In the January 2004 issue, we published an error in Fig 4. The CK18 and CK8 labels that appeared in the two top left panels were added mistakenly, also the label in row 4 column 1 was incomplete. The figure should have been published as shown below.

Objective Mothers of children with cancer confront life stress that can impact their psychological and physical health and, in turn, the health of the family. Recommendations advocate preemptive stress-management interventions; however, few studies have investigated their efficacy. Here, we report results of a parallel randomized pilot trial examining health benefits of a stress management intervention designed to teach coping skills. Methods One hundred twenty mothers (age 36 ± 8 years) of children newly diagnosed with cancer were randomized to a 12-session stress management intervention (n = 60) or usual care (n = 60). Sessions took place in the inpatient or outpatient setting of a children’s hospital. Primary outcome variables included psychological function and physical health assessed preintervention and postintervention and at 6-month follow-up (∼12 months postdiagnosis). Results Enrollment, retention, and satisfaction data supported feasibility and acceptability. Latent change score models showed the intervention reduced perceived stress (d = −0.37, p = 0.03), anxiety symptoms (ds = −0.38 and −0.56, ps < .03) and, a nonsignificant effect for depressive symptoms (d = −0.29, p = .11) across the 6 months following diagnosis. Intervention participants also endorsed fewer depressive symptoms than controls ∼12 months after diagnosis. The intervention improved stress management skills, which associated with the psychological benefits of participation. There were no intervention-related changes in perceived health or markers of inflammation. Conclusion Intervention-related improvements in stress management skills may result in better psychological health in the face of caring for a child with cancer. Trial Registration ClinicalTrials.gov identifier: NCT02022449

Chronic distress associates with peripheral release of cortisol and a parallel upregulation of innate inflammation. Typically, cortisol functions to down-regulate inflammatory processes. However, in the context of chronic stress, it is hypothesized that glucocorticoid receptors within immune cells become less sensitive to the anti-inflammatory effects of cortisol, resulting in increased systemic inflammation. Caring for a child newly diagnosed with cancer is a particularly provocative chronic stressor. Here, we examine evidence for the development of cellular resistance to glucocorticoids among 120 mothers (Aged 18-56 years; 86% Caucasian) across the 12 months following their child's new diagnosis with cancer. Measures of psychological distress, interleukin (IL)-6, and glucocorticoid resistance (GCR) were assessed 1, 6, and 12 months after the diagnosis. A latent factor for distress was derived from the covariation among symptoms of anxiety, depression, and post-traumatic stress. Latent change score models revealed a significant positive association between change in distress and change in GCR from 0 to 6 months, and 6 months-1 year. This finding provides initial evidence for a longitudinal association between change in maternal distress and change in GCR from the onset of a chronic stressor through one year. Although levels of IL-6 increased during the first six months after the child's diagnosis, the magnitude of this change was not related to change in distress or change in GCR. Given the possible health consequences of reduced immune sensitivity to glucocorticoids, future work should further explore this stress response and its clinical significance.

Background Propionic acidemia (PA), an autosomal recessive metabolic disorder, has an estimated incidence of 1:105,000–130,000 in the United States.1,2 Nutrition management is a main intervention for PA. Research in inborn errors of metabolism such as phenylketonuria has identified association of parental perceptions and practices with dietary outcomes. Parental perceptions and practices in the nutrition management of PA have not been investigated. Objective To assess the dietary perceptions and practices of parental caregivers of children affected by PA. Methods PA parents were surveyed about perceptions and practices associated with feeding their affected child(ren). The single‐page survey was anonymous, and responses to survey items were not identifiable. Parents provided information on how often they followed the prescribed diet and the rationale for any adjustments. Results Parents “always” or “most of the time” followed the prescribed diet for children 4–20 years of age; yet, open‐ended responses indicated that 71.4% made situational adjustments to their child's diet for a variety of reasons, including illness, iatrogenic effects, and social events. Conclusions PA parents make situational adjustments to their child's highly specialized diet. Uncertainty exists as to the situational adjustments being within the guidelines used by the metabolic healthcare team who rely on parents to inform them about dietary situational adjustments.

The study reported here examined the nature and effectiveness of compensatory strategies appearing in the conversational discourse of six closed head injured patients. Subject performance on a range of communication measures was compared with their judged abilities on a taxonomy of 32 compensatory strategies. Results indicated that all subjects employed a wide range of strategies but to differential effect. The overall effectiveness of these strategies correlated strongly with performance on the oral language subtest of the Western Aphasia Battery, the Communicative Abilities in Daily Living Test and a pragmatic protocol. The development of compensation following brain injury is viewed as a process of equilibration, determined in part by neurological and subject variables, and in part by ecologic variables. The implications for therapeutic management are discussed.

Background Use of intensive longitudinal methods (e.g. ecological momentary assessment, passive sensing) and machine learning (ML) models to predict risk for depression and suicide has increased in recent years. However, these studies often vary considerably in length, ML methods used, and sources of data. The present study examined predictive accuracy for depression and suicidal ideation (SI) as a function of time, comparing different combinations of ML methods and data sources. Methods Participants were 2459 first-year training physicians (55.1% female; 52.5% White) who were provided with Fitbit wearable devices and assessed daily for mood. Linear [elastic net regression (ENR)] and non-linear (random forest) ML algorithms were used to predict depression and SI at the first-quarter follow-up assessment, using two sets of variables (daily mood features only, daily mood features + passive-sensing features). To assess accuracy over time, models were estimated iteratively for each of the first 92 days of internship, using data available up to that point in time. Results ENRs using only the daily mood features generally had the best accuracy for predicting mental health outcomes, and predictive accuracy within 1 standard error of the full 92 day models was attained by weeks 7–8. Depression at 92 days could be predicted accurately (area under the curve >0.70) after only 14 days of data collection. Conclusions Simpler ML methods may outperform more complex methods until passive-sensing features become better specified. For intensive longitudinal studies, there may be limited predictive value in collecting data for more than 2 months.

A comparative content analysis of CNN, Fox News Channel, and MSNBC examined the extent to which the cable news networks utilize their news crawls or “tickers” for promotional purposes. Situated in economic, branding, and promotional theory, the study revealed that two out of three cable networks utilized their news tickers for some overt self-promotion, but used them infrequently as synergistic promotional tools for their parent companies, indicating journalistic integrity within this news space for the present time. The study also provides baseline information on the nature of cable news tickers.

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