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BackgroundIn response to COVID-19, there has been increasing momentum in telehealth development and delivery. To assess the anticipated exponential growth in telehealth, it is important to accurately capture how telehealth has been used in specific mental health fields prior to the pandemic. ObjectiveThis systematic review aimed to highlight how telehealth has been used with clinical samples in the neurodevelopmental field, including patients with neurodevelopmental disorders (NDDs), their families, and health care professionals. To identify which technologies show the greatest potential for implementation into health services, we evaluated technologies for effectiveness, economic impact, and readiness for clinical adoption. MethodsA systematic search of literature was undertaken in April 2018 and updated until December 2019, by using the Medline, Web of Science, Scopus, CINAHL Plus, EMBASE, and PsycInfo databases. Extracted data included the type of technology, how the technology was used (ie, assessment, treatment, and monitoring), participant characteristics, reported outcomes and authors’ views on clinical effectiveness, user impact (ie, feasibility and acceptability), economic impact, and readiness for clinic adoption. A quality review of the research was performed in accordance with the Oxford Centre for Evidence-Based Medicine Levels of Evidence. ResultsA total of 42 studies met the inclusion criteria. These studies included participants and family members with autism spectrum disorders (21/42, 50%), attention deficit hyperactivity disorders (8/42, 19%), attention deficit hyperactivity or autism spectrum disorders (3/42, 7%), communication disorders (7/42, 17%), and tic disorders (2/42, 5%). The focus of most studies (33/42, 79%) was on treatment, rather than assessment (4/42, 10%) or monitoring (5/42, 12%). Telehealth services demonstrated promise for being clinically effective, predominantly in relation to diagnosing and monitoring NDDs. In terms of NDD treatment, telehealth services were usually equivalent to control groups. There was some evidence of positive user and economic impacts, including increased service delivery efficiency (eg, increased treatment availability and decreased waiting times). However, these factors were not widely recorded across the studies. Telehealth was demonstrated to be cost-effective in the few studies that considered cost-effectiveness. Study quality varied, as many studies had small sample sizes and inadequate control groups. Of the 42 studies, only 11 (26%) were randomized controlled trials, 12 (29%) were case studies or case series, 6 (14%) were qualitative studies, and 5 (12%) were noncomparative trials. ConclusionsTelehealth has the potential to increase treatment availability, decrease diagnosis waiting times, and aid in NDD monitoring. Further research with more robust and adequately powered study designs that consider cost-effectiveness and increased efficiency is needed. This systematic review highlights the extent of telehealth technology use prior to the COVID-19 pandemic and the movement for investing in remote access to treatments. Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42018091156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018091156

BackgroundThe prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved. ObjectiveThis systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users’ views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders. MethodsA systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies. ResultsA total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care. ConclusionsFindings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.

The study evaluates a peer-assisted learning (PAL) scheme as an effective strategy in alleviating levels of negative emotions and, in the process, contributes to explorations of affect in first-year students in an HE in FE environment, with a particular focus on anxiety and related emotions. Various types of anxieties are defined in the context of a student's experience in HE, followed by an explanation of the present interventional study in an HE in FE institution, including the survey method used to collect data analyzed through SPSS. Surprisingly, the main findings are that overall anxiety and worry increased for students belonging to most faculties with time, regardless of participation in the PAL scheme. A positive finding was nonetheless that anxiety levels increased more steadily for students who belonged to the control group. The PAL scheme may have thus influenced how less anxious PAL students felt, compared to those who did not participate in the PAL scheme who were left feeling more anxious at the end of the semester.

SCN8A variants cause a spectrum of epilepsy phenotypes ranging from self‐limited infantile epilepsy (SeLIE) to developmental and epileptic encephalopathy. SeLIE is an infantile onset focal epilepsy, occurring in developmentally normal infants, which often resolves by 3 years. Our aim was to ascertain when epilepsy resolves in SCN8A‐SeLIE. We identified unpublished individuals with SCN8A‐SeLIE and performed detailed phenotyping. Literature was searched for published SCN8A‐SeLIE cases. Nine unpublished individuals from four families were identified (age at study = 3.5–66 years). Six had their last seizure after 3 years (range = 4–21 years); although drug‐responsive and despite multiple weaning attempts (1–5), five of six remain on antiseizure medications (carbamazepine, n = 3; lamotrigine, n = 2). We identified 29 published individuals with SCN8A‐SeLIE who had data on seizure progression. Of the 22 individuals aged at least 10 years, reported here or in the literature, nine of 22 (41%) had seizure offset prior to 3 years, five of 22 (23%) had seizure offset between 3 and 10 years, and eight of 22 (36%) had seizures after 10 years. Our data highlight that more than half of individuals with SCN8A‐SeLIE continue to have seizures into late childhood. In contrast to SeLIE due to other etiologies, many individuals have a more persistent, albeit drug‐responsive, form of epilepsy. [ABSTRACT FROM AUTHOR]

This review and synthesis of relevant literature considers the nature of boredom and boredom proneness in general terms before focusing on how the academic boredom experienced by undergraduates at university is sufficiently different from other known types to warrant a unique and important field of study. Derived from within the literature itself, academic boredom is commonly presented as a largely negative and deactivating achievement-related emotion known to impact usually adversely on student engagement and performance. Tracing traditional as well as contemporary views from within psychology, which has tended to dominate the field, findings that remain largely quantitative and highly statistical in nature are exemplified alongside the more exploratory but mixed-methods and educational work recently conducted in the UK. A comparison of the questionnaire-based self-report instruments frequently used in data collection is also included. Rooted largely within Control-Value Theory, the implications associated with academic boredom are far from trivial, particularly with respect to understanding sites and triggers, how students respond and cope and how the overall quality of the student experience might be improved. Limitations in the work undertaken to date draw attention to opportunities for further educational and interdisciplinary research.

This paper details a small-scale research project that explores the student transition into higher education (HE), delivered in a further education college (FE), and considers whether the requirements of transition at this level impacts on emotional wellbeing. As such, it aims to contribute to the growing body of research on HE-in-FE from the perspective of student transition and emotional wellbeing. The data drawn on in this paper were collected by a questionnaire, administered at two points in the first semester, to measure levels of anxiety in students, alongside a further questionnaire designed to evaluate the effectiveness of bespoke academic skills input aimed at supporting the transition into HE. From quantitative and qualitative data, key findings identify factors that influence students' emotional responses to HE, including those that exacerbate and those that mitigate negative emotional responses. Significantly, the research identifies academic factors, rather than personal or social issues, as being critical to students' emotional experiences during the transitionary period.

White-footed mice (Peromyscus leucopus) are important host reservoirs for Borrelia burgdorferi and Rickettsia rickettsii. These bacteria are responsible for the tick-borne illnesses Lyme disease and Rocky Mountain spotted fever, respectively. These illnesses infect Ohio citizens annually, as well others in the larger range where these ticks are found. The goal of this study was to test white-footed mice and ticks for B. burgdorferi and R. rickettsii at Capital University's Primmer Outdoor Learning Center located in Logan, Ohio during the summer of 2020. Blood samples and ticks were collected from mice (n = 16) over the span of six live-trapping sessions in a woodlot and fencerow on the property. Ticks were also collected from four other locations using the drag-cloth method. DNA was extracted from the blood samples (n = 13) and ticks (n = 16) and tested for the presence of B. burgdorferi and Rickettsia sp. using conventional PCR and agarose gel electrophoresis. Relative abundance of mice was slightly higher in the fencerow than in the woodlot. Only American dog ticks (Dermacentor variabilis) were found in this study. B. burgdorferi was not detected, while Rickettsia sp. were confirmed for one mouse and 14 ticks. The results from this study increase our understanding of tick-borne pathogens within the state of Ohio and suggest we need to take steps to minimize risk of disease exposure at the University field site. In the future, this work can be used to inform models to simulate tick-borne pathogen dynamics in southeastern Ohio for both Lyme disease and Rocky Mountain spotted fever. [ABSTRACT FROM AUTHOR]

South Georgia is a heavily glaciated sub‐Antarctic island in the Southern Ocean. Cumberland Bay is the largest fjord on the island, split into two arms, each with a large marine‐terminating glacier at the head. Although these glaciers have shown markedly different retreat rates over the past century, the underlying drivers of such differential retreat are not yet understood. This study uses observations and a new high‐resolution oceanographic model to characterize oceanographic variability in Cumberland Bay and to explore its influence on glacier retreat. While observations indicate a strong seasonal cycle in temperature and salinity, they reveal no clear hydrographic differences that could explain the differential glacier retreat. Model simulations suggest the subglacial outflow plume dynamics and fjord circulation are sensitive to the bathymetry adjacent to the glacier, though this does not provide persuasive reasoning for the asymmetric glacier retreat. The addition of a postulated shallow inner sill in one fjord arm, however, significantly changes the water properties in the resultant inner basin by blocking the intrusion of colder, higher salinity waters at depth. This increase in temperature could significantly increase submarine melting, which is proposed as a possible contribution to the different rates of glacier retreat observed in the two fjord arms. This study represents the first detailed description of the oceanographic variability of a sub‐Antarctic island fjord, highlighting the sensitivity of fjord oceanography to bathymetry. Notably, in fjords systems where temperature decreases with depth, the presence of a shallow sill has the potential to accelerate glacier retreat. Plain Language Summary: Cumberland Bay, a fjord on the sub‐Antarctic island of South Georgia, is split into two arms, each with a large marine‐terminating glacier. One of these glaciers is retreating much faster than the other, possibly due to differences in oceanography between the arms. Here, we investigate how the oceanography in Cumberland Bay varies seasonally and with the seabed depth by using oceanographic data and numerical ocean simulations. We find that the properties of buoyant plumes, which arise from meltwater entering the ocean from beneath the glacier, are sensitive to the seabed depth near the glaciers, resulting in strong differences in ocean flow between the fjord arms. Assuming higher ocean temperatures increase glacier melting, we find that the presence of a near‐glacier shallow sill likely increases melting by blocking deeper, colder waters and trapping warmer surface waters close to the glacier. As a shallow sill is likely to be present near the rapidly retreating glacier only, this result offers a persuasive explanation for the observed glacier retreat. Understanding the variability in oceanography and glacier retreat is important as they directly impact the marine ecosystem at South Georgia by influencing the availability of nutrients for primary production and food availability for higher predators. Key Points: Observational data and a new high‐resolution model are combined to describe oceanographic variability in Cumberland Bay, South GeorgiaWe show that the properties of buoyancy‐driven outflow plumes are sensitive to bathymetry and drive spatial differences between fjord armsWe highlight that the presence of a postulated inner sill may be a key factor in the observed rapid glacier retreat [ABSTRACT FROM AUTHOR]

Kinship caregivers raise relative children who are unable to be cared for by their parents. Most kinship caregiving takes place outside the child welfare system ("informal" care), meaning that caregivers do not have access to foster care payments to offset the costs of child rearing. The main source of financial support for informal kinship caregivers is Child-Only TANF, which is inadequate to meet the full range of caregiver needs. To address this funding gap, the authors present a comparative policy analysis of seven programs in six states that have implemented supplemental state funds for informal kinship caregivers. The authors analyze key features of each program and compare the socioeconomic and political characteristics of states that offer supplemental caregiver benefits to those of states that do not. Recommendations for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

As new generations of targeted therapies emerge and tumor genome sequencing discovers increasingly comprehensive mutation repertoires, the functional relationships of mutations to tumor phenotypes remain largely unknown. Here, we measured ex vivo sensitivity of 246 blood cancers to 63 drugs alongside genome, transcriptome, and DNA methylome analysis to understand determinants of drug response. We assembled a primary blood cancer cell encyclopedia data set that revealed disease-specific sensitivities for each cancer. Within chronic lymphocytic leukemia (CLL), responses to 62% of drugs were associated with 2 or more mutations, and linked the B cell receptor (BCR) pathway to trisomy 12, an important driver of CLL. Based on drug responses, the disease could be organized into phenotypic subgroups characterized by exploitable dependencies on BCR, mTOR, or MEK signaling and associated with mutations, gene expression, and DNA methylation. Fourteen percent of CLLs were driven by mTOR signaling in a non-BCR-dependent manner. Multivariate modeling revealed immunoglobulin heavy chain variable gene (IGHV) mutation status and trisomy 12 as the most important modulators of response to kinase inhibitors in CLL. Ex vivo drug responses were associated with outcome. This study overcomes the perception that most mutations do not influence drug response of cancer, and points to an updated approach to understanding tumor biology, with implications for biomarker discovery and cancer care., Introduction The clinical response to anticancer agents is heterogeneous, which is a major barrier to effective cancer care. Being able to more accurately predict response before choice of treatment would [...]