Faculty Bibliography

Building on a narrative synthesis of adoption theories by Wisdom et al. (2013), this review identifies 118 measures associated with the 27 adoption predictors in the synthesis. The distribution of measures is uneven across the predictors and predictors vary in modifiability. Multiple dimensions and definitions of predictors further complicate measurement efforts. For state policymakers and researchers, more effective and integrated measurement can advance the adoption of complex innovations such as evidence-based practices.

As is true in all sensory systems, chemosensory perception reflects not only the external stimulus, but also the internal state and past experiences of the perceiver. This means that perception of stable stimulus input may be highly variable as the perceiver's state (e.g., hunger/satiety, fearful/secure, etc.) and experience with the stimulus (e.g., novel/familiar, expected/unexpected) changes. That is, the same basic sensory circuit may produce different outputs depending on internal state and past experience. These changes in sensory coding and circuit function appear to derive from changes in both neuromodulatory tone and from feedback from higher order, non-sensory circuits. While these processes occur in all sensory systems, they may be particularly relevant in the chemical senses which monitor stimuli relevant to nutrition, reproduction, kin recognition and predator avoidance. This symposium will present new data from both the olfactory (Kay, Mandairon, Sadrian) and gustatory (Fontanini) systems exploring how this internal modulation occurs. The talks will include diverse research techniques primarily in awake animals (e.g., single-unit recordings, local field potential recordings, pharmacological and optogenetic manipulations, novel behavioral assays) which examine the role of neuromodulatory systems as well as inputs to primary sensory regions providing feedback information regarding expectation, memory and hedonics. TEST

Motor development-traditionally described in terms of age-related stages-is typically studied in the laboratory with participants of Western European descent. Cross-cultural studies typically focus on group differences in age-related stages relative to Western norms. We adopted a less traditional approach: We observed 5-month-olds and their mothers from six cultural groups around the world during one hour at home while they engaged in natural daily activities. We examined group differences in infants' sitting proficiency, everyday opportunities to practice sitting, the surfaces on which sitting took place, and mothers' proximity to sitting infants. Infants had opportunities to practice sitting in varied contexts-including ground, infant chairs, and raised surfaces. Proficiency varied considerably within and between cultural groups: 64% of the sample sat only with support from mother or furniture and 36% sat independently. Some infants sat unsupported for 20+ minutes, in some cases so securely that mothers moved beyond arms' reach of their infants even while infants sat on raised surfaces. Our observations of infant sitting across cultures provide new insights into the striking range of ability, varied opportunities for practice, and contextual factors that influence the proficiency of infant motor skills.

OBJECTIVE: We examined the clinical significance of moderate and severe selective eating (SE). Two levels of SE were examined in relation to concurrent psychiatric symptoms and as a risk factor for the emergence of later psychiatric symptoms. Findings are intended to guide health care providers to recognize when SE is a problem worthy of intervention. METHODS: A population cohort sample of 917 children aged 24 to 71 months and designated caregivers were recruited via primary care practices at a major medical center in the Southeast as part of an epidemiologic study of preschool anxiety. Caregivers were administered structured diagnostic interviews (the Preschool Age Psychiatric Assessment) regarding the child's eating and related self-regulatory capacities, psychiatric symptoms, functioning, and home environment variables. A subset of 188 dyads were assessed a second time approximately 24.7 months from the initial assessment. RESULTS: Both moderate and severe levels of SE were associated with psychopathological symptoms (anxiety, depression, attention-deficit/hyperactivity disorder) both concurrently and prospectively. However, the severity of psychopathological symptoms worsened as SE became more severe. Impairment in family functioning was reported at both levels of SE, as was sensory sensitivity in domains outside of food and the experience of food aversion. CONCLUSIONS: Findings suggest that health care providers should intervene at even moderate levels of SE. SE associated with impairment in function should now be diagnosed as avoidant/restrictive food intake disorder, an eating disorder that encapsulates maladaptive food restriction, which is new to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Prior studies report that 9-27% of persons receiving a hematopoietic cell transplant develop arrhythmias, but the effect on outcomes is largely unknown. We reviewed data from 1177 consecutive patients 40 years old receiving a hematopoietic cell transplant at one center during 1999-2009. Transplant indication was predominately leukemia, lymphoma and multiple myeloma. Overall, 104 patients were found to have clinically significant arrhythmia: 43 before and 61 after transplant. Post-transplant arrhythmias were most frequently atrial fibrillation (N=30), atrial flutter (N=7) and supraventricular tachycardia (N=11). Subjects with an arrhythmia post transplant were more likely to have longer median hospital stays (32 days vs 23, P=<0.001), a greater probability of an intensive care unit admission (52% vs 7%; P<0.001), greater probability of in-hospital deaths (28% vs 3%, P<0.001), and greater probability of death within 1 year of transplant (41% vs 15%; P<0.001) compared with patients without arrhythmia at any time. In a multivariate model including age at transplant, diagnosis, history of pretransplant arrhythmia, and transplant-related variables, post-transplant arrhythmia was associated with a greater risk for death within a year of transplant (odds ratio 3.5, 95% confidence interval: 2.1, 5.9; P<0.001). Our data suggest that arrhythmias after transplants are associated with significant morbidity and mortality. A prospective study of arrhythmia in the transplant setting is warranted.

Visual exploration in infants and adults has been studied using two very different paradigms: free viewing of flat screen displays in desk-mounted eye-tracking studies and real-world visual guidance of action in head-mounted eye-tracking studies. To test whether classic findings from screen-based studies generalize to real-world visual exploration and to compare natural visual exploration in infants and adults, we tested observers in a new paradigm that combines critical aspects of both previous techniques: free viewing during real-world visual exploration. Mothers and their 9-month-old infants wore head-mounted eye trackers while mothers carried their infants in a forward-facing infant carrier through a series of indoor hallways. Demands for visual guidance of action were minimal in mothers and absent for infants, so both engaged in free viewing while moving through the environment. Similar to screen-based studies, during free viewing in the real world low-level saliency was related to gaze direction. In contrast to screen-based studies, only infants - not adults - were biased to look at people, participants of both ages did not show a classic center bias, and mothers and infants did not display high levels of inter-observer consistency. Results indicate that several aspects of visual exploration of a flat screen display do not generalize to visual exploration in the real world.

Substance use during pregnancy and the postpartum period may have significant implications for both mother and the developing child. However, the neurobiological basis of the impact of substance use on parenting is less well understood. Here, we examined the impact of maternal substance use on cortical gray matter (GM) and white matter (WM) volumes and whether this was associated with individual differences in motivational systems of behavioral activation and inhibition. Mothers were included in the substance-using group if any addictive substance was used during pregnancy and/or in the immediate postpartum period (within 3 months of delivery). GM volume was reduced in substance-using mothers compared to non-substance-using mothers, particularly in frontal brain regions. In substance-using mothers, we also found that frontal GM was negatively correlated with levels of behavioral activation (i.e., the motivation to approach rewarding stimuli). This effect was absent in non-substance-using mothers. Taken together, these findings indicate a reduction in GM volume is associated with substance use and that frontal GM volumetric differences may be related to approach motivation in substance-using mothers.

BACKGROUND: Preschool hyperactivity is an early risk factor for adult mental health problems and criminality. Little is known about; (a) the patterns of long-term service costs associated with this behavioural marker in the general population and (b) the specific factors predicting hyperactivity-related costs. We undertook a prospective study investigating associations between preschool hyperactivity and average individual annual service costs up to late adolescent and young adulthood. METHODS: One-hundred and seventy individuals rated as hyperactive by their parents and 88 nonhyperactive controls were identified from a community sample of 4,215 three years olds. Baseline information about behaviour/emotional problems and background characteristics were collected. At follow-up (when individuals were aged between 14 and 25 years) information was obtained on service use, and associated costs since the age of three. Based on this information we calculated the average cost per annum incurred by each individual. RESULTS: Compared to controls, preschoolers with hyperactivity had 17.6 times higher average costs per annum across domains (apart from nonmental health costs). These were pound562 for each hyperactive individual compared with pound30 for controls. Average annual costs decreased as a function of age, with higher costs incurred at younger ages. The effects of hyperactivity remained significant when other baseline factors were added to the model. Effects were fully mediated by later psychiatric morbidity. When the hyperactive group were examined separately, costs were consistently predicted by male gender and, for some cost codes, by conduct problems. CONCLUSIONS: Preventative approaches targeting early hyperactivity may be of value. Services should be targeted towards high-risk individuals with careful consideration given to the cost-to-benefit trade-off of early intervention strategies.