Although individuals born at extremely low birth weight (ELBW; < 1,000 g) are the most vulnerable of all preterm survivors, their risk for mental health problems across the life span has not been systematically reviewed. The primary objective of this systematic review and meta-analysis was to ascertain whether the risk for mental health problems is greater for ELBW survivors than their normal birth weight (NBW) peers in childhood, adolescence, and adulthood. Forty-one studies assessing 2,712 ELBW children, adolescents, and adults and 11,127 NBW controls were reviewed. Group differences in mental health outcomes were assessed using random effects meta-analyses. The impacts of birthplace, birth era, and neurosensory impairment on mental health outcomes were assessed in subgroup analyses. Children born at ELBW were reported by parents and teachers to be at significantly greater risk than NBW controls for inattention and hyperactivity, internalizing, and externalizing symptoms. ELBW children were also at greater risk for conduct and oppositional disorders, autistic symptoms, and social difficulties. Risks for parent-reported inattention and hyperactivity, internalizing, and social problems were greater in adolescents born at ELBW. In contrast, ELBW teens self-reported lower inattention, hyperactivity, and oppositional behavior levels than their NBW peers. Depression, anxiety, and social difficulties were elevated in ELBW survivors in adulthood. Group differences were robust to region of birth, era of birth, and the presence of neurosensory impairments. The complex needs faced by children born at ELBW continue throughout development, with long-term consequences for psychological and social well-being. (PsycINFO Database Record

This systematic review suggests that AV interventions can be effective in reducing children's preoperative anxiety. Videos, multi-faceted programs, and interactive games appear to be most effective, whereas music therapy and Internet programs are less effective. While AV interventions appear potentially useful, adequately powered RCTs are required to conclusively pinpoint the components and mechanisms of the most effective AV interventions and guide practice.

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This pilot study provides preliminary evidence that STM is a feasible and acceptable intervention for reducing children's preoperative anxiety in a busy pediatric operative setting and supports the investigation of a full-scale randomized controlled trial.

Up to 5 million children are affected by perioperative anxiety in North America each year. High perioperative anxiety is predictive of numerous adverse emotional and behavioral outcomes in youth. We developed the Children's Perioperative Multidimensional Anxiety Scale (CPMAS) to address the need for a simple, age-appropriate self-report measure of pediatric perioperative anxiety in busy hospital settings. The CPMAS is a visual analog scale composed of 5 items, each of which is scored from 0-100. The objective of this study was to assess the psychometric properties of the CPMAS in children undergoing surgery. Eighty children aged 7 to 13 years who were undergoing elective surgery at a university-affiliated children's hospital were recruited. Children self-completed the CPMAS and the Screen for Childhood Anxiety Related Disorders (SCARED-C) at 3 time points: at preoperative assessment (T1), on the day of the operation (T2), and 1 month postoperatively (T3). Internal consistency, test-retest reliability, and the convergent validity of the CPMAS were assessed across all 3 visits. The CPMAS demonstrated good internal consistency (Cronbach's alpha ≥ .80) and stability (ICC = 0.71) across all 3 visits. CPMAS scores were moderately correlated with total SCARED-C scores (r values = .35 to .54, p values < .05 to .01) and SCARED-C state-related anxiety scores (r values = .29 to .71, p values < .05 to .01) at all 3 time points, suggesting the CPMAS and SCARED-C measures tap similar but not identical phenomena. These results suggest that the CPMAS has the potential to be a useful tool for evaluating perioperative anxiety in children undergoing surgery. (PsycINFO Database Record

Intensive weight-supported treadmill training (WSTT)improves locomotor function following spinal cord injury. Because of a number of factors, undergoing intensive sessions of training may not be feasible. Whether reduced amounts of training are sufficient to enhance spinal plasticity to a level that is necessary for improving function is not known. The focus of the present study was to assess differences in recovery of locomotor function and spinal plasticity as a function of the amount of steps taken during WSTT in a rodent model of spinal cord injury. Rats were spinally transected at 5 days of age. When they reached 28 days of age, a robotic system was used to implement a weight-supported treadmill training program of either 100 or 1000 steps/training session daily for 4 weeks. Antibodies for brain-derived neurotrophic factor (BDNF), TrkB, and the pre-synaptic marker, synaptophysin, were used to examine the expression of these proteins in the ventral horn of the lumbar spinal cord. Rats that received weight-supported treadmill training performed better stepping relative to untrained rats, but only the rats that received 1000 steps/training session recovered locomotor function that resembled normal patterns. Only the rats that received 1000 steps/training session recovered normal levels of synaptophysin immunoreactivity around motor neurons. Weight-supported treadmill training consisting of either 100 or 1000 steps/ training session increased BDNF immunoreactivity in the ventral horn of the lumbar spinal cord. TrkB expression in the ventral horn was not affected by spinal cord transection or weight-supported treadmill training. Synaptophysin expression, but not BDNF or TrkB expression was correlated with the recovery of stepping function. These findings suggested that a large amount of weight-supported treadmill training was necessary for restoring synaptic connections to motor neurons within the locomotor generating circuitry. Although a large amount of training was best for recovery, small amounts of training were associated with incremental gains in function and increased BDNF levels.

Key Points Question Is temperament associated with preoperative anxiety in young patients undergoing surgery? Findings In this systematic review of 23 studies including 4527 participants aged 1 to 18 years and meta-analysis of 12 studies including 1064 participants, certain temperament styles were associated with patients’ preoperative anxiety. Specifically, emotionality, intensity of reaction, and withdrawal were associated with increased preoperative anxiety, whereas activity level was associated with reduced anxiety. Meaning Knowledge of temperamental propensity to preoperative anxiety in pediatric patients may help to guide the design of future detection, prevention, and/or individualized management strategies (eg, improving emotional regulation and coping skills) aimed at reducing the adverse effects of preoperative anxiety.