The mental health care system continues to provide less care to persons in African-American and Hispanic minority groups than to whites, suggesting the need for policy initiatives to improve services for these minority groups. Future efforts at identifying trends in disparities in mental health services should use methodologies that adjust for health status and allow socioeconomic factors to mediate differences.

No abstract

OBJECTIVETraditionally, diffusion MRI (dMRI) has been performed in parallel with high-resolution conventional MRI, which requires long scan times and may require sedation or general anesthesia in infants and young children. Conversely, fast brain MRI permits image acquisition without the need for sedation, although its short pulse sequences, susceptibility to motion artifact, and contrast resolution have limited its use to assessing ventricular size or major structural variations. Here, the authors demonstrate the feasibility of leveraging a 3-direction fast brain MRI protocol to obtain reliable dMRI measures.METHODSFast brain MRI with 3-direction dMRI was performed in infants and children before and after hydrocephalus treatment. Regions of interest in the posterior limbs of the internal capsules (PLICs) and the genu of the corpus callosum (gCC) were drawn on diffusion-weighted images, and mean diffusivity (MD) data were extracted. Ventricular size was determined by the frontal occipital horn ratio (FOHR). Differences between and within groups pre- and posttreatment, and FOHR-MD correlations were assessed.RESULTSOf 40 patients who met inclusion criteria (median age 27.5 months), 15 (37.5%), 17 (42.5%), and 8 (20.0%) had posthemorrhagic hydrocephalus (PHH), congenital hydrocephalus (CH), or no intracranial abnormality (controls), respectively. A hydrocephalus group included both PHH and CH patients. Prior to treatment, the FOHR (p < 0.001) and PLIC MD (p = 0.027) were greater in the hydrocephalus group than in the controls. While the mean gCC MD in the hydrocephalus group (1.10 × 10−3 mm2/sec) was higher than that of the control group (0.98), the difference was not significant (p = 0.135). Following a median follow-up duration of 14 months, decreases in FOHR, PLIC MD, and gCC MD were observed in the hydrocephalus group and were similar to those in the control group (p = 0.107, p = 0.702, and p = 0.169, respectively). There were no correlations identified between FOHR and MDs at either time point.CONCLUSIONSThe utility of fast brain MRI can be extended beyond anatomical assessments to obtain dMRI measures. A reduction in PLIC and gCC MD to levels similar to those of controls was observed within 14 months following shunt surgery for hydrocephalus in PHH and CH infants. Further studies are required to assess the role of fast brain dMRI for assessing clinical outcomes in pediatric hydrocephalus patients.

We replicated a study of a kindergarten mathematics intervention, ROOTS, delivered in the context of a research-based core program. We randomly assigned 62 classrooms to treatment (ROOTS) or a business-as-usual control. All classrooms implemented the research-based core program (Early Learning in Mathematics). Participants included 163 treatment students and 145 control students nested within classrooms. Key differences between the current replication study and the original study included geographical region, instructional context, and student initial skill. In contrast to the significant positive effects (Hedges’s g values of .30 to .38) found in the original study, no significant differences were found between the treatment and control conditions in this study (Hedges’s g values of –.09 to .12) Pretest skills did not moderate treatment effects. We discuss these results’ implications for replication research and evaluating intervention efficacy.

No abstract