IntroductionBoth Δ9 Tetrahydrocannabidiol (THC) and cannabidiol (CBD) components of cannabis, have been shown to have anticonvulsant effects. Cannabis oils are used to treat seizures in drug‐resistant epilepsy (DRE). Recent trials provide data on dosing, side effects, and efficacy of CBD, yet there is a paucity of information on THC in epilepsy. Primary objective was to establish dosing and tolerability of TIL‐TC150 ‐ a cannabis plant extract produced by Tilray®, containing 100 mg/mL CBD and 2 mg/mL THC‐ in children with Dravet syndrome. Secondary objectives were to assess impact of therapy on seizures, electroencephalogram (EEG) and quality of life.MethodsTwenty children received add‐on therapy with TIL‐TC150. The dose ranged from 2 to 16 mg/kg/day of CBD and 0.04 to 0.32 mg/kg/day of THC. Patients were monitored for tolerability and adverse events, and secondary objectives.ResultsNineteen participants completed the 20‐week intervention. Mean dose achieved was 13.3 mg/kg/day of CBD (range 7–16 mg/kg/day) and 0.27 mg/kg/day of THC (range 0.14–0.32 mg/kg/day). Adverse events, common during titration included somnolence, anorexia, and diarrhea. Abnormalities of liver transaminases and platelets were observed with concomitant valproic acid therapy. There was a statistically significant improvement in quality of life, reduction in EEG spike activity, and median motor seizure reduction of 70.6%, with 50% responder rate of 63%.Conclusions TIL‐TC150 was safe and well tolerated in our subjects. TIL‐TC150 treatment resulted in a reduction in seizure counts, spike index on EEG, and improved quality of life measures. This study provides safety and dosing information for THC‐containing cannabinoid preparations.

Domestic sex trafficking is a growing crime in Canada, with the majority of victims being children and youth. Youth involved with Child Welfare (CW) are vastly over-represented among sex trafficking victims. Yet, it is poorly understood why these youth are so vulnerable, particularly within the Canadian context. The goal of the current study was to increase our understanding of the elevated risk status of CW involved youth who are victimized by sex traffickers, as well as explore routes into sex trafficking. To address this goal, researchers collaborated with local CW and police agencies to conduct a secondary data analysis of sex trafficking cases from 2008 to 2016. In total, data were included on 223 victims, 52 of these cases were involved with CW. Findings underscore the high-risk status of CW youth victimized by sex trafficking. All CW involved sex trafficking victims were recruited under the age of 18. CW victims were more likely to use alcohol, cocaine, and crystal methamphetamine; live in a group home; and experience childhood maltreatment. Traffickers utilized online platforms and relationships to recruit youth. Results from this study suggest early identification of high-risk status should be a priority for CW agencies. Moreover, professionals working with youth in various capacities such as, schools, hospitals, and mental health centers should be knowledgeable about risk, recruitment by traffickers, and warning signs of victimization. Public Significance StatementYouth in care of child welfare are at enhanced risk of being recruited into sex trafficking. CW victims are alarmingly young and present with complex psychosocial histories. Traffickers utilize online platforms and preexisting relationships in recruitment and employ grooming strategies rather than violence or threats in the process of recruitment.

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Despite improved survival among children with congenital heart disease (CHD), the risk of psychosocial difficulties remains largely unchanged with an increased emphasis of improving support for parents as a mechanism to optimize outcomes. Objective Using qualitative and quantitative methods, the current cross-sectional study examined parents' experiences at the time of their child's diagnosis, what they thought helped their child recover, barriers to support, and identified needs for future models of care. Method The sample included 26 parents (22 mothers, 3 fathers, and 1 mother/father pair) of children with CHD, ranging in age between 6 months and 4 years with a mean age of 2 years. Results Qualitative results were organized around five themes: (a) They (medical team) saved my child's life, (b) My child is going to be okay, (c) Not out of the woods, (d) Optimizing support for my child and myself, and (e) What still gets in the way. Parents uniformly expressed a need for greater mental health support for their children as well as programs to improve parents' skill and confidence, with no difference between age groups (< 2 years and > 2 years of age). Common barriers to service included distance and time off work. Conclusion Parents' experiences informed both acute and long term implications following CHD diagnoses, and highlight current gaps in mental health care. Direction for clinical care and improved intervention opportunities are discussed.