Characterization of Neurological Complications Among Children with Sickle Cell Disease in the United States: Findings from the 2007-2018 National Health Interview Survey (NHIS)

Background: In the United States , sickle cell disease (SCD), affects about 100,000 individuals, with roughly 2,000 babies born annually with SCD. African Americans are disproportionately affected by SCD. In addition to medical conditions, psychosocial and affective comorbidities are also observed in relation to the frequency and intensity of pain crises. Evidence also suggests robust academic challenges that begin in elementary school and persist until high school. It is estimated that about 25% to 33% of children with SCD experience neurodevelopmental complications. Neurological complications lead to cognitive deficits and educational challenges. African Americans and those with low socioeconomic status are affected the most by neurological complications. Among Children with SCD, data suggest that specialized school service utilization rates are about 37%, and grade retention ranges from 28% to 40%. We used the 2007-2018 NHIS to describe additional neurocognitive impairments and health services used among Black children aged 0-17 years with SCD and place findings into context. Methods: Data was acquired from the NHIS database. The study included an unweighted sample of 133,542 children, with 68,745 male children and 64,797 female children. Questionnaires were answered by a parent/guardian on behalf of the child. We examined (1) the prevalence of neurological conditions; (2) indicators of functional status and perceived health status; (3) use of healthcare and special educational services; (4) barriers to accessing healthcare services for a national sample of children with SCD; (5) Association of the comorbidities with the utilization of care. We hypothesized that black children with SCD would have higher levels of disease-related complications and comorbidities, as well as healthcare utilization than their counterparts without SCD. We used logistic regression to compare the associations between SCD and No SCD on various neurological conditions for all races and for Black children only groups. Results: Of the 133,542 children, 215 have SCD (.16%). Among the SCD children, 51.1% are male, 170 (79.1%) are Black, 16 (7.44%) are White, 1(.47%) are American Indian, 2 (.93%) are Asian, 21 (9.77%) are other races, and 5 (2.33%) are of Multiple Races. Among all races, Black children had a higher prevalence of SCD than other races. Black children with SCD had a higher predominance of girls than did those without SCD. They were also more likely than their counterparts without SCD to have a household income < 1% of the federal poverty levels. After applying the appropriate weights to each of the demographics, Children with SCD had higher odds of having a developmental condition such as: learning disability (Adjusted odds ratio -AOR 1.5; CI: .7, 3.5: p=0.311), intellectual disability (AOR 4.2; CI: 1.3, 13.3: p=0.014), trouble hearing (AOR 2.6; CI: 1.1, 6.1: p=0.026), trouble seeing (AOR 2.3; CI: 1.0, 5.3: p=0.061) and another developmental delay (AOR .8; CI: .1, 6.2: p=0.838). We see similar results in the Black children only sample where Black children with SCD were more likely to have a learning disability (AOR 1.3; CI: .5, 3.2; p=0.590), intellectual disability (AOR 2.4; CI: .6, 10.2: p=0.236), trouble hearing (AOR 1.6; CI: .6, 4.1: p=0.310) or trouble seeing (AOR 2.3; CI: 1.0, 5.4; p=0.048). They also exhibit other developmental delays (AOR 1.9; CI: .2, 22.4: p=0.625), although not statistically significant. Conclusion: In this study sample, it is clear that children with SCD had higher odds of having a developmental condition and in addition Black children with SCD also have a comparable odd of developing neurological complications compared to children with SCD of other races. A similar pattern was identified that Black children with SCD reported increased utilization of healthcare and special education services in the past 12 months. This creates the urgency to address the health burden for Black children with SCD that has been exaggerated by barriers to accessing comprehensive health care. Studies that further assess Black children's health burden with SCD, its neurocognitive impairment and healthcare utilization is crucial. Disclosures No relevant conflicts of interest to declare.

Hubungan psychological capital dengan komitmen organisasi pada aparatur sipil negara

Organizational commitment is the willingness of members to have a relationship with the organization. High organizational commitment will lead to high on aspects like performance, discipline and achievement. A positive psychological state must be possessed because it can affect organizational commitment. Psychological capital is a developmental condition of a person’s positive psychological state and the emergence of self-efficacy, hope, resilience, and optimism so that it is related to organizational commitment. The purpose of the study was to determine the relationship between psychological capital and organizational commitment in ASN samples. Quantitative research in design and the data gathered from 125 ASN participants with at least one year of working experience in an organization or agency. Data were collected using psychological capital (PCQ) and organizational commitment scale (OCQ). Hypothesis testing was carried out with Pearson’s product moment correlation using SPSS. The results showed that there was a positive relationship between psychological capital and organizational commitment in state civil apparatus (r=0.87, p=0.000). It means the higher the psychological capital, the higher the organizational commitment. Keywords: Organizational commitment, psychological capital, state civil apparatus

An evaluation of the online post-diagnostic groups facilitated by the autism spectrum condition service at Gloucestershire Health and Care NHS

Purpose Autism spectrum condition (ASC) is a lifelong developmental condition. According to research, it is recommended that those diagnosed with ASC should be offered post-diagnosis support to explore their diagnosis (Punshow, Skirrow and Murphy, 2009). The ASC Diagnostic Assessment Service at Gloucestershire Health Care (GHC) NHS Foundation Trust offers an assessment service to adults (18+) located within Gloucestershire. All those who receive a diagnosis are then invited to a 7-week post-diagnostic group facilitated by the multidisciplinary team. This service evaluation aimed to evaluate the aforementioned group so that it can be improved upon and thus provide a better service for future clients. Design/methodology/approach In total, 14 participants (6 males, 8 females) were interviewed for the purpose of this evaluation following their attendance at these groups. Findings The interview transcripts then underwent thematic analysis with four themes identified; “Autistic Community”, “Experience of Being Part of an Online Group”, “Opportunity for Consolidation”, and “Design Considerations and Improvements”. Further sub-themes were also identified. Overall, the service evaluation identified that the group provided a platform for sharing experiences and gaining a sense of belonging. It also highlighted that individuals have different preferences for whether groups should be facilitated online or face-to-face, and also different preferences for the duration of sessions. Further analysis also revealed the suggestion that the final session, for family and friends, should be optional so that those without a support network, do not need to attend as this caused unease in some. Further findings were also identified. Originality/value To the authors’ knowledge, existing articles have only focused on the evaluation of the availability of post-diagnostic provision and autistic individuals’ general impression of it rather than an in-depth evaluation of a specific type of support.

Improving communication for children with ASD using AAC

Autism spectrum disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person. Autism differs from person to person in severity and combinations of symptoms. There is a great range of abilities and characteristics of children with autism spectrum disorder — no two children appear or behave the same way. Symptoms can range from mild to severe and often change over time .

An elliptical blade is not a true ellipse, but a superellipse–Evidence from two Michelia species

The shape of leaf laminae exhibits considerable diversity and complexity that reflects adaptations to environmental factors such as ambient light and precipitation as well as phyletic legacy. Many leaves appear to be elliptical which may represent a ‘default’ developmental condition. However, whether their geometry truly conforms to the ellipse equation (EE), i.e., (x/a)2 + (y/b)2 = 1, remains conjectural. One alternative is described by the superellipse equation (SE), a generalized version of EE, i.e., |x/a|n +|y/b|n = 1. To test the efficacy of EE versus SE to describe leaf geometry, the leaf shapes of two Michelia species (i.e., M. cavaleriei var. platypetala, and M. maudiae), were investigated using 60 leaves from each species. Analysis shows that the majority of leaves (118 out of 120) had adjusted root-mean-square errors of < 0.05 for the nonlinear fitting of SE to leaf geometry, i.e., the mean absolute deviation from the polar point to leaf marginal points was smaller than 5% of the radius of a hypothesized circle with its area equaling leaf area. The estimates of n for the two species were ˂ 2, indicating that all sampled leaves conformed to SE and not to EE. This study confirms the existence of SE in leaves, linking this to its potential functional advantages, particularly the possible influence of leaf shape on hydraulic conductance.

Childhood Diagnoses in Individuals Diagnosed With Autism in Adulthood

Autism is a developmental condition, where symptoms are expected to occur in childhood, but a significant number of individuals are diagnosed with autism for the first time in adulthood. Here we use the National Danish Patient Registry to investigate diagnoses given in childhood among those that are diagnosed with autism in adulthood (N = 2199). We found that most childhood diagnoses were given after the age of 12, and attention-deficit hyperactivity disorder, affective disorders, anxiety, and stress disorders were the most prevalent childhood diagnoses. However, 69% of males and 61% of females with adult autism diagnoses had not received any of the included diagnoses before the age of 18. In most cases, the late autism diagnosis is therefore unlikely to be explained by either misdiagnosis or diagnostic overshadowing. This result is at odds with the prevailing notion that autistic symptoms tend to diminish with age. Therefore, further research is warranted to examine how early signs of autism may have manifested among these individuals, and how similar they are to autistic people diagnosed earlier in their development. Milder to moderate cases of psychiatric conditions that have been solely treated by family physician or school psychologists may not be fully included in our dataset.

Case Report: Trance in Mental Retardation

BACKGROUND: Mental retardation (MR) is a developmental condition that is associated with significant intellectual and adaptive behavioral limitations, whereas dissociative trance disorder (DTD) is a dissociative condition characterized by a temporary altered state of consciousness formed by one’s culture. Comorbidity between these two disorders has rarely been reported. CASE REPORT: We found a case of MR in a 32-year-old woman, Mrs. S, with a DTD who killed her five children during her trance. CONCLUSION: It was found that there is a relationship between psychosocial stressor factors, trauma, underlying psychiatric conditions, culture, and communication that influence trance conditions. Further research is needed to study and understand more about these disorders and comorbidities.

Behavioural and cognitive mechanisms of Developmental Topographical Disorientation

Individuals affected by Developmental Topographical Disorientation (DTD) get lost on a daily basis, even in the most familiar of surroundings such as their neighbourhood, the building where they have worked for many years, and, in extreme cases, even in their own homes. Individuals with DTD report a lifelong selective inability to orient despite otherwise well-preserved general cognitive functions, and the absence of any acquired brain injury or neurological condition, with general intelligence reported to be within the normal range. To date, the mechanisms underlying such a selective developmental condition remain unknown. Here, we report the findings of a 10-year-long study investigating the behavioural and cognitive mechanisms of DTD in a large sample of 1211 cases. We describe the demographics, heritability pattern, self-reported and objective spatial abilities, and some personality traits of individuals with DTD as compared to a sample of 1624 healthy controls; importantly, we test the specific hypothesis that the presence of DTD is significantly related to the inability of the individuals to form a mental representation of the spatial surroundings (i.e., a cognitive map). We found that individuals with DTD reported relatively greater levels of neuroticism and negative affect, and rated themselves more poorly on self-report measures of memory and imagery skills related to objects, faces, and places. While performing interactive tasks, as a group, the individuals with DTD performed slightly worse on a scene-based perspective-taking task, and, notably struggled to solve tasks that demand the generation and use of a cognitive map. These novel findings help define the phenotype of DTD, and lay the foundation for future studies of the neurological and genetic mechanisms of this lifelong condition.

Systematic review: Epilepsy in sturge weber syndrome

Introduction: Sturge Weber syndrome (SWS) is a rare, non-hereditary, congenital developmental condition. Abnormal embryological development would be the cause of this disease. The intensity of this process and its extension to adjacent tissues are responsible for the variety of expressions of the syndrome. The main characteristics are the presence of a facial spot at birth, known as port wine, and alterations in the central nervous system, like seizures and mental retardation. Objective: o evaluate the available surgical treatments for SWS epilepsy. Methods: The PubMed and LILACS databases were used, using “treatment” as selection criteria. A total of 18 papers selected were organized in a table for statistical analysis. Results: The majority of studies concluded that both clinical and surgical treatments could be effective in the management of SWS epilepsy, although its effectiveness depends on the disease progression. Conclusion: Clinical and surgical methods should be considered in the treatment of SWS epilepsy. An unanswered question that still remains is whether suppression of seizures could prevent future neurological symptoms and cognitive decline.