Clinical Non-adherence and Its Associated Factors Among HIV Positive Pediatrics Attending Care in South Gondar Zone Public Health Facilities, Northwest Ethiopia, 2021

Background: The most important factor in the success of HIV treatment is clinical adherence. Inadequate clinical adherence is one of the factors that affect the adherence level of highly active antiretroviral treatment and its effect on suppressed viral replication. Even though data from different settings are necessary to tackle it, pieces of evidence are limited especially in the case of clinical adherence level of HIV-infected children. Hence, this study aimed to assess clinical non-adherence level and its associated factors among HIV-positive children on HAART. Methods: A multicenter cross-sectional study was conducted from July 1 to August 30, 2021, among HIV-infected children on ART in South Gondar Zone. Data were entered into Epi Data Version 4.6 and analysis was done using Statistical Package for Social Science (SPSS) Version 25. Binary logistic regression was implemented to assess the association of factors against the outcome variable and variables with p-values ≤ 0.25 in the bivariable analysis were entered into the multivariable analysis. Finally, variables with p-values less than 0.05 were considered statistically significant factors.Result-out of 384 study participants, 383 were included in this study with a response rate of 99.7%. Nearly half of the study participants 190(49.6%) were girls. The majority, 291 (76%) of caretakers were biological mothers, and 203(53%) did not have treatment supporters. One hundred seventy-nine (46.7%) of caretakers did not disclose the status of the child about the illness. The overall prevalence of non-adherence among children on ART was 31.9 %( 95% CI: 27.2-36.6). Rural residency, diagnostic status non-disclosure, no adherence supporter, having no biological caretaker and comorbid illness were significantly associated with clinical non-adherence of HIV positive children.Conclusion-clinical non-adherence among children among HIV-positive children attending care in south Gondar zone health institutes is unacceptably high. Being rural residency, diagnostic status non-disclosure, no adherence supporter, having non-biological caretaker, and having comorbid illness were significantly associated with clinical non-adherence. Thus, attention shall be given to successful clinical adherence in HIV-positive children who uses the antiretroviral drug.

Alcohol and Cannabis Use Disorder Symptom Severity, Conduct Disorder, and Callous-Unemotional Traits and Impairment in Expression Recognition

Background: Alcohol and cannabis are commonly used by adolescents in the United States. Both alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with reduced emotion expression recognition ability. However, this work has primarily occurred in adults and has not considered neuro-cognitive risk factors associated with conduct problems that commonly co-occur with, and precede, substance use. Yet, conduct problems are also associated with reduced emotion expression recognition ability. The current study investigated the extent of negative association between AUD and CUD symptom severity and expression recognition ability over and above any association of expression recognition ability with conduct problems [conduct disorder (CD) diagnostic status].Methods: In this study, 152 youths aged 12.5–18 years (56 female; 60 diagnosed with CD) completed a rapid presentation morphed intensity facial expression task to investigate the association between relative severity of AUD/CUD and expression recognition ability.Results: Cannabis use disorder identification test (CUDIT) scores were negatively associated with recognition accuracy for higher intensity (particularly sad and fearful) expressions while CD diagnostic status was independently negatively associated with recognition of sad expressions. Alcohol use disorder identification test (AUDIT) scores were not significantly associated with expression recognition ability.Conclusions: These data indicate that relative severity of CUD and CD diagnostic status are statistically independently associated with reduced expression recognition ability. On the basis of these data, we speculate that increased cannabis use during adolescence may exacerbate a neuro-cognitive risk factor for the emergence of aggression and antisocial behavior.

Measuring the Impact of Bilingualism on Executive Functioning Via Inhibitory Control Abilities in Autistic Children

One factor that may influence how executive functions develop is exposure to more than one language in childhood. This study explored the impact of bilingualism on inhibitory control in autistic (n = 38) and non-autistic children (n = 51). Bilingualism was measured on a continuum of exposure to investigate the effects of language environment on two facets of inhibitory control. Behavioural control of motor impulses was modulated positively through increased bilingual exposure, irrespective of diagnostic status, but bilingual exposure did not significantly affect inhibition involving visual attention. The results partially support the hypothesis that bilingual exposure differentially affects components of inhibitory control and provides important evidence for families that bilingualism is not detrimental to their development.

Camouflaging Intent, First Impressions, and Age of ASC Diagnosis in Autistic Men and Women

Camouflaging of autistic traits may make autism harder to diagnose. The current study evaluated the relations between camouflaging intent, first impressions, and age of autism diagnosis. Participants comprised autistic and non-autistic adults (n = 80, 50% female) who completed the Camouflaging of Autistic Traits Questionnaire. They were later video-recorded having a conversation with a person unaware of their diagnostic status. Ten-second clips from half these videos were later shown to 127 non-autistic peers, who rated their first impressions of each participant. Results showed that autistic participants were rated more poorly on first impressions, males were rated less favourably than females, and male raters were particularly harsh in their evaluations of autistic males. Camouflaging intent did not predict first impressions but better first impressions were linked with a later age of diagnosis.

Does Informant-Based Reporting of Cognitive Decline Correlate with Age-Adjusted Hippocampal Volume in Mild Cognitive Impairment and Alzheimer’s Disease?

Background: Informant-based measures are effective screening tools for cognitive impairment. The Alzheimer’s Questionnaire (AQ) is a subjective, informant-based measure that detects amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) with high sensitivity and specificity and has been shown to predict amyloid burden. Objective: To determine whether informant-based report of cognitive decline correlates with hippocampal volume changes in MCI and AD. Methods: Retrospective chart review of 139 clinically referred patients with clinical diagnoses of aMCI or mild dementia due to AD was conducted. Diagnostic status (clinical diagnosis made by a neurologist), NeuroQuant measured MRI brain with percentile rank hippocampal volume, Montreal Cognitive Assessment (MoCA) total, AQ-Total score, and demographic variables were extracted from medical records. Spearman correlation was used to assess the relationship between hippocampal volume and AQ-Total. The AQ was used to assign diagnostic status. Thus, the relationship between the AQ and diagnostic status was excluded. Results: The sample include 88 female and 51 male participants. The mean age was 74.37±9.45, mean MOCA was 22.65±4.18, mean education was 14.80±3.35, and mean AQ score was 10.54±5.22. Hippocampal volume and the AQ correlation was r = –0.33 [95%CI –0.47 to –0.17], p < 0.0001. Conclusion: In a mixed-clinical sample of patients presenting to an outpatient memory disorders center, higher endorseme-nts of functional impairments by caregivers were significantly associated with smaller hippocampal volumes. When used in conjunction with other available measures, these findings further support the role of the AQ in clinical decision-making and demonstrate an additional relationship between clinical measures and volumetric MRI.