Predictors of Functional Impairment in Bipolar Disorder: Results From 13 Cohorts From Seven Countries by the Global Bipolar Cohort Collaborative.

Objectives: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD.

Methods: Thirteen cohorts from 7 countries included = 5882 individuals with BD across multiple sites.

Interpersonal Factors, Peer Relationship Stressors, and Gender Differences in Adolescent Depression.

Purpose Of Review: Compared to boys, girls value close relationships more. Thus, heightened affiliative proclivities may serve as a particularly salient psychosocial risk factor for depression in adolescent girls. The purpose of this review is to examine whether the preponderance of depression in girls is because of gender differences in interpersonal vulnerabilities and peer relationship stressors and/or in the associations between these factors and depression.

Parental recommendations and exercise attitudes in congenital hearts.

Background: Children and young people with CHD benefit from regular physical activity. Parents are reported as facilitators and barriers to their children's physical activity. The aim of this study was to explore parental factors, child factors, and their clinical experience on physical activity participation in young people with CHD.

Electronic Health Record Adolescent Confidentiality in a Safety Net Setting.

Background: The 21st Century Cures Act provides improved access to one's medical record but presents new challenges to adolescent confidentiality in the domain of health care information technology. Adolescent patients, who have the right to confidential care in certain areas as dictated by state law, face the prospect of parents and guardians erroneously accessing their confidential health information.

Objectives: Our institution, the largest safety net hospital in our region, sought to quantify the proportion of adolescent patient portal accounts likely being accessed by guardians and to implement corrective measures for the patient portal sign-up process in our electronic health record (EHR) system.

Oral glucose tolerance test to diagnose gestational diabetes mellitus: Impact of variations in specimen handling.

To improve birth outcomes, all pregnant women without known diabetes are recommended for an oral glucose tolerance test (OGTT) to screen for hyperglycaemia in pregnancy (diabetes in pregnancy or gestational diabetes mellitus (GDM)). This narrative review presents contemporary approaches to minimise preanalytical glycolysis in OGTT samples with a focus on GDM diagnosis using criteria derived from the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. The challenges of implementing each approach across a diverse Australian healthcare setting were explored.

Troponins in myocardial infarction and injury.

Troponins are proteins that are integral components of the contractile mechanism of muscle, including cardiac muscle. Cardiac troponins Iand T can be detected in the blood of most people after puberty, at concentrations reflecting cardiac mass, sex and age. Current laboratory assays are approximately 1000 times more sensitive than those used previously.

The intra-individual variation of cardiac troponin I: the effects of sex, age, climatic season, and time between samples.

Objectives: Knowing the intra-individual variation (CVi), also termed within subject biological variation, of an analyte is essential to properly interpret apparent changes in concentration. While there have been many studies assessing the CVi of cardiac troponin (cTnI), they have been limited in looking at CVi in different settings, and there is no data available on whether CVi might change in different settings.

Methods: We used our large cTnI data bank to look at the CVi of cTnI in Emergency Department (ED) patients who had an acute myocardial infarction event excluded.

Predictors of functional impairment in bipolar disorder: Results from 13 cohorts from seven countries by the global bipolar cohort collaborative.

Objectives: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD.

Methods: Thirteen cohorts from 7 countries included n = 5882 individuals with BD across multiple sites.

C-reactive protein and affective inhibition in bipolar disorder.

Background: Individuals with bipolar disorder (BD) experience cognitive and affective processing deficits that often persist beyond the remission of acute mood symptoms. One possible biological mechanism for these deficits involves the potential effects of chronic low-grade peripheral inflammation on brain function. Peripheral inflammation has been associated with reduced executive functioning and memory performance, as well as altered reward processing in BD, but whether it is also implicated in cognitive-affective processing remains unknown.

Provider perspectives on telemental health implementation: Lessons learned during the COVID-19 pandemic and paths forward.

After years of slow and fragmented implementation of telemental health (TMH), the coronavirus disease (COVID-19) pandemic necessitated widespread adoption. With the initial state of public health emergency behind us, we are at a decision point on whether to continue with TMH or return to a largely in-person care model. In this qualitative study, we investigated clinicians' perspectives on advantages and disadvantages of TMH in outpatient mental healthcare as well as considerations for future implementation.

Choice of Statistical Tools for Outlier Removal Causes Substantial Changes in Analyte Reference Intervals in Healthy Populations.

Background: Reference intervals are an important aid in medical practice as they provide clinicians a guide as to whether a patient is healthy or diseased.Outlier results in population studies are removed by any of a variety of statistical measures. We have compared several methods of outlier removal and applied them to a large body of analytes from a large population of healthy persons.

New Zealand blackcurrant extract enhances muscle oxygenation during repeated intermittent forearm muscle contractions in advanced and elite rock climbers.

Anthocyanin-rich New Zealand blackcurrant (NZBC) may improve forearm muscle oxygenation and enhance performance in high-level rock climbers. As such, using a double-blind, randomised, cross-over design study, twelve participants performed an oxidative capacity assessment, and two successive exhaustive exercise trials (submaximal forearm muscle contractions at 60% of their maximal volitional contraction). Each visit was conducted following 7-days intake of 600 mg·day NZBC extract or placebo.

New Zealand Blackcurrant Extract Enhances Muscle Oxygenation During Forearm Exercise in Intermediate-Level Rock Climbers.

The delivery to and utilization of oxygenated hemoglobin to the forearm muscles are key determinants of rock-climbing performance. Anthocyanin-rich New Zealand blackcurrant (NZBC) has been suggested to improve blood flow and may enhance forearm endurance performance. As such, a double-blind, randomized crossover design study with 12 participants performed submaximal intermittent contractions (at 40% maximal voluntary contraction) to failure after a 7-day intake of 600 mg/day NZBC extract or placebo.

Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus.

Objective: Preanalytical processing of blood samples can affect plasma glucose measurement because ongoing glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined.

Age-related differences in hs-cTnI concentration in healthy adults.

Background: Because the 99th percentile is of such importance in defining myocardial injury and myocardial infarction, it is important to know whether there are real age-related differences in troponin 99th percentiles.

Methods: We went to our database from the Canberra Heart Study where 1062 apparently healthy subjects were extensively screened for occult cardiac disease, and looking at persons aged <65 years and >65 years, for men and women separately, we compared a variety of cutpoints from the 99th percentile down to the 50th percentile.

Results: With our rigorous criteria for defining cardiac health, we excluded 67.

Are the changes in diagnostic criteria for gestational diabetes mellitus reflected in perinatal outcomes? A retrospective assessment.

Background: Gestational diabetes mellitus (GDM) is glucose intolerance first diagnosed during pregnancy not due to overt diabetes. Recent changes to the diagnostic guidelines have been shown to increase the apparent occurrence of GDM.

Aim: The aim of this study was to compare retrospectively the neonatal outcomes between groups defined using the new and old criteria to assess the impact of guideline changes on pregnancy outcomes.

The importance of low level QC for high sensitivity troponin assays.

Background: With the advent of the new high-sensitivity troponin assays, it is becoming critical to measure troponin accurately to low concentrations. To ensure assay performance is acceptable, appropriate QC must be run.

Methods: In addition to the routine use of commercial QC material, we prepared pools of human QC material with low troponin concentrations close to the limit of quantitation, and ran these regularly on our laboratory analysers.

The relationship of plasma creatinine (as eGFR) and high-sensitivity cardiac troponin and NT-proBNP concentrations in a hospital and community outpatient population.

Objectives: While persons with overt renal failure have a well-described rise in troponin and NT-proBNP, it is less well described what the relationship is between cardiac markers and persons with impaired renal function, not requiring dialysis.

Design & Methods: We have collected ALL samples referred to our pathology practice over a 24h period and measured hs-cTnI, hs-cTnT, NT-proBNP, calculated the eGFR, and related our measurements to clinical outcomes.

Results: For both men and women, for all of hs-cTnI, hs-cTnT and NT-proBNP, there was a graded response, as renal function worsened, the concentration of the cardiac marker increased.

Predictors of parental knowledge of adolescent sexual experience: United States, 2012.

Parent-child sexual health communication has been shown to protect against adolescent sexual risk-taking behavior. Parent knowledge of adolescent sexual experience can inform timing and content of conversations; however, little is known about factors associated with such knowledge. To investigate this question, parent-child dyads (N = 942) from a U.

Statistical considerations for determining high-sensitivity cardiac troponin reference intervals.

The troponin 99th percentile is used as the laboratory decision point in the diagnosis of acute myocardial infarction. A recent publication has shown that the statistical treatment for outlier removal may dramatically change the calculated troponin 99th percentile. We have used our large database from the previously reported Canberra Heart Study to independently assess the effect of various methods for removing outliers on the calculated 99th percentile.