Objective To determine how state guidance documents address equity concerns in K-12 schools during the coronavirus disease 2019 pandemic. Study design Using online searches, we collected state-level documents from all 50 states and the District of Columbia discussing reopening plans for K-12 schools in the 2020-2021 academic year. We examined whether these documents explicitly mentioned equity as a concern, as well as if and how they addressed the following equity issues: food insecurity and child nutrition, homelessness or temporary housing, lack of access to Internet/technology, students with disabilities or special needs, English-language learners, students involved with or on the verge of involvement with the Department of Children and Family Services or an equivalent agency, mental health support, students/staff at greater risk of severe illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and students/staff living with someone at greater risk of severe illness from SARS-CoV-2 infection. Results Forty-four of 51 states (86%) explicitly mentioned equity as a concern or guiding principle. At least 90% of states offered guidance for 7 equity issues. Fewer than 75% of states addressed homelessness or temporary housing, students involved with or on the verge of involvement with Department of Children and Family Services or an equivalent agency, and students/staff living with someone at greater risk of severe illness from SARS-CoV-2 infection. Conclusions Wide variability exists in state-level guidance to help K-12 schools develop reopening plans that protect those who are most vulnerable to learning loss or reduced access to basic needs. Interpretation and implementation by local educational agencies will need to be assessed.
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Trichotillomania is a prevalent but often hidden psychiatric condition, characterized by repetitive hair pulling. The aim of this study was to confirm or refute structural brain abnormalities in trichotillomania by pooling all available global data. De-identified MRI scans were pooled by contacting authors of previous studies. Cortical thickness and sub-cortical volumes were compared between patients and controls. Patients (n = 76) and controls (n = 41) were well-matched in terms of demographic characteristics. Trichotillomania patients showed excess cortical thickness in a cluster maximal at right inferior frontal gyrus, unrelated to symptom severity. No significant sub-cortical volume differences were detected in the regions of interest. Morphometric changes in the right inferior frontal gyrus appear to play a central role in the pathophysiology of trichotillomania, and to be trait in nature. The findings are distinct from other impulsive-compulsive disorders (OCD, ADHD, gambling disorder), which have typically been associated with reduced, rather than increased, cortical thickness. Future work should examine sub-cortical and cerebellar morphology using analytic approaches designed for this purpose, and should also characterize grey matter densities/volumes.Electronic supplementary materialThe online version of this article (doi:10.1007/s11682-017-9746-3) contains supplementary material, which is available to authorized users.
Excoriation (skin-picking) disorder (SPD) shares symptomology with other obsessive-compulsive and related disorders. Few studies, however, have examined the neurological profile of patients with SPD. This study examined differences in cortical thickness and basal ganglia structural volumes between 20 individuals with SPD and 16 healthy controls using magnetic resonance imaging (MRI). There were no significant differences in demographic variables (age, gender, education and race) between groups. All subjects completed a structural MRI scan and completed a battery of clinical assessments focusing on SPD symptom severity, depression and anxiety symptoms, and quality of life. No statistically significant differences in basal ganglia (caudate, putamen, and nucleus accumbens) structural volumes were found between groups. In individuals with SPD, increasing impulsiveness correlated positively with increased cortical thickness in the left insula, and skin picking severity correlated negatively with cortical thickness in the left supramarginal gyrus and a region encompassing the right inferior parietal, right temporal and right supramarginal gyrus. This study suggests similarities and differences exist in symptomology between SPD and the other obsessive-compulsive and related disorders. Additional neuroimaging research is needed to better delineate the underlying neurobiology of SPD.
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