Most research on irritability and child psychopathology has focused on depressive disorders, bipolar disorder, and/or oppositional defiant disorder (ODD). Less is known about relationships between ...child anxiety and irritability and moderators of such associations.
Structural equation modeling (SEM) was used to examine associations between anxiety severity and irritability in a large sample of treatment-seeking youth with anxiety disorders (N = 663, aged 7-19 years, mean = 12.25 years), after accounting for comorbid depressive disorders and ODD. Additional analyses examined whether associations were moderated by child gender, age, and generalized anxiety disorder (GAD) status.
There was a direct link between child anxiety and irritability even after accounting for comorbid depressive disorders and ODD. Links between child anxiety and irritability were robust across child gender and age. Furthermore, relationships between child anxiety and irritability were comparable across youth with and without GAD, suggesting that the anxiety-irritability link is relevant across child anxiety disorders and not confined to youth with GAD.
Findings add to an increasing body of evidence linking child irritability to a range of internalizing and externalizing psychopathologies, and suggest that child anxiety assessment should systematically incorporate irritability evaluations. Moreover, youth in clinical settings displaying irritability should be assessed for the presence of anxiety. Treatments for childhood anxiety may do well to incorporate new treatment modules as needed that specifically target problems of irritability.
Abstract Objectives Nearly 65% to 70% of pregnant women in the United States experience one or more stressful life events (SLEs), which can lead to adverse maternal and/or fetal outcomes. This study ...aimed to identify groups of women with similar patterns of antenatal SLE experiences, and to examine their sociodemographic correlates. Methods Data from the 2009 to 2011 Pregnancy Risk Assessment Monitoring System were used and latent class analysis performed ( N = 115,704) to identify unobserved class membership. The relative likelihood of membership in each latent class was explored using multinomial logistic regression. Results A three-class model was the most appropriate, with the majority (64%) in low-stress class. The illness/death related-stress class (13%) had a high prevalence of illness (77%) and death (63%) of someone close or a family member, whereas those in the multiple stressors (22%) class endorsed most other SLEs. Unmarried and lowest poverty women were, respectively, more (adjusted odds ratio, 2.36; 95% confidence interval, 2.12–2.62) and less likely (adjusted odds ratio, 0.09; 95% confidence interval, 0.07–0.11) to be in the multiple stressors class. The highest prevalence of severe pregnancy-associated nausea/vomiting, preterm labor, and postpartum depression was in the multiple stress class, followed by illness/death, and low-stress classes. Conclusions That one out of every five and one out of every eight women were in the multiple stressors and illness/death related-stress classes, respectively, suggests that antenatal SLEs are common. The greater likelihood of adverse maternal health outcomes in both the illness/death stress and the multiple stressors classes suggests the importance of screening for these SLEs and providing support to pregnant women.
Advanced age is a recognized prognostic indicator of poor outcome after subarachnoid hemorrhage (SAH). The relationship of age to other prognostic factors and outcome was evaluated using data from ...the multicenter randomized trial of nicardipine in SAH conducted in 21 neurosurgical centers in North America. Among the 906 patients who were studied, five different age groups were considered: 40 years or less, 41 to 50, 51 to 60, 61 to 70, and more than 71 years. Twenty-three percent of the individuals enrolled were older than 60 years of age. Women outnumbered men in all age groups. Level of consciousness (p = 0.0002) and World Federation of Neurological Surgeons grade (p = 0.0001) at admission worsened with advancing age. Age was also related to the presence of a thick subarachnoid clot (p = 0.0001), intraventricular hemorrhage (p = 0.0003), and hydrocephalus (p = 0.0001) on an admission computerized tomography scan. The rebleeding rate increased from 4.5% in the youngest age group to 16.4% in patients more than 70 years of age (p = 0.002). As expected, preexisting medical conditions, such as diabetes (p = 0.028), hypertension (p = 0.0001), and pulmonary (p = 0.0084), myocardial (p = 0.0001), and cerebrovascular diseases (p = 0.0001), were positively associated with age. There were no age-related differences in the day of admission following SAH, timing of the surgery and/or location, and size (small vs. large) of the ruptured aneurysm. During the treatment period, the incidence of severe complications (that is, those complications considered life threatening by the reporting investigator) increased with advancing age, occurring in 28%, 33%, 36%, 40%, and 46% of the patients in each advancing age group, respectively (p = 0.0002). No differences were observed in the reported frequency of surgical complications. No age-related differences were found in the overall incidence of angiographic vasospasm; however, symptomatic vasospasm was more frequently reported in the older age groups (p = 0.01). Overall outcome, assessed using the Glasgow Outcome Scale at 3 months post-SAH, was poorer with advancing age (p < 0.001). Multivariate analysis of overall outcome, adjusting for the different prognostic factors, did not remove the age effect, which suggests that the aging brain has a less optimal response to the initial bleeding. Age as a risk factor is a continuum; however, there seems to be a significant increased risk of poor outcome after the age of 60 years.
Previous research has documented that deviant peer affiliation (DP) and externalizing behavior problems (EXT) are highly related and often co-occur. However, the directionality of the association ...between DP and EXT remains debatable. In addition, few studies have examined the longitudinal effects of child maltreatment types on co-development of DP and EXT overtime. Therefore, this study examined the role of child maltreatment in predicting the co-development of DP and EXT.
DP and EXT were assessed at ages 12, 14, and 16. DP was measured using 13 items from the modified version of the Youth Risk Behavior and Monitoring the Future Survey. EXT was measured using the Child Behavior Checklist. Each type of child maltreatment (birth to age 12) was assessed using the CPS substantiated cases.
The results indicated that, on average, DP increased over time, whereas EXT decreased over time. In addition, the initial levels of EXT were associated with the slope of DP. Conditional parallel-process latent growth curve modeling identified that physically abused adolescents had higher initial levels of DP and showed a slower increase in DP, while those who had been emotionally abused were associated with a steeper decrease in EXT.
The findings offer several meaningful implications for practice. First, early assessment of and treatment for EXT may be helpful in preventing DP over time. In addition, practitioners could assess each type of maltreatment to tailor preventive interventions for early onset and ongoing development of DP and EXT.
Gluon jets are identified in hadronic Z decays as all the particles in a hemisphere opposite to a hemisphere containing two tagged quark jets. Gluon jets defined in this manner are equivalent to ...gluon jets produced from a color singlet point source and thus correspond to the definition employed for most theoretical calculations. In a separate stage of the analysis, we select quark jets in a manner to correspond to calculations, as the particles in hemispheres of flavor tagged light quark (uds) events. We present the distributions of rapidity, scaled energy, the logarithm of the momentum, and transverse momentum with respect to the jet axes, for charged particles in these gluon and quark jets. We also examine the charged particle multiplicity distributions of the jets in restricted intervals of rapidity. For soft particles at large , we observe the charged particle multiplicity ratio of gluon to quark jets to be , in agreement with the prediction that this ratio should approximately equal the ratio of QCD color factors, . The intervals used to define soft particles and large for this result, GeV/ and GeV/, are motivated by the predictions of the Herwig Monte Carlo multihadronic event generator. Additionally, our gluon jet data allow a sensitive test of the phenomenon of non-leading QCD terms known as color reconnection. We test the model of color reconnection implemented in the Ariadne Monte Carlo multihadronic event generator and find it to be disfavored by our data.
Female gender is a recognized risk factor for the occurrence of aneurysmal subarachnoid hemorrhage. In the present study the authors analyzed differences in admission characteristics and outcome ...between 578 women (64%) and 328 men (36%) who were enrolled in a recently completed clinical trial. The female-to-male ratio was nearly 2:1. The women in the study were older than the men (mean age 51.4 years vs 47.3 years, respectively, p<0.001). Female patients harbored aneurysms of the internal carotid artery more frequently than male patients (36.8% vs. 18.0%, p<0.001) and more often had multiple aneurysms (32.4% vs. 17.6%, p<0.001). On the other hand, anterior cerebral artery aneurysms were more commonly encountered in men (46.1% in men vs. 26.6% in women, p<0.001). Other baseline prognostic factors were balanced between the gender groups. Surgery was performed equally in both sexes (98%), although the time to operation was shorter for women (mean 3.6 days for women vs. 5.3 days for men, p = 0.0002). In the placebo group, the occurrence of vasospasm was not statistically different between the two groups. Primary causes of death and disability were the same, and favorable outcome rates at 3 months were not statistically different between the genders (69.7% for women vs. 73.4% for men, p = 0.243). The odds of a favorable outcome in women versus one in men were not statistically significant either before of after adjustment for age. These observations lead the authors to suggest that although women are older and harbor more aneurysms, the 3-month outcome for women and men who experience aneurysmal subarachnoid hemorrhage is the same.
Because of their action as cerebral vasodilators, dihydropyridine calcium antagonists have received intense scrutiny for their potential benefit in ameliorating the devastating consequences of ...delayed cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH). From October, 1987, to September, 1989, 41 North American neurosurgical centers in the Cooperative Aneurysm Study accrued 906 patients with recent (Days 0 to 7) aneurysmal SAH into a prospective randomized double-blind placebo-controlled trial of high-dose intravenous nicardipine to test whether treatment with this agent improved overall outcome. Eligible patients received 0.15 mg/kg/hr of either nicardipine or placebo by continuous infusion for up to 14 days following hemorrhage. The 449 patients randomly assigned to the nicardipine-treated group and the 457 patients assigned to the placebo-treated group were balanced with regard to prognostic factors for ischemic deficits from vasospasm and for overall outcome. Other medical and surgical interventions were used with similar frequency in both groups, except that antihypertensive agents were used less frequently in the nicardipine-treated patients (26% of the nicardipine-treated group vs. 43% of the placebo-treated group, p < 0.001), and more patients in the placebo-treated group had intentional hypervolemia, induced hypertension, and/or hemodilution administered therapeutically for symptomatic vasospasm (38% of the placebo-treated group vs. 25% of the nicardipine-treated group, p < 0.001). The incidence of symptomatic vasospasm during the treatment period was higher in the placebo-treated group (46%) than in the nicardipine-treated group (32%) (p < 0.001). Despite the reduction in symptomatic vasospasm in the nicardipine-treated group, overall outcome at 3 months was similar between the two groups. Fifty-five percent of nicardipine-treated patients were rated as having a good recovery according to the Glasgow Outcome Scale at follow-up review and 17% were dead, compared to 56% and 18%, respectively, in the placebo-treated group (not statistically significant). These data suggest that high-dose intravenous nicardipine treatment is associated with a reduced incidence of symptomatic vasospasm in patients with recent aneurysmal SAH, but not with an improvement in overall outcome at 3 months when compared to standard management in North America. It is postulated that, while nicardipine prevents vasospasm, hypertensive/hypervolemic therapy may be effective in reversing ischemic deficits from vasospasm once they occur.
Abstract
Introduction
Sleep duration has been associated with adverse health outcomes. However, few studies have investigated sleep duration trends over time and how these relate to race, income, ...education, and other factors. We investigated sleep duration trends from 2005 through 2014, inclusive, in the U.S.
Methods
A time trend analysis of self-reported sleep duration (hours) was performed in 30,238 adults (18–85 years) with National Health and Nutrition Examination Survey 2005–2014 data. Trend analyses were performed to evaluate the time trend of sleep duration for the following variables: sleep duration categorized as shorter (<7), normal (7-<9), longer (≥9) hours; sex, race, weight (underweight, normal weight, overweight, obese), income (low, medium, high), education (<high school (HS), HS, some college or graduate), age (18–44, 45–64, ≥65 years) and smoking (current vs. nonsmokers). Average sleep durations for these sub-populations were also examined. Given the complex survey design, sample weights were adjusted to produce accurate population estimates.
Results
From 2005 through 2014, average adult sleep duration was 6 hours 54 minutes. Significantly increased trends (P≤0.05) were found overall and in shorter sleepers, males, African-Americans (AA), those ≥65 years, those with low income, in high school graduates, and in overweight individuals. Average sleep durations’ significant (P≤0.05) patterns were as follows: females > whites; whites > other races (Mexican, other) > AA; aged ≥65 > 18–44 > 45–64 years; higher income > middle and low income; college or some college > high school or less; underweight > normal > overweight > obese; and non-smokers > smokers.
Conclusion
From 2005–2014, significantly increased sleep duration trends were found in the U.S. population overall and among shorter sleepers. Over nine years, males, African Americans, those with less than or high school education, low and middle income, and overweight populations demonstrated less average sleep, vis-a-vis their respective comparison groups, yet increased sleep duration trends, indicating time trends should be considered in analyses and interpretations of sleep duration data. Adults aged ≥65 years slept more on average and showed an increased sleep duration trend during this period.
Support (If Any):
This final analysis of hadronic and leptonic cross-sections and of leptonic forward-backward asymmetries in \({\mathrme}^+{\mathrme}^-\) collisions with the OPAL detector makes use of the full LEP 1 ...data sample comprising \(161 \mathrm{pb}^{-1}\) of integrated luminosity and \(4.5\times10^6\) selected Z decays. An interpretation of the data in terms of contributions from pure Z exchange and from \(\gamma/\)Z interference allows the parameters of the Z resonance to be determined in a model-independent way. Our results are in good agreement with lepton universality and consistent with the vector and axial-vector couplings predicted in the Standard Model. A fit to the complete dataset yields the fundamental Z resonance parameters: \(m_{\mathrm{Z}} = (91.1852 \pm 0.0030)\) GeV, \(\Gamma_{\mathrm{Z}} = (2.4948 \pm 0.0041)\) GeV, \(\sigma^0_{\mathrm{h}} = (41.501 \pm 0.055)\) nb, \(R_{\ell} = 20.823 \pm 0.044\), and \(A_{\mathrm{FB}}^{0,\ell} = 0.0145 \pm 0.0017\). Transforming these parameters gives a measurement of the ratio between the decay width into invisible particles and the width to a single species of charged lepton, \(\Gamma_{\mathrm{inv}}/\Gamma_{\ell\ell} = 5.942 \pm 0.027\). Attributing the entire invisible width to neutrino decays and assuming the Standard Model couplings for neutrinos, this translates into a measurement of the effective number of light neutrino species, \(N_{\nu} = 2.984 \pm 0.013\). Interpreting the data within the context of the Standard Model allows the mass of the top quark, \(m_{\mathrm{t}} = (162 ^{+29}_{-16})\) GeV, to be determined through its influence on radiative corrections. Alternatively, utilising the direct external measurement of \(m_{\mathrm{t}}\) as an additional constraint leads to a measurement of the strong coupling constant and the mass of the Higgs boson: \(\alpha_{\mathrm{s}}(m_{\mathrm{Z}}) = 0.127 \pm 0.005\) and \(m_{\mathrm{H}} = (390^{+750}_{-280})\) GeV.
Cross-sections for hadronic, and lepton pair final states in collisions at =183 GeV, measured with the OPAL detector at LEP, are presented and compared with the predictions of the Standard Model. ...Forward-backward asymmetries for the leptonic final states have also been measured. Cross-sections and asymmetries are also presented for data recorded in 1997 at =130 and 136 GeV. The results are used to measure the energy dependence of the electromagnetic coupling constant , and to place limits on new physics as described by four-fermion contact interactions or by the exchange of a new heavy particle such as a leptoquark, or of a squark or sneutrino in supersymmetric theories with R-parity violation.
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