Faculty Bibliography

BACKGROUND: South Africa and Trinidad and Tobago are disproportionately impacted by high rates of HIV/AIDS among adolescents. OBJECTIVE: The article describes the HIV crises in these countries; outlines a community participatory research framework to adapt and deliver family-based prevention; and presents preliminary data from intervention pilots in each setting. METHODS: Adapted interventions were piloted with N = 140 families in South Africa and N=16 families in Trinidad and Tobago to refine recruitment and retention efforts and to assess the adapted interventions' impact on family and risk-related constructs. RESULTS: Both settings reported promising results including high recruitment and retention and favourable pre to post changes in parent/youth frequency and comfort in talking about sensitive subjects, HIV transmission knowledge and attitudes about persons with HIV/AIDS. CONCLUSION: International HIV-prevention alliances are increasing. Such alliances are challenged by trust issues, power-differentials and ideological differences. Recommendations are provided on how some challenges can be overcome.

Discusses the potential roles of parents in cognitive-behavioral therapy (CBT) with anxious youth and how parents can both facilitate and/or impede treatment progress. Parents facilitate the attainment of treatment goals by providing invaluable information regarding the child's level of functioning and assisting the therapist with the development and implementation of treatment components such as exposure tasks. Parental involvement in treatment also gives the therapist an opportunity to more fully assess and address family factors that may be maintaining the child's anxiety. Common challenges encountered with parents that may impede treatment progress include rescuing the child from anxious situations, under- or over-involvement in the treatment process, difficulty setting limits, and the presence of parental psychopathology. Finally, the relevance of developmental level, child gender, diagnosis, and the presence of parental psychopathology to the decision of how and when to include parents in treatment is discussed. (journal abstract)

Following status epilepticus in the rat, dentate granule cell neurogenesis increases greatly, and many of the new neurons appear to develop ectopically, in the hilar region of the hippocampal formation. It has been suggested that the ectopic hilar granule cells could contribute to the spontaneous seizures that ultimately develop after status epilepticus. However, the population has never been quantified, so it is unclear whether it is substantial enough to have a strong influence on epileptogenesis. To quantify this population, the total number of ectopic hilar granule cells was estimated using unbiased stereology at different times after pilocarpine-induced status epilepticus. The number of hilar neurons immunoreactive for Prox-1, a granule-cell-specific marker, was estimated using the optical fractionator method. The results indicate that the size of the hilar ectopic granule cell population after status epilepticus is substantial, and stable over time. Interestingly, the size of the population appears to be correlated with the frequency of behavioral seizures, because animals with more ectopic granule cells in the hilus have more frequent behavioral seizures. The hilar ectopic granule cell population does not appear to vary systematically across the septotemporal axis, although it is associated with an increase in volume of the hilus. The results provide new insight into the potential role of ectopic hilar granule cells in the pilocarpine model of temporal lobe epilepsy

BACKGROUND: This pilot study examined the effectiveness of memantine hydrochloride in improving cognitive functioning and behavioral symptoms in children with pervasive developmental disorders (PDDs). METHOD: Subjects aged 3-12 years inclusive were enrolled in this 8-week, open-label study. Expressive and receptive language, nonverbal IQ, and nonverbal memory measures were administered at baseline and after 8 weeks of treatment with 0.4 mg/kg of memantine hydrochloride. Throughout the study, the Aberrant Behavior Checklist (ABC) was sent in weekly by parents as a measure of behavioral change. RESULTS: Twelve of 14 subjects completed the study. Significant improvement from baseline was noted on the memory test (Children's Memory Scale Dot Learning Subtest). There were no significant differences from baseline on measures of expressive or receptive language or nonverbal IQ. There were significant improvements on a number of ABC subscales, including hyperactivity, lethargy, and irritability. There were no overall significant statistical differences from baseline on the Clinical Global Improvement-Severity (CGI-S) scale. On the Clinical Global Improvement-Improvement (CGI-I), 4 of 14 subjects showed minimal improvement, and none was deemed 'much-improved' or 'very much improved.' CONCLUSIONS: This small, prospective, open-label study suggests that memantine may be useful in the treatment of memory functioning and some behavioral symptoms in PDDs. The investigators did not see the same degree of change as endorsed by caretakers. Controlled studies are needed to substantiate and clarify these preliminary findings

This case study illustrates one successful outcome of an intensive, outpatient, treatment project for adolescents with mood disorders. An 18-year-old female with symptoms across several DSM-IV Axis I classifications, including a depressive disorder, and her parents participated in a year-long, multimodal intervention that included mood-focused psychoeducation and coaching designed to impact on her, her family, school, and community systems. Self-report, clinician-driven, and ecologically valid measures were used to assess treatment effects on psychiatric symptoms and psychosocial functioning. Results on the Child and Adolescent Functional Assessment Scale demonstrated considerable gains in the following areas: Home, school/work, social behavior, self-harm, thinking/communication, and substance use. During the intervention, she went from failing several of her classes to graduating from high school. In addition, she made the Honours' List in her first semester at a local community college. A discussion of intervention pluses and pitfalls specific to the case highlight the necessity to influence the various spheres of the young person's life

The leptin hormone is critical for normal food intake and metabolism. While leptin receptor (Lepr) function has been well studied in the hypothalamus, the functional relevance of Lepr expression in the ventral tegmental area (VTA) has not been investigated. The VTA contains dopamine neurons that are important in modulating motivated behavior, addiction, and reward. Here, we show that VTA dopamine neurons express Lepr mRNA and respond to leptin with activation of an intracellular JAK-STAT pathway and a reduction in firing rate. Direct administration of leptin to the VTA caused decreased food intake while long-term RNAi-mediated knockdown of Lepr in the VTA led to increased food intake, locomotor activity, and sensitivity to highly palatable food. These data support a critical role for VTA Lepr in regulating feeding behavior and provide functional evidence for direct action of a peripheral metabolic signal on VTA dopamine neurons.

Catatonia is a common syndrome that was first described in the literature by Karl Kahlbaum in 1874. The literature is still developing and remains unclear on many issues, especially classification, diagnosis, and pathophysiology. Clinicians caring for psychiatric patients with catatonic syndromes continue to face many dilemmas in diagnosis and treatment. We discuss many of the common problems encountered in the care of a catatonic patient, and discuss each problem with a review of the literature. Focus is on practical aspects of classification, epidemiology, differential diagnosis, treatment, medical comorbidity, cognition, emotion, prognosis, and areas for future research in catatonic syndromes

The purpose of this article is to provide easily accessible readability information for 49 parent- and 35 child- and adolescent-report measures commonly used by clinicians and researchers. There is a great deal of variability in reading ability required across measures. The majority of parent-report measures (65%) required reading ability above the 8th grade level. The average child-/adolescent-report measure required reading ability above the 6th grade level. Given the potential contribution of readability to a measure's reliability, validity, and overall utility, examining and accounting for readability should be a more common practice in test construction and administration.