in brain structure in children born preterm and exposed to chorioamnionitis.

OBJECTIVE: We sought to determine if children born preterm and exposed to chorioamnionitis have differences in brain structure measured at 6-10 years of age using magnetic resonance imaging (MRI). STUDY DESIGN: Structural MRI was performed with 11 preterm children (8.5 ± 1.7 years) with chorioamnionitis and 16 preterm children (8.7 ± 1.4 years) without chorioamnionitis. Cortical surface reconstruction and volumetric segmentation were performed with FreeSurfer image analysis software. Subcortical structures were analyzed using multivariate analysis. RESULTS: Widespread regional differences in cortical thickness were observed. With chorioamnionitis, the frontal and temporal lobes were primarily affected by decreased cortical thickness, and the limbic, parietal, and occipital lobes were primarily affected by increased cortical thickness when compared to the comparison group. Subcortical differences were observed in the hippocampus and lateral ventricle. CONCLUSION: Using MRI, chorioamnionitis is associated with longterm widespread regional effects on brain development in children born prematurely. Our study is limited by its small sample size.

Children's Brain Development Benefits from Longer Gestation.

Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.

Cortical and subcortical changes in typically developing preadolescent children.

There is evidence that abnormal cerebral development during childhood is a risk factor for various cognitive and psychiatric disorders. There is not, however, sufficient normative data available on large samples of typically developing children, especially within the narrow preadolescent age range. We analyzed high resolution MRI images from 126 normally developing children between ages 6 and 10 years. Age related differences in cortical thickness and in the volumes of major subcortical structures were assessed. Thinner cortices were observed in the occipital, parietal and somatosensory regions as well as in distinct regions of the temporal and frontal lobes with increasing age. Among the major subcortical structures analyzed in this study, only the thalamus showed increased volume with age after accounting for intracranial volume. Within the age range studied age-related cortical and subcortical differences were similar for boys and girls except for the right insula, where girls showed a slight increase in thickness with age. The findings reveal age-associated changes in brain anatomy, providing information about the trajectory of normal brain development during late childhood.

Analytical techniques for characterization of raw materials in cell culture media.

Raw materials are a critical part of any cell culture medium; therefore, it is of utmost importance to understand and characterize them for high-quality product. The raw material characterization (RMC) program at SAFC focuses on individual screening of raw materials both analytically and biologically. The goal of the program is to develop the best-in-class knowledge base of the raw materials used in SAFC's media formulations and their impact on performance of products.

Gray matter correlates of cognitive ability tests used for vocational guidance.

BACKGROUND: Individual differences in cognitive abilities provide information that is valuable for vocational guidance, but there is an ongoing debate about the role of ability factors, including general intelligence (g), compared to individual tests. Neuroimaging can help identify brain parameters that may account for individual differences in both factors and tests. Here we investigate how eight tests used in vocational guidance correlate to regional gray matter. We compare brain networks identified by using scores for ability factors (general and specific) to those identified by using individual tests to determine whether these relatively broad and narrow approaches yield similar results. FINDINGS: Using MRI and voxel-based morphometry (VBM), we correlated gray matter with independent ability factors (general intelligence, speed of reasoning, numerical, spatial, memory) and individual test scores from a battery of cognitive tests completed by 40 individuals seeking vocational guidance. Patterns of gray matter correlations differed between group ability factors and individual tests. Moreover, tests within the same factor showed qualitatively different brain correlates to some degree. CONCLUSIONS: The psychometric factor structure of cognitive tests can help identify brain networks related to cognitive abilities beyond a general intelligence factor (g). Correlates of individual ability tests with gray matter, however, appear to have some differences from the correlates for group factors.