Publications by authors named "Lester K"

Background: The identification of predictors of treatment response is crucial for improving treatment outcome for children with anxiety disorders. Machine learning methods provide opportunities to identify combinations of factors that contribute to risk prediction models.

Methods: A machine learning approach was applied to predict anxiety disorder remission in a large sample of 2114 anxious youth (5-18 years).

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Negative self-perceptions are implicated in the development and maintenance of depression in young people, but little is known about their receptiveness to change in response to treatment. This paper reports on a pre-registered meta-analysis examining the extent to which treatments for depression in young people aged 11-24 result in changes to self-perceptions. Controlled treatment trials examining outcomes related to self-perceptions were synthesised (k = 20, N = 2041), finding small reductions in both symptoms of depression (g = -0.

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The aftermath of the Covid-19 pandemic has seen an increase in persistent school absenteeism and Emotionally-Based School Avoidance (EBSA). However, suitable evidence-based psychological interventions are often unavailable. We aimed to assess the feasibility and acceptability of a new parent-focused online program, Intervention for School Anxiety and Absenteeism in Children (ISAAC), which has been co-designed with parents and practitioners.

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Background: Children whose parents have anxiety problems are at increased risk of developing anxiety themselves. Parenting behaviors are a contributing factor to intergenerational transmission. Interventions which seek to limit anxiogenic parenting behaviors have shown potential in reducing anxiety in offspring but are not widely accessible.

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Article Synopsis
  • Mothers with eating disorders often worry about the potential impact on their children and the risk of passing those issues down to them.
  • The study involved interviews with 18 mothers from the UK, USA, and Australia, focusing on their experiences and support needs regarding eating disorders.
  • Key findings highlighted themes such as maternal reflections on their own eating disorders, strategies to prevent passing on these issues, communication about their disorders with their children, and the support they feel they need to break the cycle of eating disorders in the family.
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Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with a complex, multifactorial aetiology. Raised intraocular pressure (IOP) is the most important clinically modifiable risk factor for POAG. All current pharmacological agents target aqueous humour dynamics to lower IOP.

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Background: Children and adolescents demonstrate diverse patterns of symptom change and disorder remission following cognitive behavioural therapy (CBT) for anxiety disorders. To better understand children who respond sub-optimally to CBT, this study investigated youths (N = 1,483) who continued to meet criteria for one or more clinical anxiety diagnosis immediately following treatment or at any point during the 12 months following treatment.

Methods: Data were collected from 10 clinical sites with assessments at pre-and post-treatment and at least once more at 3, 6 or 12-month follow-up.

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School absences have risen following the COVID-19 pandemic and persistent absenteeism remains high in primary and secondary schools in England compared with pre-pandemic levels. This coincides with an upward trend in emotionally based school avoidance (EBSA). EBSA adversely affects children's educational attainment, health, social functioning and life prospects and warrants early intervention before a pattern of absenteeism becomes entrenched.

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Transient killer whales have been documented hunting marine mammals across a variety of habitats. However, relatively little has been reported about their predatory behaviours near deep submarine canyons and oceanic environments. We used a long-term database of sightings and encounters with these predators in and around the Monterey Submarine Canyon, California to describe foraging behaviour, diet, seasonal occurrence, and habitat use patterns.

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Background: The use of a second informant (co-respondent) is a common method of identifying potential bias in outcome data (e.g., parent-report child outcomes).

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Importance: Disparities persist across the trajectory of serious illness, including at the end of life. Patient navigation has been shown to reduce disparities and improve outcomes for underserved populations.

Objective: To determine the effectiveness of a lay patient navigator intervention, Apoyo con Cariño, in improving palliative care outcomes among Hispanic patients.

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Emotionally-based school avoidance (EBSA) is an important driver of persistent school absenteeism and may have worsened in the context of COVID-19. This paper describes the development of a brief parent-focused psychosocial intervention with the goal to address the lack of accessible early interventions for EBSA. The developmental process used a person-based approach with two phases.

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Cornelia de Lange syndrome (CdLS) is a congenital disorder featuring facial dysmorphism, postnatal growth deficits, cognitive disability and upper limb abnormalities. CdLS is genetically heterogeneous, with cases arising from mutation of BRD4, a bromodomain protein that binds and reads acetylated histones. In this study, we have modeled CdLS facial pathology through mouse neural crest cell (NCC)-specific mutation of BRD4 to characterize cellular and molecular function in craniofacial development.

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Background: RECOVER is a multicentre post-approval study of Elexacaftor/Tezacaftor/Ivacaftor (ETI) in pwCF in Ireland and the UK. The CFAbd-Score is the first validated CF-specific patient reported outcome measure (PROM) focusing on gastrointestinal symptoms; it comprises 28 items in 5 domains. In a preliminary study, we previously reported reductions in abdominal symptoms (AS) in pwCF after 26 weeks of ETI-therapy using the CFAbd-Score.

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Clinical trials have shown that use of elexacaftor/tezacaftor/ivacaftor (ETI) is associated with improvements in sweat chloride, pulmonary function, nutrition, and quality of life in people with cystic fibrosis (CF). Little is known about the impact of ETI on ventilation inhomogeneity and lung structure. RECOVER is a real-world study designed to measure the impact of ETI in people with CF.

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The Janssen and Newfoundland and Labrador Health Innovation Partnership (JANL-HIP) was established to carry out Real-World Evidence (RWE) projects to generate evidence about disease pathways, healthcare delivery, the effects of clinical interventions. Doing so will support and influence clinical decision-making in Newfoundland and Labrador (NL). This case study describes the foundational elements necessary for a real-world evidence generation project in NL and may provide learning for the effective execution of real-world studies in other jurisdictions.

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Neptune-sized planets exhibit a wide range of compositions and densities, depending on factors related to their formation and evolution history, such as the distance from their host stars and atmospheric escape processes. They can vary from relatively low-density planets with thick hydrogen-helium atmospheres to higher-density planets with a substantial amount of water or a rocky interior with a thinner atmosphere, such as HD 95338 b (ref. ), TOI-849 b (ref.

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Background: Eating disorders may disrupt parenting, and there is evidence to suggest that the children of parents with eating disorders are at greater risk for the development of eating disorders themselves. This study sought to broaden and extend current understandings of the lived experiences of mothers who have eating disorders.

Method: A qualitative study using thematic analysis was conducted.

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Background: Covid-19 related school closures radically disrupted children's access to social and educational opportunities and changed daily life for millions of families across the world. Emerging evidence indicates that, overall, closures were associated with a decline in children's mental health and well-being, although individual experiences varied widely. The extent to which primary schools adapted remote well-being support is likely to have contributed to child and family adjustment, although this has not yet been fully explored in Covid related research.

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In order to maximise the learning potential of medical education programmes aimed at interdisciplinary or multidisciplinary teams, it is important to understand how the effectiveness of these programmes can vary between healthcare professionals from different specialities. Measuring the impact of educational activities between specialities may facilitate the development of future interdisciplinary and multidisciplinary education programmes, yielding enhanced learner outcomes and, ultimately, improving outcomes for patients. In this analysis, we report on a new approach to measuring change in knowledge and competence among learners from different physician specialities.

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Background: Parent-report questionnaires are a common method of generating data on child outcomes in mental health studies. A second report from another person who knows the child (co-respondent) is implemented to reduce bias and increase objectivity. The success of this approach is dependent on the engagement of co-respondents, which can be difficult.

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Article Synopsis
  • Over the past two decades, chances for young kids to have self-directed outdoor play and social interaction during school have decreased, leading play dates to become more important for children's social development.
  • Research indicates that play dates positively affect social and emotional growth, but parental social networks heavily influence access to these play opportunities.
  • Parents view play dates as beneficial but tightly monitor them, which may restrict children's free play and highlight disparities in access based on social status.
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