Secondary attention-deficit/hyperactivity disorder following perinatal and childhood stroke: impact on cognitive and academic outcomes

This cross-sectional retrospective clinical research study examines a large group of children followed within a pediatric stroke program and a developmental attention-deficit/hyperactivity disorder (ADHD) clinic at the Hospital for Sick Children, between May 2004 and June 2016. All children with a history of stroke who participated in a neuropsychological assessment between the ages of 4 and 18 years were considered for inclusion. From a sample of 275 participants with a history of stroke, 36 children (13.1%) received a diagnosis of secondary ADHD. Children with secondary ADHD were younger at the time of stroke and more likely to be identified as having a presumed perinatal stroke and persistent seizures than children without secondary ADHD diagnoses. There were no differences in pattern of lesion, size, or laterality between children who developed secondary ADHD and those who did not. Children with secondary ADHD had the lowest scores across all cognitive and academic measures compared to children with stroke-only and developmental ADHD. Findings highlight the added risk of receiving a diagnosis of secondary ADHD following pediatric stroke. Implications for future research and directed intervention are discussed.     

Proclaiming and cultivating ‘childlikeness’: a subversive thread in Christian anthropology

If contemporary public discourse struggles with truncated notions of what it means to be human, nowhere is this more obvious than in our discussion and treatment of children. By and large, in our public discourse, we treat children as ‘little adults’ – as consumers, objects of beauty and fashion, career aspirants and sometimes even as sexual beings. By contrast, Jesus put children – as children – at the centre of his project in proclaiming the kingdom of God. He preserved a special place for children in his ministry, and in all three synoptics, he called his followers to ‘childlikeness’. This paper examines a subversive thread in historic theological anthropology. The nature of ‘childlikeness’ is explored and possible ways to cultivate childlikeness for adults are discussed. The notion of childlikeness has been rediscovered in recent times by the ‘Child Theology Movement’, but, in this paper, I wish to examine three linked authors who wrote on ‘childlikeness’ in the 19th and 20th centuries, predating the Child Theology Movement by some decades: George MacDonald, Baron Friedrich von Hügel and Gwendolen Greene.     

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty,Utility, Fairness,and Accountability for Reasonableness

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations.     

Connecting the self to traumatic and positive events: links to identity and well-being

Self-event connections in autobiographical narratives help integrate specific episodes from memory into the life story, which has implications for identity and well-being. Previous research has distinguished differential relations between positive and negative self-event connections to psychological well-being but less research has examined identity. In this study, examining self-event connections in emerging adults’ narratives, 225 participants narrated a traumatic and an intensely positive experience and completed questionnaires assessing identity development and well-being. Participants who described more negative connections to self overall had higher psychological distress and identity distress, compared to those who described fewer negative connections. Participants who described positive connections to the self in traumatic events were more likely to have lower psychological distress, higher post-traumatic growth, and higher identity commitment, whereas positive connections in positive events was related to higher identity exploration and marginally higher post-traumatic growth. These findings contribute to a growing body of literature that suggests linking autobiographical memories to self can have differential effects on identity and well-being depending on the valence of the event and the connections made.     

Likelihood of Attending Treatment for Anxiety Among Veteran Primary Care Patients: Patient Preferences for Treatment Attributes

Anxiety is common, but under-treated, in primary care. Behavioral health providers embedded in primary care can help address this treatment gap. Guidance on anxiety treatment preferences would help inform tailoring of clinical practice and new interventions to be more patient-centered and increase treatment engagement. We surveyed 144 non-treatment seeking Veteran primary care patients (82.6 % male, 85.4 % White, age M = 59.8 years, SD = 13.9) reporting current anxiety symptoms (M = 13.87, SD = 3.66, on the Generalized Anxiety Disorder-7 Questionnaire) on their likelihood of attending anxiety treatment featuring various levels of 11 attributes (modality, type, location, format, provider, visit frequency, visit length, treatment duration, type of psychotherapy, symptom focus, and topic/skill). Participants indicated clear preferences for individual, face-to-face treatment in primary care, occurring once a month for at least 30 min and lasting at least three sessions. They also tended to prefer a stress management approach focused on trouble sleeping or fatigue, but all topics/skills were rated equivalently. For most attributes, the highest rated options were consistent with characteristics of integrated care. Implications for research and practice are discussed.     

Children’s Influence on Their Parent’s Adult Development: Mothers’ and Fathers’ Receptivity to Children’s Requests for Change

This mixed-method study examined parents’ experiences of their children’s influence on parent’s continuing adult development. Mothers and fathers from 30 families were separately interviewed regarding two of their children who were between 8 and 14 years old. Parents reported on recent events when their younger and older child successfully requested that parents change their preferences, attitudes, and personal behaviors. Mothers reported more direct child influence than fathers, and both parents reported that they were more receptive to influence from their older children. Thematic analyses revealed that parents were generally comfortable with child influence and constructed their children as actors and agents. Parents attributed their receptivity to agentic qualities of children’s requests, goals for empowering children, and maintaining their mutual relationship. The findings provided insight into the transactional and relational nature of children’s influence and the direct and indirect impact of children on the adult development of parents.     

A Comparison of the Effects of Ethics Training on International and US Students

As scientific and engineering efforts become increasingly global in nature, the need to understand differences in perceptions of research ethics issues across countries and cultures is imperative. However, investigations into the connection between nationality and ethical decision-making in the sciences have largely generated mixed results. In Study 1 of this paper, a measure of biases and compensatory strategies that could influence ethical decisions was administered. Results from this study indicated that graduate students from the United States and international graduate students studying in the US are prone to different biases. Based on these findings, recommendations are made for developing ethics education interventions to target these decision-making biases. In Study 2, we employed an ethics training intervention based on ethical sensemaking and used a well-established measure of ethical decision-making that more fully captures the content of ethical judgment. Similar to Study 1, the results obtained in this study suggest differences do exist between graduate students from the US and international graduate students in ethical decision-making prior to taking the research ethics training. However, similar effects were observed for both groups following the completion of the ethics training intervention.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Gender Differences in the Construction of Spirituality, Work, Learning, and Community by Baalei Teshuvah

This paper explores the question, “How do Jewish men and women who have become Orthodox (baalei teshuvah) compare in their constructions of spirituality, work, learning, religious practices, and community?” It is based on a qualitative research study that included interviews with 48 baalei teshuvah (24 men, 24 women), two focus groups, and ten key informant interviews. Participants were from the East Coast of the USA. We found the women more affirmative about their spirituality and feelings about community; men identified with these experiences but not the terminology. The men gave more attention to work and to their struggles integrating work and religion. The women expressed excitement about learning whereas the men conveyed self-consciousness over their language and learning deficiencies.