Interactions of dietary whole-grain intake with fasting glucose- and insulin-related genetic loci in individuals of European descent: a meta-analysis of 14 cohort studies.

Whole-grain foods are touted for multiple health benefits, including enhancing insulin sensitivity and reducing type 2 diabetes risk. Recent genome-wide association studies (GWAS) have identified several single nucleotide polymorphisms (SNPs) associated with fasting glucose and insulin concentrations in individuals free of diabetes. We tested the hypothesis that whole-grain food intake and genetic variation interact to influence concentrations of fasting glucose and insulin. Via meta-analysis of data from 14 cohorts comprising ∼ 48,000 participants of European descent, we studied interactions of whole-grain intake with loci previously associated in GWAS with fasting glucose (16 loci) and/or insulin (2 loci) concentrations. For tests of interaction, we considered a P value <0.0028 (0.05 of 18 tests) as statistically significant. Greater whole-grain food intake was associated with lower fasting glucose and insulin concentrations independent of demographics, other dietary and lifestyle factors, and BMI (β [95% CI] per 1-serving-greater whole-grain intake: -0.009 mmol/l glucose [-0.013 to -0.005], P < 0.0001 and -0.011 pmol/l [ln] insulin [-0.015 to -0.007], P = 0.0003). No interactions met our multiple testing-adjusted statistical significance threshold. The strongest SNP interaction with whole-grain intake was rs780094 (GCKR) for fasting insulin (P = 0.006), where greater whole-grain intake was associated with a smaller reduction in fasting insulin concentrations in those with the insulin-raising allele. Our results support the favorable association of whole-grain intake with fasting glucose and insulin and suggest a potential interaction between variation in GCKR and whole-grain intake in influencing fasting insulin concentrations.

Six new loci associated with body mass index highlight a neuronal influence on body weight regulation.

Common variants at only two loci, FTO and MC4R, have been reproducibly associated with body mass index (BMI) in humans. To identify additional loci, we conducted meta-analysis of 15 genome-wide association studies for BMI (n > 32,000) and followed up top signals in 14 additional cohorts (n > 59,000). We strongly confirm FTO and MC4R and identify six additional loci (P < 5 x 10(-8)): TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1 (where a 45-kb deletion polymorphism is a candidate causal variant). Several of the likely causal genes are highly expressed or known to act in the central nervous system (CNS), emphasizing, as in rare monogenic forms of obesity, the role of the CNS in predisposition to obesity.

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants.

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. We used data from 751 studies including 4,372,000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Wellcome Trust.

Calculation of the magnetic field penetration depth for high-Tc cuprate superconductors based on the Interlayer Pair Tunneling model /

In this work, the magnetic field penetration depth for high-Tc cuprate superconductors is calculated using a recent Interlayer Pair Tunneling (ILPT) model proposed by Chakravarty, Sudb0, Anderson, and Strong [1] to explain high temperature superconductivity. This model involves a "hopping" of Cooper pairs between layers of the unit cell which acts to amplify the pairing mechanism within the planes themselves. Recent work has shown that this model can account reasonably well for the isotope effect and the dependence of Tc on nonmagnetic in-plane impurities [2] , as well as the Knight shift curves [3] and the presence of a magnetic peak in the neutron scattering intensity [4]. In the latter case, Yin et al. emphasize that the pair tunneling must be the dominant pairing mechanism in the high-Tc cuprates in order to capture the features found in experiments. The goal of this work is to determine whether or not the ILPT model can account for the experimental observations of the magnetic field penetration depth in YBa2Cu307_a7. Calculations are performed in the weak and strong coupling limits, and the efi"ects of both small and large strengths of interlayer pair tunneling are investigated. Furthermore, as a follow up to the penetration depth calculations, both the neutron scattering intensity and the Knight shift are calculated within the ILPT formalism. The aim is to determine if the ILPT model can yield results consistent with experiments performed for these properties. The results for all three thermodynamic properties considered are not consistent with the notion that the interlayer pair tunneling must be the dominate pairing mechanism in these high-Tc cuprate superconductors. Instead, it is found that reasonable agreement with experiments is obtained for small strengths of pair tunneling, and that large pair tunneling yields results which do not resemble those of the experiments.

Electrical properties of some single crystal dodecaborides /|nby Jyoti Burte. -- 260 St. Catharines [Ont. : s. n.],

PreVi011.3 ':i or~ : indicat e('. tk~t ho t~)rE's sed ~-Al B 12 1i~2, ~' a semiconductor. r:Toreove r , the s i mpl.(~ electronic t heory also indi cates that ~ -AIB1 2 should be a semico nductor, since thf're is one nonbonding e 'Le ctrofl per AlB12- uni t. JPor these reasons, we decided to measure t he electrical n ropert i ~ s of ~ -AlB1 2 single crystal s . Singl e crystal s of¥- AIB 12 ab ou t 1 x 1 r1n1 . size were grown from a copper mel t at 12500 C. The melt technique coupled. 1,vi th slow cooling vilas used because of i ts advantages such as : siTYInle set- up of the expe rimon t ; only e ;l.sil y available c hemi cals are required and it i s a c omparatively strair::bt forvvard y,le t hod still yielding crystal s big enouGh for OtU' purpose . Copper rms used as a solvent , i nst8ad of previOl.wly used aluminum , because it allows c.l.'ystal growth at hig he r t emneratures. HovlGver, the cry s tals of ] -AlB12 shm'red very hi gh res i s t ance a t r oom temperature . From our neasureJ'lents we conclude that the r esistivity of j3- Al B12 is, at least, given as ~ = 4. x 107 oblD .em •• Those results are inc ons i s t ent wi 'uh the ones .. reported by IIiss Khin fo r bot- pressed j3-AlB12 g i ven a s = 7600 ohm . em . or I e s s . ' Since tbe hot pressing was done at about 800 - ' 9000C i n ~ rap hi te moul ds 1,7i th 97% AlB12- p oVJder, vie thi nk there is pas s ib i 1 i ty th a.t lower borides or borot] carbide are , being formed, ':.Jhich are k11 own to be good semiconductors . v7e tried to ro-pe r-AlB12 by addi'J,'?: agents s uch as l:Ig , IG.-InO 4. ' HgS04 , KI12PO 4·' etc. to t he melt .. However , all these re age 11 t eel either reduced the yield and size of t lJe crystals or r;ave crystals of high r esis'can ce again. We think tba t molten copper keeps t he i mpurities off . There is also a pos s i bil i ty t hc:!,t these doping agents get oxidi~::;ed at '1 250°C • Hence, we co ~ clud e that J -AIB12 has v~ ry high r es i stance at r oom temperature . This was a l s o C011 - fi rmed by checki ng the siYlgle and. polycrystals of .~-AIB12 from Norton Co., Ontario and Cooper Nletallurgical Association. Boron carbide has been reported to be a semiconductor with ~ - 0.3 to 0.8 ohm . cm. for hotpres sed s araples. Boron carbide b e inq: struct urally related to ¥-AIB12 , we de cided to study the electrical prone rties of it~ Single crystals. These crystals were cut from a Single melt grovvn crystal a t Norton Co., Ontario. The resistivity of th," se crystal s was measured by the Van der Pam-v' s ~ nethod, which \vas very c onvenient fo r our crystal sha-pp.s. Some of the crystals showed resistivity ~ == 0.50 ob,Tn.cr] . i n agreement with the previously reported results . However , a few crystals showed lower resistivity e.g . 0 .13 and 0.20 ohm.cra • • The Hall mobility could .not be measured and th8reiore i s lower than 0 .16 em 2 v - 1 sec -1 • This is in agreement \vith t he re1)orted Hall mobility for pyrolytic boron . _ 2 -1 -1 carbide as 0.13 cm v sec • We also studied the orientation of the boron carbide crystals by the Jjaue-method. The inclination of c-axis with res pect to x-ray be81Il was det ermined . This was found to be 100 t o 20° f or normal resistivity sarnples (0.5 ohm . cm.) and 27 - 30° for t he lower r esistivity samples (0.1 ~5 to 0.20 ohm.cm .). This indica tes the possibility that th.e r es if.1tivity of B13C3 i s orientation dependent.

The green movement in Canada

The green movement has evolved over the last twenty years from various social, peace and ecology activist organizations into direct political participation in parliamentary institutions through the Green Party. Although there is no definable theory of green politics, the culmination of interacting social movements as well as feminist, decentralist and in many cases, left wing political ideology, has produced a specific kind of political direction for the Greens internationally. As a result of the increased a ttention and awareness given to ecological issues , combined with the heightened evidence of large scale environmental deterioration, public attitudes and government decisions on development and natural resource management have been significantly altered. The Green Party of Canada is still r elatively young in comparison to its European counterparts, although ecologica l awareness and interest in t he green movement in Canada is strong, as reflected not only in support on a political level for the Canadian Greens I but for environmental issues and a ctivism in general. For this reason it s important to determine whether or not the Green Party is a significant aspect of the Canadian green movement, and if in fact its representation is necessary as an active participant in the Canadian political system . The Green Party of Canada, as a vital aspect of the Canadian green movement, and its connection to international green organizations can be examined primarily through the examp l es of both the Canadian Greens and the Green party of Ontario , by using original party documents and literature, information gained through Green party meetings and discussions with members, and commentary by Green theorists where app licable. As well, the influence on the Canadian green movement by the German Green Party is outlined , again mainly through party literature, documents and critiques of the party's experiences. This study reveals several existing and potential problems fo r t he Green Party in Canada, and the political fut ure of the Canadian green movement in general. Some, such as the real i ties of the Canadian political system are external to the movement, and may be overcome with adjustments in goals and methods, and a realization of the changing attitude towards environmental issues in a political context . On the other hand, internal party disfunctions in both organization and direction, caused mainly by the indefinite parameters of green ideology, threaten to exploit the already problematic aspects evident in t he Green Party . Aside from its somewhat slow beginnings, the Green Party in Canada has developed into a strong grassroots social movement, not however from its political visibility but from the steady growth in the popul ari ty of ecological pol i t ics in Canada. Due to the seeming enormity of the obstacles facing the Greens in their effort 4 to achieve electoral success, it is doubtful that Parliamentary representation will be achieved without a major re-orientation of party organization and methods. UI timately the strength of the Green Party in Canada will be based upon its ability to survive as a significant movement, and its willingness to continue to challenge political thought and practice.

Attachment and alcohol : testing a motivational model of problem drinking /

The purpose of this study was to replicate and extend a motivational model of problem drinking (Cooper, Frone, Russel, & Mudar, 1995; Read, Wood, Kahler, Maddock & Tibor, 2003), testing the notion that attachment is a common antecedent for both the affective and social paths to problem drinking. The model was tested with data from three samples, first-year university students (N=679), students about to graduate from university (N=206), and first-time clients at an addiction treatment facility (N=21 1). Participants completed a battery of questionnaires assessing alcohol use, alcohol-related consequences, drinking motives, peer models of alcohol use, positive and negative affect, attachment anxiety and attachment avoidance. Results underscored the importance of the affective path to problem drinking, while putting the social path to problem drinking into question. While drinking to cope was most prominent among the clinical sample, coping motives served as a risk factor for problem drinking for both individuals identified as problem drinkers and university students. Moreover, drinking for enhancement purposes appeared to be the strongest overall predictor of alcohol use. Results of the present study also supported the notion that attachment anxiety and avoidance are antecedents for the affective path to problem drinking, such that those with higher levels of attachment anxiety and avoidance were more vulnerable to experiencing adverse consequences related to their drinking, explained in terms of diminished affect regulation. Evidence that nonsecure attachment is a potent predictor of problem drinking was also demonstrated by the finding that attachment anxiety was directly related to alcohol-related consequences over and above its indirect relationship through affect regulation. However, results failed to show that attachment anxiety or attachment avoidance increased the risk of problem drinking via social influence.

Closing the summer learning gap for vulnerable junior kindergarten students

Under current academic calendars across North America, summer vacation creates a significant gap in the learning cycle. I t has been argued that this gap actually decreases student achievement levels over the course of the summer. In a synthesis of 39 studies Cooper, Nye, Charlton, Lindsay, & Greathouse (1996) indicated that summer learning loss equaled at least one month of instruction as measured by grade level equivalents on standardized test scores whereby children's test scores were at least one month lower when they returned to school in the fall than scores were when students left in the summer. Specifically, Cooper et aI., (1996) found that the summer learning loss phenomena may be particularly troublesome for less advantaged children including those with speech and language delays, children at-risk for reading disabilities, children from lower socio-economic backgrounds, and children learning English as a second language. In general, research illustrated clearly that the summer learning gap can be particularly problematic for vulnerable children and furthermore, that literacy skills may be the area of achievement that is most affected. A foundational pillar to this research project is including primary caregivers as authentic partners in a summer literacy program designed to support their children's literacy needs. This pillar led the research team to use the Learning Begins at Home: A Research-Based Family Literacy Program Curriculum designed by Antoinette Doyle, Kathleen Hipfner-Boucher, and Janette Pelletier from the Ontario Institute for the Studies of Education. The LBH program is designed to be flexibly adapted to suit the needs of each individual participating family. As indicated by Timmons (2008) literacy interventions are most powerful when they include authentic family involvement. Based on this research, a requirement for participating in the summer literacy program was involvement of a child and one of their primary caregivers. The participating caregiver was integrally involved in the program, participating in workshop activities prior to and following hands-on literacy work with their child. By including primary caregivers as authentic partners, the research team encouraged a paradigmatic shift in the family whereby literacy activities become routine within their household. 5 Participants in this study were 14 children from junior kindergarten classrooms within the Niagara Catholic District School Board. As children were referred to the program, they were assessed by a trained emergent literacy specialist (from Speech Services Niagara) to identify whether they met the eligibility requirements for participation in the summer program. To be eligible to participate, children demonstrated significant literacy needs (i.e. below 25%ile on the Test of Preschool Early Literacy described below). Children with low incidence disabilities (i.e. profound sensory impairments, severe intellectual impairments, developmental disabilities, etc) were excluded as participants. The research team used a standard pre- and posttest design whereby all participating children were assessed with the Test of Preschool Early Literacy (Lonigan et aI., 2007), and a standard measure of letter names and sounds. Pretests were administered two weeks prior to the commencement of the program and the first set of posttests was administered immediately following the program. A second set of posttests was administered in December 2009 to measure the sustainability of the program. As a result of the program, all children scored statistically significantly higher on their literacy scores at the post-program assessment point immediately following the program and also at the Dec-post-program assessment point. These results in general indicated that the summer family literacy program made an immediate impact on the emergent literacy skills of participating children. All participating children demonstrated significant increases in print and phonological awareness as well as their letter sound understanding.

Second Welland Canal - Book 1, Survey Map 11 - St. Catharines and Locks 3 and 4

Survey map of the Second Welland Canal created by the Welland Canal Company showing the Town of St. Catharines. Identified structures associated with the Canal include Lock 3 and its Lock House, Lock 4 and its Lock House, Hydraulic Race, and a floating tow path. The surveyors' measurements and notes can be seen in red and black ink and pencil. Local area landmarks are also identified and include streets and roads (ex. Geneva Street, Ontario Street, St. Paul Street, and Merritville Road), Lincoln Mills and its Store House, T. M. Merritt's Store House, Cooper Shop, L. Shickluna's Dry Dock, Peter McGill's Grist Mill, J. Flint's Saw Factory, T. Hosteter's Gristing Mill, J. Dougan Builder's shop or office, Norris and Nelson Mill, G. N. Oil Foundry and its Machine Shop and Boiler, a barrel shed, woolen factory, Estate of P. Nihen (or T. Nihan), Norris and Nelson's Wharf, the W. C. Office, and structures (possibly houses) or small properties belonging to T. Adams, and A. K. Boomer. Properties and property owners of note are: Concession 6 Lots 16, 17, and 18, Concession 7 Lots 16, 17, and 18, Alva Dittrick, James R. Benson, W. B. Robinson, and C. Phelps.

Second Welland Canal - Book 1, Survey Map 13 - St. Catharines and Locks 4 and 5

Survey map of the Second Welland Canal created by the Welland Canal Company showing the Town of St. Catharines. Identified structures associated with the Canal include Lock 4, Lock House, Lock 5, Small Lock House, the towing path, and Gasometer for Canal. The surveyors' measurements and notes can be seen in red and black ink and pencil. Local area landmarks are also identified and include streets and roads (ex. Geneva Street, Queenston Street, and Academy Street), C. Phelps Mill and Store House, St. Catharines and Welland Canal Gas Works, William Mahony's Tannery, Cooper Shop, a barrel shed, barn, and gas tanks. Properties and property owners of note are: Concession 6 Lots 14, 14, and 16, Concession 7 Lots 14, 15, and 16, C. Phelps, R. M. Clement, Orson Phelps, R. Collier, D. P. Haynes, W. Chace, and John Soper.

Second Welland Canal - Book 3, Survey Map 12 - Village of Welland

Survey map of the Second Welland Canal created by the Welland Canal Company showing the canal in the Village of Welland. Identified structures and features associated with the Canal include the towing path, the old canal, the aqueduct lock, the new aqueduct, the old aqueduct, Lock Tenders House, a waste weir, culvert, covered drain, drain, dam, flume, and the canal's New Line. The surveyors' measurements and notes can be seen in red and black ink and pencil. Local area landmarks are also identified and include bridges, roads, and streets (ex. Division Street and Main Street), Chippewa Creek, Mill Pond, Mill Race, Court House and Gaol, Seeley (Seely) and Dunlop Saw Mill, Seeley (Seely) and Dunlop (Burnt) Grist Mill, Montrose Grist Mill, M. Caferty (Cafferty) City Hotel, Welland House by Wilkerson, Eli Mead Wharf Lot, A. Sherwood Wharf Lot, D. P. Myers Store, M. Cook Grist Mill, A. H. Cosby Saw Mill, Betts Lumber Yard, T. Quinn Tavern, a Carding Mill, shed, several barns, a hotel, and several structures or properties belonging to: J. P Evans, W. A. Phillips, S. Hampton, M. Silverthorne, D. McEwing, W. B. Hendershott (Hendershot), T. Burgar, J. Brookfield, A. Hendershott, Joseph Burgar, C. Demrie, M. Cafferty, J. Spencer, Mrs. Curran, John Lemon, D. Cooper, H. A. Rose, J. Bridges, A. Chapman, and R. Morewood. A structure belonging to a D. McKelly or McKully, and a store belonging to a J. Fino or Finn are also present. Properties and property owners of note are: Lots 247 and 248 of the Thorold Township, 5th Concession Lots 26 and 25 of the Crowland Township, Smith Shotwell, Eli Mead, D. P Myers, Donaldson, McFarland, Mrs. Silverthorne, Price, and Griffth. A County Court House Lot containing the Court House, Gaol and Gaol Yard is present.

Dyad function-based cognitive behavioural therapy as a treatment for obsessive compulsive disorder in two school aged children with high functioning autism

Children with High-Functioning Autism (HF A) are more vulnerable to developing Obsessive Compulsive Disorder (OCD) than typically developing children and those with Low-Functioning Autism (Gadow et al., 2005). This study used a multiple baseline design across behaviours (Cooper, Heron, & Heward, 2007) to investigate if a two phase function-based Cognitive Behaviour Therapy (CBT) would decrease obsessive compulsive behaviours (OCBs) in two children ages 7 and 9 who met criteria for OCD and HF A. This multimodal treatment package consisted of treatment enhancements to meet the children's cognitive, linguistic, and social challenges associated with their HF A diagnosis, as well as a manual and accompanied children's workbook (Vause, Neil, & Feldman, in progress). In line with previous research conducted on CBT as a treatment for OCD in this population (e.g., Wood et at, 2009), the children in this study experienced clinically significant decreases in their OCBs as a result of receiving the CBT protocol.

Unchained Minds: Self-Accounts of Madness

This thesis explores the connection between the historical and social construction of madness in relation to how society currently views madness and schizophrenia. The anti-psychiatry movement has been outlined using the work of anti-psychiatrists David Cooper, R. D. Laing and Franco Basaglia. Foucault’s work regarding madness and the asylum is also reviewed to give an overarching analysis of madness, including analysis of its creation. With the help of Basaglia, madness as class warfare and social disease are explored. By connecting this analysis to the medicalization of schizophrenia and the use of counter-narratives, this thesis uses the work of Deleuze and Guattari to illustrate how mental illness can be redefined through deterritorialization, reterritorialization and lines of flight. Specifically, this thesis uses a Foucauldian textual analysis to examine self-narratives of schizophrenia including, the films A Beautiful Mind and The Best of Youth, and the books Two Accounts of a Journey Through Madness, The Center Cannot Hold and Living With Voices. These self-narratives illustrate the importance of considering an individual’s voice when determining treatment options for mental illness. Overall, a shift in thinking is needed. The findings suggest self-help groups are not enough on their own and should be combined with medical intervention. Self-narratives are an important step in the recovery process as it allows one to come to terms with their voice hearing experiences. As well, self-narratives are useful in the treatment process as a tool that can help to redefine dominant conceptualizations of schizophrenia and mental illness today.

I Believe in me, not OCB: Evaluation of Group Function-Based CBT as a Treatment for Obsessive Compulsive Behaviour in Four Children with HFA

Researchers have conceptualized repetitive behaviours in individuals with Autism Spectrum Disorder (ASD) on a continuum oflower-Ievel, motoric, repetitive behaviours and higher-order, repetitive behaviours that include symptoms ofOCD (Hollander, Wang, Braun, & Marsh, 2009). Although obsessional, ritualistic, and stereotyped behaviours are a core feature of ASD, individuals with ASD frequently experience obsessions and compulsions that meet DSM-IV-TR (American Psychiatric Association, 2000) criteria for Obsessive-Compulsive Disorder (OCD). Given the acknowledged difficulty in differentiating between OCD and Autism-related obsessive-compulsive phenomena, the present study uses the term Obsessive Compulsive Behaviour (OCB) to represent both phenomena. This study used a multiple baseline design across behaviours and ABC designs (Cooper, Heron, & Heward, 2007) to investigate if a 9-week Group Function-Based Cognitive Behavioural Therapy (CBT) decreased OCB in four children (ages 7 - 11 years) with High Functioning Autism (HFA). Key treatment components included traditional CBT components (awareness training, cognitive-behavioural skills training, exposure and response prevention) as well as function-based assessment and intervention. Time series data indicated significant decreases in OCBs. Standardized assessments showed decreases in symptom severity, and increases in quality of life for the participants and their families. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed child are discussed.