Purpose Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child’s early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers’ mental health, parenting competence and engagement in treatment. Methods Mothers were referred from community health providers for a Phase 1 trial to assess feasibility, acceptability and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty and single parenthood. 99 mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post- self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and PTSD), parenting and intervention satisfaction. Results Results indicate that MP participation was associated with reduction in depression, PTSD and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70% of the 10 groups (completers; N=68) improved on parenting and mental health outcomes, in contrast to non-completers (N=12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Conclusions Results indicate that MP is feasible, acceptable and holds promise for improving maternal mental health and parenting competence among high-risk dyads. Further research is warranted to evaluate the efficacy of MP using randomized controlled designs.

BackgroundWe sought to identify factors associated with participant retention in a 2-year, physician-lead, multidisciplinary, clinical weight management program that employs meal replacements to produce weight loss and intensive behavioral interventions and financial incentives for weight loss maintenance. We studied 270 participants enrolled in 2010 and 2011. Sociodemographic factors, health insurance, distance traveled, body mass index, comorbidities, health-related quality-of-life, and depression were explored as potential predictors of retention.ResultsMean age was 49 ± 8 years and BMI was 41 ± 5 kg/m2. Retention was excellent at 3 months (90%) and 6 months (83%). Attrition was greatest after participants were transitioned to regular foodstuffs and fell to 67% at 12 months and 51% at 2 years. Weight decreased by 15 ± 12 kg and BMI decreased by 5.1 ± 4.0 kg/m2 in 2-year completers. Older age, lower baseline BMI, and financial incentives for program participation were independently associated with retention. Fewer depressive symptoms at baseline were associated with retention.ConclusionsThis multidisciplinary, clinical, weight management program demonstrated high retention and excellent outcomes. Older age at baseline, less extreme obesity, and financial incentives were associated with program retention.

Mutations in the Cu/Zn superoxide dismutase gene (SOD-1) are reported in 20% of familial amyotrophic lateral sclerosis (ALS) cases, but no definite report of a mutation in a "truly" sporadic case of ALS has been proved. We present the first case of a novel SOD-1 mutation in a patient with genetically proven sporadic ALS. This mutation (H80A) is believed to alter zinc ligand binding, and its functional significance correlates well with the aggressive clinical course and postmortem findings observed in this patient.

Objective To evaluate the feasibility of a brief, intensive weight loss intervention (IWL) to improve reproductive outcomes in obese subfertile women. Design Pilot study of IWL versus standard-of-care nutrition counseling (SCN) Setting Single-site, academic institution Patients Obese women (BMI 35 – 45 kg/m2) with anovulatory subfertility. Interventions Women were rigorously pre-screened to rule out secondary causes of subfertility. Eligible women were randomized to IWL or SCN. IWL consisted of 12 weeks of very-low energy diet (800 kcal/day) + 4 weeks of a low-calorie conventional food-based diet (CFD) to promote 15% weight loss. SCN consisted of 16 weeks of CFD to promote ≥ 5% weight loss. Women were transitioned to weight maintenance diets and referred back to reproductive endocrinology for ovulation induction. Main Outcome Measures Feasibility of recruitment, randomization, intervention implementation, and retention. Results Thirty-nine women were screened, 25 (64%) were eligible to participate, and 14 of those eligible (56%) agreed to be randomized - 7 in each group. One withdrew from the IWL group and 2 from the SCN group. Percent weight loss was greater in the IWL group than in the SCN group (13±5% vs. 4±4%) (p=0.01). Three of six women in the IWL group conceived and delivered term pregnancies. No pregnancies occurred in the SCN group. Conclusions After rigorous screening, 44% of eligible women completed the study. IWL was associated with greater percentage weight loss and improvements in insulin sensitivity. Trial Registration ClinicalTrials.gov NCT01894074

Purpose To evaluate the effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high-risk mothers with young children in a community-based randomized controlled trial (CB-RCT). Methods Participants (N = 122) were high-risk mothers (e.g., interpersonal trauma histories, mental health problems, poverty) and their young children (age < 6 years), randomized either to Mom Power, a parenting intervention (treatment condition) or weekly mailings of parenting information (control condition). In this study, the 13-session intervention was delivered by community clinicians trained to fidelity. Pre- and post-trial assessments included mothers’ mental health symptoms, parenting stress and helplessness, and connection to care. Results Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast, control mothers increased in parent-child role-reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated for mothers with interpersonal trauma histories. Conclusions Results of this CB-RCT confirm the effectiveness of Mom Power for improving mental health and parenting outcomes for high-risk, trauma exposed women with young children.