We here identify and characterize an extracellular modulator of Hedgehog signaling in Drosophila, Shifted. Shifted is required for high levels of long-range signaling in the developing wing imaginal disc. Surprisingly, shifted encodes the only Drosophila ortholog of the secreted vertebrate protein Wnt Inhibitory Factor-1 (WIF-1), whose known role is to bind to extracellular Wnts and inhibit their activity. However, Shifted does not regulate Hedgehog signaling by affecting Wingless or Wnt signaling. We show instead that Shifted is a secreted protein that acts over a long distance and is required for the normal accumulation of Hh protein and its movement in the wing. Our data further indicate that Shf interacts with Hh and the heparan sulfate proteoglycans. Therefore, we propose that Shf stabilizes the interaction between Hh and the proteoglycans, an unexpected role for a member of the WIF-1 family.

This study examines medical admission patterns among adolescents with restrictive eating disorders before and after the onset of the COVID-19 pandemic. What's Known on This SubjectLimited data suggest the COVID-19 pandemic has been associated with worsening mental health outcomes, including worsening symptoms of eating disorders. Little is known about the potential effects of the pandemic on medical admission patterns among adolescents with eating disorders. What This Study AddsMedical admissions among adolescents with eating disorders at our institution increased significantly during the COVID-19 pandemic, with the number of admissions during the first twelve months of the pandemic more than double the mean for the previous three years.

Objectives: Eating disorders are common and serious conditions affecting up to 4% of the population. The mortality rate is high. Despite the seriousness and prevalence of eating disorders in children and adolescents, no Canadian practice guidelines exist to facilitate treatment decisions. This leaves clinicians without any guidance as to which treatment they should use. Our objective was to produce such a guideline. Methods: Using systematic review, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and the assembly of a panel of diverse stakeholders from across the country, we developed high quality treatment guidelines that are focused on interventions for children and adolescents with eating disorders. Results: Strong recommendations were supported specifically in favour of Family-Based Treatment, and more generally in terms of least intensive treatment environment. Weak recommendations in favour of Multi-Family Therapy, Cognitive Behavioural Therapy, Adolescent Focused Psychotherapy, adjunctive Yoga and atypical antipsychotics were confirmed. Conclusions: Several gaps for future work were identified including enhanced research efforts on new primary and adjunctive treatments in order to address severe eating disorders and complex co-morbidities.

The studies aimed to evaluate the effectiveness of the Triple P-based "Driving Mum and Dad Mad" television series in improving positive parenting behaviours and child wellbeing over a six month period. A secondary aim was to compare the effectiveness of the intervention with (enhanced condition) and without (standard condition) extra support and resources. The influence of demographic details and parenting background were recorded to check for effects on outcomes and compliance. HypothesesParticipants were recruited across two waves, GPE1 (N = 450) and GPE2 (N = 270). Data from these two waves were combined. Both assessment groups used a repeated measures design and were randomly allocated to the two intervention conditions (standard or enhanced). Participants in the enhanced condition received downloadable tip sheets, a workbook and media resources in addition to the standard reminders to watch the series. All parents were administered a set of questionnaires measuring family background (Family Background Questionnaire); parental anger (Parental Anger Inventory); parenting style (Parenting Scale); parenting confidence for dealing with misbehaviour (Parenting Task Checklist); inter-parental conflict (Parent Problem Checklist); child disruptive behaviour (Eyberg Child Behavior Inventory); parental relationship satisfaction (Relationship Quality Index); and mood (Depression Anxiety Stress Scale). These were administered pre-intervention, as well as 12 weeks and 6 months after watching the series. Parents were also assessed on the number of episodes they watched, child-problem severity and demographic details. Hypotheses were as follows: 1. Parental factors, such as level of dysfunctional parenting style and anger, may influence the success of the interventions and persistence with watching the television series. 2. Demographic variables may influence intervention outcomes and viewing compliance. For example, based on prior research, parents from lower socio-economic status (SES) backgrounds were predicted to show less positive changes to parenting and child outcomes than parents from higher socio-economic backgrounds. 3. Severity of child problems may influence compliance and satisfaction outcomes. Parents of children with problems of greater severity were predicted to be less likely to complete watching the series, due to increased feelings of pressure and responsibility. ResultsResults were found to support the effectiveness of the media-based interventions over 12 week and 6-months for all measured variables apart from parental relationship quality. Information was found for the other hypotheses:-1. Parents with lower DASS and PS scores were more likely to have poorer reported child and parent outcomes. 2. Partner SES was significantly correlated with poorer reported child and parent outcomes. Additionally, parents from higher socio-economic backgrounds were more likely to watch the entire series and use the strategies at six-month follow-up. 3. Parents who reported greater severity of child problems were more ...

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