Who got vaccinated against H1N1 pandemic influenza? A longitudinal study in four U.S. cities

The recent H1N1 pandemic influenza stimulated numerous studies into the attitudes and intentions about the H1N1 vaccine. However, no study has investigated prospective predictors of vaccination behaviour. We conducted a two-wave longitudinal study among residents in four U.S. cities during the course of the H1N1 outbreak, using Internet surveys to assess demographic, cognitive and emotional predictors of H1N1 vaccination behaviour. Surveys were conducted at two time points, before (Time 1) and after (Time 2) the H1N1 vaccine was widely available to the public. Results show that Time 2 vaccination rates, but not Time 1 vaccination intentions, tracked H1N1 prevalence across the four cities. Receipt of seasonal influenza vaccine in the previous year, worry, compliance with recommended interventions, household size and education assessed at Time 1 were significant prospective predictors of vaccination behaviour. Perception of the H1N1 vaccine, social influence and prioritised vaccine recipient status assessed at Time 2 also predicted vaccination behaviour. Critically, worry about H1N1 mediated the effects of both objective risk (prevalence at the city level) and perceived risk on vaccination behaviour. These results suggest that H1N1 vaccination behaviour appropriately reflected objective risk across regions, and worry acted as the mechanism by which vaccination behaviour followed objective risk.     

Assessment of executive functioning in childhood epilepsy: the Tower of London and BRIEF

Children and adolescents with epilepsy are known to demonstrate executive function dysfunction, including working memory deficits and planning deficits. Accordingly, assessing specific executive function skills is important when evaluating these individuals. The present investigation examined the utility of two measures of executive functions-the Tower of London and the Behavioral Rating Inventory of Executive Functioning (BRIEF)-in a pediatric epilepsy sample. Ninety clinically referred children and adolescents with seizures were included. Both the Tower of London and BRIEF identified executive dysfunction in these individuals, but only the Tower of London variables showed significant relations with epilepsy severity variables such as age of epilepsy onset, seizure frequency, number of antiepileptic medications, etc. Further, the Tower of London and BRIEF variables were uncorrelated. Results indicate that objective measures of executive function deficits are more closely related to epilepsy severity but may not predict observable deficits, as reported by parents. Comprehensive evaluation of such deficits, therefore, should include both objective measures as well as subjective ratings from caregivers.     

Attention and social functioning in children with malformations of cortical development and stroke

Attention and social functioning and their interrelationships have not been routinely examined in children with early brain insult (EBI). This study aimed to describe attention and social functioning in children with two types of EBI: malformations of cortical development (MCD) and stroke. Children diagnosed with MCD (n = 14, 6 males) or stroke (n = 14, 8 males) aged 8 to 14 years (M = 12 years 11 months) completed neuropsychological assessments to examine attention processes. Primary caregivers completed a questionnaire to assess executive components of children's attention and teachers completed a questionnaire to measure children's social functioning. Brain scans (MRI or CT) were coded by a pediatric neuroradiologist. Higher rates of impairments in attention and social function were found in children with EBI compared with normative expectations. Children with MCD experienced more global and clinically significant levels of impairment than children with stroke; though impairments were present in both groups. A strong association between executive components of attention and social function was observed. In addition, complex attention processes were associated with social function. The findings emphasize the reciprocity between attention, behavior and social outcomes, and the vulnerability of social function following EBI.     

Trends in Telehealth versus On-site Clinical Genetics Appointments in Manitoba: A Comparative Study

Telehealth involves the use of information and communications technology to deliver health services to patients over distance. Canada is well suited to benefit from telehealth since many individuals live in remote, rural and isolated locations. Manitoba is the easternmost prairie province and MBTelehealth is an active Canadian program that currently has 105 sites in 73 communities. Although studies of patient satisfaction comparing telehealth to on-site clinical visits have been conducted, a comparative study of the types of genetics patients seen via these two modalities has not been performed previously. In this study we: (1) examined the uptake of telehealth in Genetics in Manitoba; (2) contrasted telehealth usage in Genetics with other clinical programs; and (3) performed a comparative study of the types of Genetics referrals seen in 2008 on-site versus via telehealth. Results indicate the uptake of telehealth is increasing and has made genetics outreach clinics unnecessary. The Program of Genetics and Metabolism is consistently one of the top ten utilizers of telehealth within the province. With respect to discipline, chi square analysis revealed the trends were not significantly different for on-site and telehealth encounters, with prenatal referrals being the most common and Hereditary Breast and Ovarian Cancer referrals being the least common. Referrals within each discipline varied depending on the need for fetal assessment and physical examination. Telehealth was utilized regularly for test results sessions across all disciplines.     

Mushroom bodies of the honeybee brain show cell population-specific plasticity in expression of amine-receptor genes

Dopamine and octopamine released in the mushroom bodies of the insect brain play a critical role in the formation of aversive and appetitive memories, respectively. As recent evidence suggests a complex relationship between the effects of these two amines on the output of mushroom body circuits, we compared the expression of dopamine- and octopamine-receptor genes in three major subpopulations of mushroom body intrinsic neurons (Kenyon cells). Using the brain of the honeybee, Apis mellifera, we found that expression of amine-receptor genes differs markedly across Kenyon cell subpopulations. We found, in addition, that levels of expression of these genes change dramatically during the lifetime of the bee and that shifts in expression are cell population-specific. Differential expression of amine-receptor genes in mushroom body neurons and the plasticity that exists at this level are features largely ignored in current models of mushroom body function. However, our results are consistent with the growing body of evidence that short- and long-term olfactory memories form in different regions of the mushroom bodies of the brain and that there is functional compartmentalization of the modulatory inputs to this multifunctional brain center.     

High Behavioral Approach System (BAS) sensitivity, reward responsiveness, and goal-striving predict first onset of bipolar spectrum disorders: a prospective behavioral high-risk design

A prospective, behavioral high-risk design provided a theoretically guided examination of vulnerability to first onset of bipolar spectrum disorder based on the Behavioral Approach System (BAS) model. Adolescents (ages 14-19) at an "age of risk" for bipolar disorder onset were screened on BAS sensitivity by interviewers blind to current symptoms, lifetime history, and family history of psychopathology. Participants were selected with high versus moderate levels of BAS sensitivity and administered a lifetime diagnostic interview. Those with a bipolar spectrum disorder, psychosis, or hypomanic episode with onset prior to the BAS sensitivity assessment were excluded. High BAS (n = 171) and moderate BAS (n = 119) sensitivity participants in the final sample completed baseline measures of symptoms, goal-setting, and reward responsiveness and were followed prospectively with semistructured diagnostic interviews every 6 months. Consistent with the vulnerability hypothesis of the BAS model of bipolar disorder, high BAS participants had a greater likelihood, and shorter time to onset, of bipolar spectrum disorder than moderate BAS participants across an average of 12.8 months of follow-up (12.9% vs. 4.2%), controlling for baseline depressive and hypomanic symptoms, and family history of bipolar disorder. High reward responsiveness on a behavioral task and ambitious goal-striving for popular fame and financial success (but not impulsivity) also predicted first onset of bipolar spectrum disorder controlling for the covariates and BAS risk group, and ambitious goal-striving partially mediated the BAS risk group effect. We discuss implications of the findings for the BAS model of bipolar disorder and early intervention efforts.