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Objectives: Clinical heterogeneity among patients in addiction treatment settings represents a challenge as most of the treatment programs are designed to treat substance use disorders (SUD) generally rather than offering more tailored approaches addressing individual patient needs. Systematic characterization of clinical heterogeneity may permit more individualized care paths toward improving outcomes. Methods: Data were collected from a large inpatient SUD treatment program between April 2018 and March 2020 (n = 1519). Latent profile analysis (LPA) was applied to identify latent clusters based on differences in substance use and co-occurring depression, anxiety, and post-traumatic stress disorder. Results: Five distinct profiles emerged: Profile 1 (38%) exhibited the lowest substance use and lowest psychiatric severity (Overall Low); Profile 2 (39%) exhibited high alcohol and psychiatric severity; Profile 3 (13%) exhibited high opioid severity and low psychiatric severity. Profile 4 (8%) exhibited high cannabis use and high psychiatric severity, and profile 5 (3%) exhibited high polysubstance use other than alcohol and cannabis use. The latter two profiles were younger and exhibited higher self-regulatory deficits. The (High Alc/high psych) and the (High Cann/Psych) profiles exhibited differentially higher psychiatric severity. Profiles showing high polysubstance use, as well as high cannabis use and high psychiatric severity, showed significantly higher impulsive behavior than the others. Conclusions: LPA revealed five clusters of patients varying substantially in terms of SUD and psychiatric severity. Addressing common features of clinical heterogeneity for tailored care paths in a personalized treatment approach may improve treatment outcomes. [ABSTRACT FROM AUTHOR]

This study describes medical interpreters' experiences with behavioral health (BH) services in a primary care clinic. Focus group data with medical interpreters representing multiple languages was analyzed using hybrid inductive-deductive thematic analysis. Themes related to interpreter roles were: (1) case management, (2) patient-interpreter relationship, and (3) patient-provider liaison. Themes related to barriers and facilitators to interpreter-mediated BH care were: (1) cultural factors, (2) patient-provider interactions, (3) BH-specific considerations, and (4) clinic factors. Results illustrate ways that interpreters directly (e.g. interpreter-mediated services) and indirectly (e.g. relationship building) support care. The interpreter-patient relationship reportedly helped improve patient attitudes and buy-in for BH. [ABSTRACT FROM AUTHOR]

Objective. Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two independent adolescent samples (T1: Summer 2020; T2: Winter 2020/21). Methods and Measures. Six hundred sixty-two Canadian adolescents (T1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (T2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation difficulties, and measures of anxious and depressive symptoms. Results. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms through affect dysregulation, but only at T1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both T1 and T2 and had an indirect effect through affect dysregulation and suppression. Conclusion. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities. [ABSTRACT FROM AUTHOR]

Objective: Body dissatisfaction elevates the risk for disordered eating behaviors. Excessive exercise is prevalent among college women and associated with harm. Risk theory posits a bidirectional relationship between risk factors for disordered eating behaviors and the behaviors themselves. This study investigated the longitudinal, reciprocal relationship between body dissatisfaction and excessive exercise. Participants and methods: College women (n = 302) assessed in August (baseline) and November (follow-up). Results: Baseline body dissatisfaction significantly predicted increases in excessive exercise endorsement at follow-up, controlling for baseline excessive exercise endorsement and body mass index (BMI). Baseline excessive exercise endorsement predicted increases in body dissatisfaction at follow-up, controlling for baseline body dissatisfaction and BMI. Conclusions: Findings support the presence of a positive feedback loop between body dissatisfaction and excessive exercise; both predict increases in risk for the other, regardless of weight status. Future research should test whether this process is ongoing and predicts further distress. [ABSTRACT FROM AUTHOR]

Are resilient employees so tough that they neglect to rest? To answer this question, eleven extraordinarily resilient professional caregivers (positive deviants [PD]) were interviewed about their meanings and practices of rest. Additionally, five professionals who scored extremely low in resilience and four who were average were also interviewed. Analysis of interviews revealed that PD caregivers held multifaceted interpretive schema of rest. Namely, they embraced bounded physicality, the limited ability to engage in space and time. In turn, they viewed rest as a (a) strategic defense and (b) normal indispensable joy, and practiced rest through (c) multimodal care. Thus, findings implied that resilient employees make rest a priority. The paper contributes to the communicative theory of resilience and the meanings of work literatures. [ABSTRACT FROM AUTHOR]

Shared decision-making (SDM) aims to create a context in which patients and surgeons work together to explore treatment options and goals of care. The objective of the current study was to characterize demographic factors, behaviors, and perceptions of patient involvement among surgeons relative to SDM. Using a cross-sectional survey methodology, surgeon demographics, behaviors, and perceptions of patient involvement were assessed. Surgeon approaches to SDM were measured using a 100-point scale ranging from 'patient-led' (0) to 'surgeon-led' (100). Among 241 respondents, most were male (n = 123, 67.2%) and White (n = 124, 69.3%); roughly one-half of surgeons had been in practice ≥10 years (n = 120, 52.4%). Surgeon approaches to SDM ranged from 0 to 81.0, with a median rating of 50.0 (IQR: 35.5, 62.0). Reported approaches to SDM were associated with years in practice, sharing information, and perceptions of patient involvement. Surgeons in practice 10 + years most frequently utilized a 'Shared, Patient-led' approach to SDM (27.5%), while individuals with less experience more often employed a 'Shared, Surgeon-led' approach (33.3%, p = 0.031). Surgeons with a 'Patient-led' approach perceived patient involvement as most important (M = 3.82, SD = 0.16), while respondents who had a 'Surgeon-led' approach considered this less important (M = 3.57, SD = 0.38; p < 0.001). Surgeon factors including demographics, behaviors, and perceptions of patient involvement influenced SDM approaches. SDM between patients and surgeons should strive to be more dynamic and tailored to each specific patient's needs to promote optimal patient-centered care. [ABSTRACT FROM AUTHOR]

Objective: To critically review contemporary theoretical models, diagnostic approaches, clinical features, and assessment findings in Functional Cognitive Disorder (FCD), and make recommendations for neuropsychological evaluation of this condition. Method: Narrative review. Results: FCD is common in neuropsychological practice. It is characterized by cognitive symptoms that are not better explained by another medical or psychiatric disorder. The cognitive symptoms are associated with distress and/or limitations in daily functioning, but are potentially reversible with appropriate identification and treatment. Historically, a variety of diagnostic frameworks have attempted to capture this condition. A contemporary conceptualization of FCD positions it as a subtype of Functional Neurological Disorder, with shared and unique etiological factors. Patients with FCD tend to perform normally on neuropsychological testing or demonstrate relatively weak memory acquisition (e.g. list learning trials) in comparison to strong attention and delayed recall performance. Careful history-taking and behavioral observations are essential to support the diagnosis of FCD. Areas of ongoing controversy include operationalizing "internal inconsistencies" and the role of performance validity testing. Evidence for targeted interventions remains scarce. Conclusions: Neuropsychologists familiar with FCD can uniquely contribute to the care of patients with this condition by improving diagnostic clarity, richening case formulation, communicating effectively with referrers, and leading clinical management. Further research is needed to refine diagnosis, prognosis, and treatment. [ABSTRACT FROM AUTHOR]

Special populations like people living with HIV/AIDS (PLWHA) and people with opioid use disorder (OUD) smoke tobacco cigarettes at rates three to four times greater than the general population. Patients with tobacco use disorder exhibit attentional bias (AB) for cigarette cues. Eye tracking can quantify this bias by measuring fixation time (FT) on cigarette and matched neutral cues, to calculate an AB score. Although previous studies have measured this bias in people who smoke without any other comorbid conditions, no study, to our knowledge, has measured or compared this bias in special populations. We performed exploratory analyses on eye tracking data collected in two separate randomized clinical trials (RCTs) (NCT05049460, NCT05295953). We compared FT and cigarette-cue AB score (measured by subtracting FT on neutral cues from FT on cigarette cues) between PLWHA and people with OUD who smoke, using a visual probe task and Tobii Pro Fusion eye tracker. We used two cigarette cue types, one encompassing people smoking cigarettes and the other consisting of cigarette paraphernalia. We used two cue presentation times, 1000 and 2000 milliseconds (ms). Cues of people smoking cigarettes elicited greater AB than cues of cigarette paraphernalia across both subject groups when cues were presented for 2000 ms, but not 1000 ms. PLWHA who smoke exhibited greater AB for cues of people smoking cigarettes than cigarette paraphernalia when presented for 2000 ms compared to people with OUD who smoke. We use cigarette-cue AB to quantify craving and cigarette consumption in two populations smoking at elevated rates. The addition of social cues potentiates cigarette cue AB, based on cue type and stimulus presentation time. Understanding the neurobiology of this relationship can help design novel smoking cessation treatments that target AB and prevent relapse in these populations with suboptimal response to smoking cessation treatments. Clinical trials that provided the data for post hoc analyses are NCT05049460 and NCT05295953. [ABSTRACT FROM AUTHOR]

Patients with psychogenic nonepileptic seizure (PNES) who fail performance validity testing (PVT) may appear to produce non-valid cognitive profiles. Consequently, they may not get referred to treatment and events persist, with worsening disability and high resource utilization. As a result, we report pre- and post-treatment neuropsychological evaluation findings in a 59-year-old woman with a confirmed diagnosis of PNES established using video-EEG monitoring. At pre-treatment baseline neuropsychological evaluation, PNES events occurred weekly to daily. Performance was impaired across PVTs and across multiple cognitive domains. After behavioral intervention specific to PNES, these events substantially reduced in frequency to rare stress-induced flares. Post-treatment neuropsychological evaluation revealed marked improvement of most cognitive and behavioral scores from baseline, and valid PVT scores. We review predisposing, precipitating, and perpetuating factors for PNES and cognitive impairment in this case and discuss the patient's outcome from treatment. Effectively managing PNES events and dissociative tendencies while reducing unnecessary pharmacological interventions appears to have allowed this patient to function closer to her optimal state. This case illustrates the complexity of Functional Neurologic Disorder (FND) clinical presentation and challenges the assumption that suboptimal neuropsychological performance predicts poor treatment engagement and outcome. We showcase the reversibility of PNES and cognitive manifestations of FND using targeted psychotherapeutic interventions, which resulted in reduced disability and associated healthcare costs, as well as re-engagement in life. [ABSTRACT FROM AUTHOR]

Internationally, COVID-19 has forced educational reform and disrupted already strained social work field education systems. This inquiry began pre-pandemic, responding to placement scarcity, which was only exacerbated by the pandemic as agencies migrated to online service delivery and universities responded to sudden placement cancellations. Educators found themselves navigating two interlinked global trends: 1) workplace learning that was changing radically; and 2) the immediate need to identify and develop placement opportunities. This article presents themes from a co-operative inquiry that interrogated four innovative international placement scenarios from Australia, Canada, Ireland, and New Zealand, highlighting enablers, markers, and aspects of quality learning. The four exemplars evidence the pedagogical challenges and opportunities presented by placement innovation and online learning. These placements reveal how tensions regarding placement scarcity, rapid placement innovation, and the concurrent need to mitigate risk while preserving placement quality were managed. The authors propose that creativity and innovation guided by well-articulated educational principles, learning outcomes, and pedagogical practices, promote the construction of quality placements that transcend potential risks. The challenge moving forward is upholding contemporary approaches to placement teaching and learning that ensure social work students' acquisition of professional knowledge, values and skills that are necessary for practice. [ABSTRACT FROM AUTHOR]

Abstract Objectives. While oppositional defiance is often considered a childhood behavioural problem, the negative impact of symptoms on relationships and emotional wellbeing may endure well into young adulthood and can affect overall physical health. However, little is known about the co - occurrence of oppositional defiance symptoms (ODS) and changes in physical health functioning, particularly during the transition to young adulthood. This study examines the coupled change between ODS and physical health symptoms during this critical developmental period to inform the long - term somatic manifestations of ODS. Methods. Participants (N = 662; 52% female) from the Victoria Healthy Youth Survey (V-HYS) were assessed for ten years across six biennial occasions from ages 12–18 to ages 22–30. A multilevel time -varying covariation model, disaggregating within- and between - person variability, examined whether change in ODS was systematically associated with change in physical health symptoms. Results. On average, individuals with higher ODS reported more physical health symptoms. Moreover, ODS also shared a significant within - person time - varying association with physical health, suggesting that the two symptom domains fluctuated together within - individuals across time, irrespective of between - person differences. Conclusion. This study provides a novel within- and between - person demonstration of the link between ODS and physical health symptoms from youth to young adulthood. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive weakness and eventual death, usually within 3-5 years. An ALS diagnosis is associated with substantial emotional distress for both the affected person and their family care-partners which impairs the ability to engage in important conversations about long term care planning, negatively impacts ALS symptoms for the patient, and quality of life for both patient and care-partner. Here we 1) discuss published works identified by the authors about psychosocial interventions for the ALS population, 2) identify a lack of early, dyadic interventions to support psychosocial needs of people with ALS and care-partners; 3) describe the Neurodegenerative Diseases (NDD) framework for early dyadic intervention development and 4) propose an adaptation of an evidence-based early dyadic psychosocial intervention, Recovering Together, for the unique needs of people with ALS and their care-partners (Resilient Together-ALS; RT-ALS) using the NDD framework. Future work will use stakeholder feedback to optimize the intervention for subsequent efficacy testing. [ABSTRACT FROM AUTHOR]

This paper describes three case studies from an outpatient intercultural therapeutic program founded and run by Yaqui health professionals and traditional healers to serve members of the Yaqui tribe residing in Sonora, Mexico. This pilot therapeutic program has been designed specifically for Indigenous individuals, incorporating the ceremonial use of naturally derived psychedelics in addressing substance use disorders and other mental health issues. The program employs a community-based approach, integrating various traditional Indigenous healing practices like the sweatlodge (temazcal), medicinal plant preparations, and the ritualistic use of selected psychedelics from natural sources (such as ayahuasca, peyote, and secretions from Incilius alvarius). These approaches are complemented by culturally attuned group and individual psychotherapy sessions, as well as group sports, community meals, collaborative construction efforts for a permanent clinical infrastructure, and cultural engagements such as art, crafts, and collective music. To evaluate the program's efficacy, safety, and cultural implications, an ongoing observational study is being conducted by an international team of researchers. The preliminary results demonstrate therapeutic progress and improved psychometric outcomes observed in the three case studies presented, indicating promise for this intercultural therapeutic intervention. [ABSTRACT FROM AUTHOR]

Practitioners and scholars increasingly employ social media listening platforms (SMLPs) driven by artificial intelligence (AI) to extract actionable insights from large amounts of social media data informing research questions and brand strategy. Due to their proprietary nature, AI tools within SMLPs are "black boxes" that force users to accept results on blind faith, a source of concern in industry and academia. This study seeks to provide greater understanding of the strengths and weaknesses of SMLPs by assessing the AI-based results of leading SMLP Crimson Hexagon (now Brandwatch Consumer Research) against those of a standard human content analysis and an analysis conducted using Linguistic Inquiry and Word Count (LIWC). Analyzing a random 10,000-post sample of the conversation around the Nike "Dream Crazy" ad featuring Colin Kaepernick, findings reveal Crimson Hexagon's AI tools to be woefully unreliable in terms of brand identification as well as detection of post and brand sentiment polarity, specific emotions, and brand outcomes, demonstrating the hazards of blindly relying upon conclusions drawn from black-box social media listening platforms. Findings highlight the need for researchers to examine algorithm documentation and training data sets, as well as assess AI-generated data prior to use in research models and decisions. [ABSTRACT FROM AUTHOR]

Subjective responses to psychoactive drugs have served as intriguing windows into consciousness as well as useful predictors. Subjective reactions to psychedelic molecules are particularly interesting given how they covary with subsequent improvements associated with psychedelic-assisted treatments. Although links between subjective reactions and decreases in treatment-resistant clinical depression, end-of-life anxiety, and maladaptive consumption of alcohol and nicotine appear in the empirical literature, the measurement of these subjective responses has proven difficult. Several scales developed over many decades show reasonable internal consistency. Studies suggest that many have a replicable factor structure and other good psychometric properties, but samples are often small and self-selected. We review the psychometric properties of some of the most widely used scales and detail their links to improvement in response to psychedelic-assisted treatments. Generally, assessments of mystical experiences or oceanic boundlessness correlate with improvements. Challenging subjective experiences, psychological insight, and emotional breakthroughs also show considerable promise, though replication would strengthen conclusions. We suggest a collaborative approach where investigators can focus on key responses to ensure that the field will eventually have data from many participants who report their subjective reactions to psychedelic molecules in a therapeutic setting. This may aid in predicting improvement amongst targeted conditions and wellbeing. [ABSTRACT FROM AUTHOR]

Attitudes about male caregivers in child daycare were explored in two studies. In Study 1 participants (N = 301) read a written vignette asking them to imagine themselves as parents who are choosing a daycare centre for their infant. Using a 2 × 2 between-subjects design, the sex of the caregiver and that of the child were randomly manipulated in the vignette. Participants were then asked about whether and why they'd choose the centre for their infant. Study 2 involved semi-structured interviews with daycare centre professionals (N = 10) about their attitudes regarding male caregivers. The interviews were analyzed qualitatively for emerging themes. Results from the two sets of data converge to suggest that a negative social bias is widely perceived to be a barrier to the inclusion of men in daycare work. At the same time, empirical evidence directly demonstrating such (explicit or implicit) bias remains elusive. [ABSTRACT FROM AUTHOR]

The objective of this scoping literature review is to investigate: what is known about the connection between philosophical and spiritual worldviews and professional resilience in frontline social work and human services? Resilience is essential to these professionals sustaining practice during difficult times, and philosophical and spiritual worldviews are recognized as providing comfort and helping people function. The review showed that little is known about the role of philosophical and spiritual worldviews in the resilience of these professionals. We recommend that future research investigate whether engaging with the strength found in philosophical and spiritual worldviews promotes the resilience of these professionals. [ABSTRACT FROM AUTHOR]

This article presents new quantitative results on the distribution of residential green space for people with disabilities in the United States, building on and bridging scholarly research in two distinct domains: one involving approaches that quantify disparities in green space access among racialized minorities and socioeconomically disadvantaged groups, and the other using qualitative methods that demonstrate that most green spaces remain inaccessible and unwelcoming to disabled visitors. Using generalized additive models (GAMs) that controlled for demographic factors and climatological characteristics, we find that residential areas with more green space generally have a higher proportion of disabled residents. The statistical results run counter to expectations from the literature, thus complicating the prevailing narrative and indicating a need for mixed-methods research to examine multiple dimensions of access and environmental justice. Using cluster analysis to assess spatial trends, we detect residential clusters of high disability and low green space and find that they are located in predominantly non-White, urban, and more socioeconomically disadvantaged neighborhoods compared to clusters of high disability and high green space. Cluster analysis results suggest that there are inequities in green space access at the intersection of disability, race, and class, as well as across the urban–rural continuum. [ABSTRACT FROM AUTHOR]

This observational retrospective real-world study examined changes in healthcare resource utilization (HCRU) pre- and post-initiation of aripiprazole once-monthly (AOM 400) in patients with schizophrenia or bipolar I disorder. Electronic health record-derived, de-identified data from the NeuroBlu Database (2013–2020) were used to identify patients ≥18 years with schizophrenia (n = 222) or bipolar I disorder (n = 129) who were prescribed AOM 400, and had visit data within 3, 6, 9, or 12 months pre- and post-initial AOM 400 prescription. Rates of inpatient hospitalization, emergency department visits, inpatient readmissions, and average length of stay were examined and compared over 3, 6, 9, and 12 months pre-/post-AOM 400 using a McNemar test. Statistically significant differences were seen in both schizophrenia and bipolar I disorder patient cohorts pre- and post-AOM 400 in inpatient hospitalization rates (p <.001 all time points, both cohorts) and 30-day readmission per patient rates (p <.001 all time points, both cohorts). Statistically significant improvement in mean length of stay was observed in both cohorts at all time points, except for at six months in patients with schizophrenia. Emergency department visit rates were significantly lower after AOM 400 initiation for both cohorts at all time points (p <.001). A reduction in the rate of hospitalizations, emergency department visits, 30-day readmissions, and average length-of-stay was observed for patients diagnosed with either schizophrenia or bipolar I disorder, which suggests a positive effect of AOM 400 treatment on HCRU outcomes and is supportive of earlier analyses from different data sources. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the mental health experiences of adults 50 years of age and older living in a rural community in British Columbia. This study used critical social theory and interpretive description. Purposive sampling was used to recruit 8 adults aged 50 years and older. Participants used digital cameras and spent up to five weeks taking photos of representations of their life as an older adult with a mental health concern in a rural community. Semi-structured interviews were used to explore participants' reasons for taking various photos, unveiling their experiences. Constant comparison was used to analyze the data. Four key themes were identified: mental wellbeing (hope, spirituality, and gratitude; nature and losses); stigma; services and supports; and environment. There is a significant need for more health care providers for rural older adults' mental health. Additionally, there is a need for integrated services and peer-led supports to address the needs of this population. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, educators around the globe seek to understand how to support students whose academic performance is impacted by mental health challenges. This article presents a co-operative inquiry undertaken by colleagues in Canada and Australia, responding to the question; what insights can the existing Carleton University framework of reflective questions offer to educators responding to student mental health challenges in social work education during the COVID-19 pandemic? The risks and complexities of attending to student mental health needs are illustrated by a pandemic-informed case study that extends the framework into this unique context and illustrates the importance of respecting learning requirements, combating discrimination, protecting students' rights, and honouring the professional and legislative mandates of social work within all responses aimed at supporting student mental health resilience during COVID-19. This article acknowledges the limitations of previous practices guiding work with students with mental health needs during any period of crisis or disaster and demonstrates that the Carleton University framework assists in developing improved processes and policy grounded in social work's commitment to social justice and critical reflection. [ABSTRACT FROM AUTHOR]

This paper is a response to Inoue's (2020) article, Teaching Antiracist Reading. Our focus is to contextualize his framework using a disciplinary literacy lens for reading literary text in secondary and postsecondary English Language Arts (ELA) classrooms. After briefly explaining the recommendations made by Inoue (2020) and disciplinary literacy, specifically in English Language Arts, we suggest opportunities for incorporating Inoue's framework when reading literary text to support antiracist reading and interpretive practices. We also provide two caveats. First, interpretations must be student-led, which includes the form in which those interpretations are communicated. Second, literary theory has been rooted in racist practices, which necessitates new lenses to interpret the texts. [ABSTRACT FROM AUTHOR]

Quality of life (QoL) is influenced by physical and psychological health, but includes subjective qualities that are inherent in social and cognitive processes necessary for healthy aging and overall well-being. A quantitative study analyzed the effects of art therapy for 14 aging adults utilizing the Brunnsviken Brief Quality of Life Scale (BBQ) at pre, mid, and post 32-week study. Regression analysis showed significant positive changes in two areas: Importance of Learning and Leisure. Participating in art therapy increased the importance of learning and leisure, that are influential factors in QoL for aging adults. This demonstrates that art therapy has the potential to support healthy aging. [ABSTRACT FROM AUTHOR]

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. [ABSTRACT FROM AUTHOR]

Tamarillo (Solanum betaceum Cav.) is a sub-tropical fruit with unique flavour and colour, known to be highly nutritious. Tamarillo has nutritional adequacy score of 7.4 (red type) to 7.9 (gold type) and it is a rich source of vitamins A, B6, C, dietary fibre and potassium. Phenolics, carotenoids and anthocyanins are considered as the main bioactive components, with 70 volatile compounds and organic acids that contribute to flavour. Potential health benefits include antioxidant, anti-obesity, anti-cancer and prebiotic properties. Anti-microbial and antifungal activities and proteolytic activity have also been demonstrated. This review summarizes chemical composition and bioactive properties of tamarillo from eight different countries (Argentina, Brazil, Colombia, Ecuador, New Zealand, Malaysia, Panama and Taiwan). Information on carbohydrates, dietary fibre, vitamins, minerals, volatiles, phenolic compounds, anthocyanins, total phenolic content and antioxidant activities of tamarillo are compared based on cultivars and geographical sources. Tamarillo possesses higher antioxidant activity than apples and kiwifruit. Applications of tamarillo as a functional ingredient for health, food, cosmetics and pharmaceutical products are also highlighted. Recently reported antimicrobial and antifungal properties make it even more attractive as a functional ingredient to enhance safety and shelf life of foods. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate gender differences in determinants of bystander intervention (BI) participation among undergraduate students using the Reasoned Action Approach (RAA). Students (n = 291) were recruited via an online survey disseminated in general education courses at two US universities. The survey evaluated intentions, attitudes, perceived norms, and perceived behavioral control toward participating in BI. Two linear regression models (man/woman) were used to understand how constructs of RAA regressed on intentions. Students, 18–24 years old, were mostly women (60.1%) and lowerclassmen (80.4%). While both models were significant, the model better predicted intentions among women (adjusted R2 =.598) compared to men (adjusted R2 =.479). Women had significantly higher intentions, attitudes, and perceived behavioral control to engage in BI compared to men (p <.05). Results show that men and women have different views on BI, and ways to promote BI may be better if they were tailored by gender. This provides insight into the role gender plays in BI to prevent sexual assault and could enhance health education approaches on campuses. [ABSTRACT FROM AUTHOR]

Cancer cells reprogram their metabolism to maintain sustained proliferation, which creates unique metabolic dependencies between malignant and healthy cells that can be exploited for therapy. In acute myeloid leukemia (AML), mitochondrial inhibitors that block tricarboxylic acid cycle enzymes or electron transport chain complexes have recently shown clinical promise. The isocitrate dehydrogenase 1 inhibitor ivosidenib, the isocitrate dehydrogenase 2 inhibitor enasidenib, and the BH3 mimetic venetoclax received FDA approval for treatment of AML in the last few years. Other mitochondrial inhibitors including CPI-613, CB-839, dihydroorotate dehydrogenase inhibitors, IACS-010759, and mubritinib, have shown encouraging preclinical efficacy and are currently being evaluated in clinical trials. In this review, we summarize recent metabolism-based therapies and their ability to target altered cancer metabolism in AML. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and subsequent economic crisis has provided a unique opportunity to investigate the effects of economic shifts on substance use. Existing literature on this relationship is limited and conflicting, warranting further exploration. Objective: This study aimed to identify relationships between socioeconomic status (SES), demographic variables, and substance use patterns before and after government-mandated business closures due to COVID-19. Methods: Participants were recruited based on self-reported substance use through Amazon's Mechanical Turk (MTurk). Qualifying participants (N = 315, 43% female, mean age = 35.35) reported their substance use and SES for two-week periods before and after pandemic-related business closures. Regression models analyzed relationships between substance use and study variables. Results: Regression models found that, during COVID-19 closures, greater financial strain predicted decreased benzodiazepine (β = −1.12) and tobacco (β = 1.59) use. Additionally, certain predictor variables (e.g., participants' age [β = 1.22], race [β = −4.43], psychiatric disorders including ADHD [β = −2.73] and anxiety [β = 1.53], and concomitant substance use [β = 3.38]) predicted changes in substance use patterns; however, the directionality of these associations varied across substances. Conclusion: Specific substance use patterns were significantly and differentially impacted by economic strain, psychiatric diagnoses, and concomitant substance use. These results can help direct harm reduction efforts toward populations at greatest risk of harmful substance use following the pandemic. [ABSTRACT FROM AUTHOR]

The Black-breasted Button-quail is a threatened forest inhabiting button-quail endemic to the east coast of Australia. Their distribution in the largest undeveloped portion of littoral forest within their range has, until this study, remained unsurveyed. In addition, their use of littoral vegetation is poorly described. Here we present findings from targeted camera trapping surveys in the Great Sandy Region collectively; K'gari (Fraser Island), Cooloola and Inskip Peninsula, Queensland. We also review all published and unpublished reports of this species in this region, and assess their veracity. The associations of high veracity records with vegetation communities are presented. The species was most readily associated with littoral forest along the eastern coast of K'gari and Cooloola. Our findings reaffirm the distribution of Black-breasted Button-quail along the coast of K'gari, further they are distributed along the Cooloola coast and in a few isolated inland sites. This study addresses one of the persistent knowledge gaps documented in the 2010 and 2020 Action Plan for Australian Birds, pertaining to the species use and distribution in littoral vegetation of the Great Sandy Region. We anticipate the proposed distribution presented here will prove valuable in future surveys and research on this species in the Great Sandy region. [ABSTRACT FROM AUTHOR]

Objective: Intimate partner violence (IPV) remains a public health concern for women age 18-25. While much is known about the IPV risk and experiences of heterosexual women, little is known about the IPV risk and experiences of their LGBTQ + counterparts and any contributions of multiple marginalization in such risk. This study examines the emotional, physical, and sexual intimate partner violence (IPV) vulnerability of emerging adult college women with and without multiple minority statuses (e.g., women with both racial/ethnic and sexual minority identities). Participants: Participants were 9,435 women ages 18-25 from the National College Health Assessment (NCHA). Results: Findings demonstrate that being a sexual minority increases risk vulnerability for all forms of IPV, regardless of race. Conclusions: The risk for college women with multiple marginalized identities is exponentially greater than either their White or heterosexual counterparts. Implications for colleges/universities, university counseling centers and professionals, and future research directions are discussed. [ABSTRACT FROM AUTHOR]

The study examined the role social support plays in the relationship between life stress and problem alcohol use behavior in a sample of Black emerging adults in college with histories of parental substance use disorders (SUD). Participants were 1,007 Black emerging adult college students, recruited as part of a larger multi-wave, multisite, study investigating coping behavior among emerging adults in college. Findings suggest that Black college students with parental SUDs engage in riskier and coping motivated drinking behaviors more than those without such histories, and their alcohol use behaviors are more strongly linked to experiencing life stress, despite similar levels of perceived social support. Social support from friends and sufficient global social support help to mediate this adverse relationship. Parental SUD may serve as a readily identifiable risk factor for risky drinking behavior among Black college students. Implications for future research and clinical practice are presented. [ABSTRACT FROM AUTHOR]

Emerging adults experience increased morbidity as a result of psychological distress and risky sexual behavior. This study examines how sexual behaviors (e.g., condom use inconsistency and past year STI history) differ among emerging adults with low, moderate, and high psychological distress. Participants are 251,254 emerging adults attending colleges and universities in the United States who participated in the National College Health Assessment (NCHA). Findings suggest a dose-response relationship between psychological distress, condom use inconsistency, and past STI history, such that an association between greater psychological distress and condom use inconsistency and/or past year history of sexually transmitted infections (STIs). [ABSTRACT FROM AUTHOR]

Background:There is a pressing need for assessment approaches that can be deployed remotely to measure cognitive outcomes in clinical trials and longitudinal aging cohorts. We evaluated the utility of a mobile phone-based intensive measurement study for this purpose. Method:A small cohort of healthy older adults (N = 17, mean age = 73) completed five assessment "bursts" over 12 months, with each measurement burst involving two assessments daily for five consecutive days. Each assessment included brief tests of visual short-term memory and information processing speed, as well as surveys measuring state factors that can affect cognition. Results:At study endpoint we had 94% retention, 97% compliance, and high participant satisfaction. Mobile cognitive test scores demonstrated good reliability, moderate correlations with in-person baseline neuropsychological testing, and significant associations with participant age and education level. Conclusions: Mobile phone-based intensive measurement designs represent a promising assessment approach for measuring cognition longitudinally in older adults. [ABSTRACT FROM AUTHOR]

Previous work has shown that solvent extraction (SX) and extraction chromatography (EXC) systems containing mixtures of extractants can be utilized to impart selectivity and improved physical characteristics that were not achievable with a single extractant. In an effort to discover EXC materials with unique selectivity and improved physical properties, we studied the extraction of selected metal ions from nitric acid and hydrochloric acid by EXC resins prepared from mixtures of N,N,N',N'-tetra-n-octyldiglycolamide (TODGA) and 4,4′(5′)-di-t-butylcyclohexano 18-crown-6 (dtBCH18C6). Except for enhanced extraction of Ra and Ba from dilute HNO3, the EXC resins essentially exhibited the metal ion extraction properties expected from materials prepared with the individual extractants. The origin of the Ra/Ba enhancement was studied by solvent extraction variation studies in 1-octanol and n-dodecane and on extraction chromatography resins, indicating that the enhancement may not be a true synergistic interaction between the extractants, but a phase modification by the TODGA related to the co-extraction of HNO3 and water. Additionally, the influence of alkyl substituents on the DGA extractant and potential applications of the mixed extractant system in analytical chemistry and nuclear medicine were explored with extraction chromatography resins prepared from the extractant mixtures. [ABSTRACT FROM AUTHOR]

To provide prevalence estimates of needs of people with dementia living at home, and to determine sources of variation associated with needs for this population. A systematic review and meta-analysis was performed searching CINAHL, MEDLINE, PsycINFO and ASSIA databases. Following quality checks, random effects meta-analysis produced prevalence estimates for needs reported by people with dementia and by their informal caregivers. Fixed effects models were undertaken to compare caregiver and person with dementia reported needs. Heterogeneity was explored through sensitivity analysis. The study protocol was registered with Prospero #CRD42017074119 Six retrieved studies published between 2005 and 2017 including 1011 people with dementia and 1188 caregivers were included in the analysis. All data were collected using Camberwell Assessment of Need for the Elderly. Prevalence estimates are provided for 24 needs reported by participants in The Netherlands, United Kingdom, Poland, Ireland, Germany, Norway, Portugal, Italy and Sweden. Most prevalent needs reported by people with dementia were Memory 0.713 [95% CI 0.627, 0.791]; Food 0.706 [95% CI 0.547, 0.842]; Household activities 0.677 [95% CI 0.613, 0.738]; and Money 0.566 [95% CI 0.416, 0.711]. Caregivers reported greater prevalence than people with dementia did for 22 of 24 needs, although the priority ranking of needs was similar. Exploration of heterogeneity revealed that people with young onset dementia were the major source of variation for 24 out of 48 analyses. Increased understanding of prevalence of needs of people with dementia and associated heterogeneity can assist in planning services to meet those needs. [ABSTRACT FROM AUTHOR]

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Recent impossibility theorems for fair risk assessment extend to the domain of epistemic justice. We translate the relevant model, demonstrating that the problems of fair risk assessment and just credibility assessment are structurally the same. We motivate the fairness criteria involved in the theorems as also being appropriate in the setting of testimonial justice. Any account of testimonial justice that implies the fairness/justice criteria must be abandoned, on pain of triviality. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of training intensity and environmental condition on the hydration status of Elite football players. Methods: Eleven elite football players completed three training sessions of varying intensity in cool (12°C) and warm (23°C) environments. Training demands was measured by Global Positioning System, sweat rate and sweat sodium concentration were measured using dermal patches and body mass change. Results: Warm condition increased sweat rate (0.9 ± 0.3 vs 1.7 ± 0.3 L.h-1, P<0.001), fluid intake (0.7 ± 0.1 vs 1.5 ± 0.2 L, P<0.001), total sodium loss (1405 ± 340 vs 2946 ± 958 mg, P<0.001) and total sweat loss (1.4 ± 0.5 vs 2.5 ± 0.4 L, P<0.001) compared to cool. Training intensity increased sweat sodium concentration (16.1 ± 6.6 vs 54.6 ± 22.2 mmol.L-1, P<0.001) and sodium loss (779 ± 231 vs 1405 ± 340 mg) in both environmental conditions. Total sweat loss and sodium loss were positively correlated with total distance covered (r=0.48, P=0.005 and r=0.4, P=0.023, respectively), meanwhile sodium loss was also positively correlated with the total number of high-intensity efforts (r=0.35, P=0.045). Conclusions: The results show that training load and environmental condition have a major impact on the hydration status of elite football players, hence hydration strategies should be developed accordingly. [ABSTRACT FROM AUTHOR]

Recent research highlighted the therapeutic potential of ayahuasca, a psychoactive plant brew used ritually in traditional Amazonian medicine (TAM). The present study evaluates the impact of integrating ayahuasca and TAM with psychotherapy on depression and anxiety in an inpatient addiction treatment program. Male patients (N = 31) were evaluated pre and post treatment using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI). Clinical and sociodemographic characteristics, motivation, quality of life, spirituality, and treatment satisfaction were also measured and analyzed by means of two tailed t-test, one way ANOVA and Spearman test. From pre- to post-treatment, patients showed significant reductions in scores of anxiety (from 20.8 to 11.6, p <.002) and depression (from 18.7 to 7.5, p <.001). Similarly, patients showed higher scores of quality of life (p <.001) and spirituality (p <.001) upon discharge, which correlated with their reduction in scores of anxiety and depression. While future results will evaluate the efficacy of this treatment on measures of addiction at follow-up, the present results build upon previous research to bring further support to the use of Ayahuasca and Amazonian medicine in mental health treatments with a transpersonal focus. [ABSTRACT FROM AUTHOR]

Chronic pain conditions are common among children and engender cascading effects across social, emotional, and behavioral domains for the child and family. Mobile health (mHealth) describes the practice of delivering healthcare via mobile devices and may be an ideal solution to increase access and reach of evidence-based behavioral health interventions. The aim of this narrative review is to present a state-of-the-art overview of evidence-based mHealth efforts within the field of pediatric chronic pain and consider new and promising directions for study. Given the nascent nature of the field, published mHealth interventions in all stages of development are discussed. Literature was identified through a non-systematic search in PubMed and Google Scholar, and a review of reference lists of papers that were identified as particularly relevant or foundational (within and outside of the chronic pain literature). mHealth is a promising interventional modality with early evidence suggesting it is primed to enhance behavioral health delivery and patient outcomes. There are many exciting future directions to be explored including drawing inspiration from digital health technology to generate new ways of thinking about the optimal treatment of pediatric chronic pain. [ABSTRACT FROM AUTHOR]

Engagement in personally meaningful activities is associated with greater well-being. However, most studies use cross-sectional or recall methods, and the researchers pre-determine which activities are 'meaningful.' This study examined an idiographic measure of meaningful activity participation in relation to well-being. Participants (N = 160; M age = 43.3 years; 77% female) rated the meaningfulness of 46 daily activities at baseline and reported their activities on eight random days over the next 4 weeks. Half the participants also completed measures of meaning salience and mood on the same days. All participants reported on psychological well-being at baseline and 4-week follow-up. Meaningful activity participation was positively associated with meaning salience and positive mood. Average engagement in meaningful activities over 8 days was positively associated with subjective vitality, life satisfaction, and purpose in life at follow-up. An idiographic measure of meaningful activity participation may further be understanding of the relationship between meaningful activity participation and well-being. Abbreviations: ACT - Acceptance and Commitment Therapy; LET - Life Engagement Test; MALM - Meaningful Activity and Life Meaning; MAPA - Meaningful Activities Participation Assessment; PANAS - Positive and Negative Affect Schedule; PHQ-8 - Patient Health Questionnaire-8; SDT - Self-determination Theory; SVS - Subjective Vitality Scale; SWLS - Satisfaction with Life Scale; TOMS - Thoughts of Meaning Scale [ABSTRACT FROM AUTHOR]

Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA. Children with DS were recruited to take part in a larger study of OSA (N = 202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA. Obstructive apnoea/hypopnoea index was in the normal range (0–1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β =.23, R2 =.05, p =.025), emotional control (β =.20, R2 =.04, p =.047) and shifting (β =.24, R2 =.06, p =.023). Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development. [ABSTRACT FROM AUTHOR]

Methylphenidate remains a first-line medication for treating ADHD in children and adults. However, its behavioral pharmacological similarities to methamphetamine and cocaine have historically created concern for its potential as a drug of abuse. In September 2019, the FDA published a docket requesting comments for the development of abuse deterrent formulations for CNS stimulants, emphasizing the abuse of methylphenidate as a public health concern. We conducted a narrative review of research on the clinical pharmacology, therapeutic efficacy, and abuse potential of methylphenidate. Several studies indicate that methylphenidate has at least some abuse potential. Methylphenidate, amphetamine, methamphetamine, and cocaine overlap in their subjective, reinforcing, and discriminative stimulus effects. Regardless, methylphenidate remains an efficacious treatment for ADHD in children and adults when properly adhered to, especially when paired with non-pharmacological treatments. The development of abuse deterrent formulations of methylphenidate is warranted. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether observational studies comparing laparotomy versus peritoneal drainage for surgical treatment of necrotizing enterocolitis (NEC) in preterm infants differ from randomized controlled trials (RCTs) of the same interventions. Further, in the absence of sufficient RCT evidence, it is uncertain how best to use existing observational data to guide clinical decision making.Methods: We performed a systematic review and meta-analysis of articles comparing laparotomy versus peritoneal drainage for preterm infants with NEC. Two authors independently searched PubMed and the Cochrane Database of Systematic Reviews, from 1 January 1990 to 1 May 2017 and selected articles that: (1) included low birthweight (<2500 g) or preterm (<37-week gestation) infants, (2) compared laparotomy versus peritoneal drainage for NEC, and (3) reported all-cause mortality (primary outcome) in both groups. The same two authors extracted data about study outcomes and about study quality, which was assessed using the Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting of RCTs and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for reporting of observational studies. Random-effects meta-analysis was used to generate weighted odds ratios (OR).Results: Twenty-five observational studies and two RCTs met all eligibility criteria. Outcomes were reported for 16,288 patients: 16,103 from observational studies and 185 from RCTs. Meta-analysis of observational studies demonstrated significantly lower mortality after laparotomy, as compared to peritoneal drainage (pooled OR 0.54, 95% CI 0.34-0.84). In contrast, RCTs demonstrated no difference in mortality (pooled OR 0.85, 95% CI 0.47-1.54). In post hoc analyses, observational studies were separated into two subgroups: low versus high quality of reporting, based on the STROBE checklist. Observational studies with low quality of reporting significantly favored laparotomy (pooled OR 0.38, 95% CI 0.18-0.81). In contrast and similar to RCTs, observational studies with high quality of reporting showed no difference in mortality (pooled OR 0.67, 95% CI 0.37-1.19).Conclusions: Neither RCTs nor observational studies with high quality of reporting demonstrate differences in mortality when preterm infants with surgical NEC are managed with laparotomy or peritoneal drainage. While RCTs remain a gold standard for evaluation of therapies, results from high quality observational studies may approximate the results of RCTs and might guide clinical practice until adequate RCT evidence is available. [ABSTRACT FROM AUTHOR]

Faced with increasing demand for their services, Emergency Medical Services (EMS) agencies must find more efficient ways to use their limited resources. This includes moving beyond the traditional response and transport model. Alternative Response Units (ARUs) are one way to meet the prehospital medical needs of some members of the public while reducing ambulance transports. They are non-transport vehicles tasked with very specific medical missions. These can include acute management of low-acuity complaints, ongoing home care for chronic medical conditions, preventive medicine, and post-hospital discharge follow-up visits. Their focus can be tailored to the individual needs of the agency. The Philadelphia Fire Department (PFD) operates one of the busiest EMS systems in the country. It has added additional staff and ambulances in recent years yet continues to face an increasing call volume. In an effort to reduce ambulance transports, the PFD recently introduced two ARUs. The first unit, AR-1, is deployed on a university campus and responds to students with low acuity medical complaints or mild alcohol intoxication. It provides many of these a courtesy ride to one of two university emergency departments for further evaluation, eliminating the need for ambulance transport. The second unit, AR-2, works in an area heavily impacted by the opioid crisis. It responds to individuals who have overdosed, been revived with naloxone, and refuse ambulance transport but are interested in long-term treatment for their opioid use disorder. The staff of AR-2 has successfully placed some of these individuals in treatment programs the same day. The AR-1 program is financially supported by the university while AR-2 is funded by the PFD and a federal grant. Both have the potential to decrease ambulance transports or reduce 9-1-1 calls. Whether these or other ARU programs can be financially sustained long-term is unclear. It is also unknown if ARUs represent a better investment than using the money to purchase additional transport vehicles. However, as health care evolves, EMS must innovate and adapt so it can continue to meet the prehospital needs of the public in a timely and cost-effective manner. [ABSTRACT FROM AUTHOR]

People who are exposed to life-threatening trauma are at risk of developing posttraumatic stress disorder (PTSD). In addition to psychological manifestations, PTSD is associated with an increased risk of myocardial infarction, arrhythmias, hypertension, and other cardiovascular problems. We previously reported that rats exposed to a predator-based model of PTSD develop myocardial hypersensitivity to ischemic injury. This study characterized cardiac changes in histology and gene expression in rats exposed this model. Male rats were subjected to two cat exposures (separated by a period of 10 d) and daily cage-mate changes for 31 d. Control rats were not exposed to the cat or cage-mate changes. Ventricular tissue was analyzed by RNA sequencing, western blotting, histology, and immunohistochemistry. Multifocal lesions characterized by necrosis, mononuclear cell infiltration, and collagen deposition were observed in hearts from all stressed rats but none of the control rats. Gene expression analysis identified clusters of upregulated genes associated with endothelial to mesenchymal transition, endothelial migration, mesenchyme differentiation, and extracellular matrix remodeling in hearts from stressed rats. Consistent with endothelial to mesenchymal transition, rats from stressed hearts exhibited increased expression of α-smooth muscle actin (a myofibroblast marker) and a decrease in the number of CD31 positive endothelial cells. These data provide evidence that predator-based stress induces myocardial lesions and reprograming of cardiac gene expression. These changes may underlie the myocardial hypersensitivity to ischemia observed in these animals. This rat model may provide a useful tool for investigating the cardiac impact of PTSD and other forms of chronic psychological stress. Lay summary Chronic predator stress induces the formation of myocardial lesions characterized by necrosis, collagen deposition, and mononuclear cell infiltration. This is accompanied by changes in gene expression and histology that are indicative of cardiac remodeling. These changes may underlie the increased risk of arrhythmias, myocardial infarction, and other cardiac pathologies in people who have PTSD or other forms of chronic stress. [ABSTRACT FROM AUTHOR]