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Substance use disorders (SUDs) incur serious social and personal costs. The risk for SUDs is complex, with risk factors ranging from social conditions to individual genetic variation. We examined whether models that include a clinical/environmental risk index (CERI) and polygenic scores (PGS) are able to identify individuals at increased risk of SUD in young adulthood across four longitudinal cohorts for a combined sample of N = 15,134. Our analyses included participants of European (NEUR = 12,659) and African (NAFR = 2475) ancestries. SUD outcomes included: (1) alcohol dependence, (2) nicotine dependence; (3) drug dependence, and (4) any substance dependence. In the models containing the PGS and CERI, the CERI was associated with all three outcomes (ORs = 01.37-1.67). PGS for problematic alcohol use, externalizing, and smoking quantity were associated with alcohol dependence, drug dependence, and nicotine dependence, respectively (OR = 1.11-1.33). PGS for problematic alcohol use and externalizing were also associated with any substance dependence (ORs = 1.09-1.18). The full model explained 6-13% of the variance in SUDs. Those in the top 10% of CERI and PGS had relative risk ratios of 3.86-8.04 for each SUD relative to the bottom 90%. Overall, the combined measures of clinical, environmental, and genetic risk demonstrated modest ability to distinguish between affected and unaffected individuals in young adulthood. PGS were significant but added little in addition to the clinical/environmental risk index. Results from our analysis demonstrate there is still considerable work to be done before tools such as these are ready for clinical applications.

Understanding which biological pathways are specific versus general across diagnostic categories and levels of symptom severity is critical to improving nosology and treatment of psychopathology. Here, we combine transdiagnostic and dimensional approaches to genetic discovery for the first time, conducting a novel multivariate genome-wide association study of eight psychiatric symptoms and disorders broadly related to mood disturbance and psychosis. We identify two transdiagnostic genetic liabilities that distinguish between common forms of psychopathology versus rarer forms of serious mental illness. Biological annotation revealed divergent genetic architectures that differentially implicated prenatal neurodevelopment and neuronal function and regulation. These findings inform psychiatric nosology and biological models of psychopathology, as they suggest that the severity of mood and psychotic symptoms present in serious mental illness may reflect a difference in kind rather than merely in degree.

Genome-wide association studies (GWAS) identify genetic variants associated with a trait, regardless of how those variants are associated with the outcome. Characterizing whether variants for psychiatric outcomes operate via specific versus general pathways provides more informative measures of genetic risk. In the current analysis, we used multivariate GWAS to tease apart variants associated with problematic alcohol use (ALCP-total) through either a shared risk for externalizing (EXT) or a problematic alcohol use-specific risk (ALCP-specific). SNPs associated with ALCP-specific were primarily related to alcohol metabolism. Genetic correlations showed ALCP-specific was predominantly associated with alcohol use and other forms of psychopathology, but not other forms of substance use. Polygenic scores for ALCP-total were associated with multiple forms of substance use, but polygenic scores for ALCP-specific were only associated with alcohol phenotypes. Polygenic scores for both ALCP-specific and EXT show different patterns of associations with alcohol misuse across development. Our results demonstrate that focusing on both shared and specific risk can better characterize pathways of risk for substance use disorders. Parsing risk pathways will become increasingly relevant as genetic information is incorporated into clinical practice.

Polygenic indexes (PGIs) are DNA-based predictors. Their value for research in many scientific disciplines is growing rapidly. As a resource for researchers, we used a consistent methodology to construct PGIs for 47 phenotypes in 11 datasets. To maximize the PGIs' prediction accuracies, we constructed them using genome-wide association studies-some not previously published-from multiple data sources, including 23andMe and UK Biobank. We present a theoretical framework to help interpret analyses involving PGIs. A key insight is that a PGI can be understood as an unbiased but noisy measure of a latent variable we call the 'additive SNP factor'. Regressions in which the true regressor is this factor but the PGI is used as its proxy therefore suffer from errors-in-variables bias. We derive an estimator that corrects for the bias, illustrate the correction, and make a Python tool for implementing it publicly available.

Behaviors and disorders related to self-regulation, such as substance use, antisocial behavior and attention-deficit/hyperactivity disorder, are collectively referred to as externalizing and have shared genetic liability. We applied a multivariate approach that leverages genetic correlations among externalizing traits for genome-wide association analyses. By pooling data from ~1.5 million people, our approach is statistically more powerful than single-trait analyses and identifies more than 500 genetic loci. The loci were enriched for genes expressed in the brain and related to nervous system development. A polygenic score constructed from our results predicts a range of behavioral and medical outcomes that were not part of genome-wide analyses, including traits that until now lacked well-performing polygenic scores, such as opioid use disorder, suicide, HIV infections, criminal convictions and unemployment. Our findings are consistent with the idea that persistent difficulties in self-regulation can be conceptualized as a neurodevelopmental trait with complex and far-reaching social and health correlates.

We conducted genome-wide association studies (GWAS) of relative intake from the macronutrients fat, protein, carbohydrates, and sugar in over 235,000 individuals of European ancestries. We identified 21 unique, approximately independent lead SNPs. Fourteen lead SNPs are uniquely associated with one macronutrient at genome-wide significance (P

For more than 40 years, health and physical education (HPE) academics in universities and teacher education colleges have drawn attention to issues of social justice specific to the context of PE and advocated for teachers in fields, gymnasiums and other physical activity spaces to do a better job of promoting more equitable outcomes for all students. Building on this advocacy, in the late 1990s, countries such as Sweden, Norway and New Zealand designed HPE curricula that address social justice. However, limited research has focused specifically on the enactment of social justice in HPE practice. Drawing on a larger international project involving Sweden, Norway and New Zealand the aim of this article is therefore to explore the constitution of social justice pedagogies across these three different HPE contexts and more specifically how HPE teaching practice may be understood from regulative, normative and cultural perspectives on social justice. The data reported on in this paper were generated from educational acts, curriculum documents, observations of HPE lessons in each of the three countries and follow-up teacher interviews. In order to analyse the data, we employed Scott's (2008. "Institutions and organizations: Ideas and interests" (3rd ed). Sage) institutional theory to further understand and discuss the enactment of social justice across the three different countries in HPE practice. In our representation and analysis of the findings we draw attention to how social justice pedagogies are informed differently by institutionalised governing systems and therefore they may be enacted differently by teachers in different societies. In particular, we highlight the influence of (i) regulative; (ii) normative; (iii) cultural-cognitive elements on practice. We conclude by pointing out the complex interplay between regulative, normative and cultural-cognitive elements that both enable and constrain HPE teachers' enactments of social justice in HPE practice.

Abstract Genome-wide association studies (GWAS) identify genetic variants associated with a trait, regardless of how those variants are associated with the outcome. Characterizing whether variants for psychiatric outcomes operate via specific versus general pathways provides more informative measures of genetic risk. In the current analysis, we used multivariate GWAS to tease apart variants associated with problematic alcohol use (ALCP-total) through either a shared risk for externalizing (EXT) or a problematic alcohol use-specific risk (ALCP-specific). SNPs associated with ALCP-specific were primarily related to alcohol metabolism. Genetic correlations showed ALCP-specific was predominantly associated with alcohol use and other forms of psychopathology, but not other forms of substance use. Polygenic scores for ALCP-total were associated with multiple forms of substance use, but polygenic scores for ALCP-specific were only associated with alcohol phenotypes. Polygenic scores for both ALCP-specific and EXT show different patterns of associations with alcohol misuse across development. Our results demonstrate that focusing on both shared and specific risk can better characterize pathways of risk for substance use disorders. Parsing risk pathways will become increasingly relevant as genetic information is incorporated into clinical practice.

Syftet med den studie som ligger till grund för artikeln var att öka förståelsen för hur lärare i idrott och hälsa kan bedriva en inkluderande undervisning som kännetecknas av social rättvisa och där alla elever har möjlighet att delta och lyckas. Studien genomfördes inom ramen för ett internationellt samarbetsprojekt som undersökte hur lärare i idrott och hälsa hanterar frågor om inkludering, jämlikhet och social rättvisa i undervisningen. I denna artikel redovisas resultat från observationer av undervisning i idrott och hälsa i årskurs 7 till 9 i Sverige med tillhörande intervjuer av fem lärare i ämnet. Resultaten visar att lärarna använde sig av flera olika strategier kopplat till tre huvudteman: (1) skapa goda relationer med och mellan elever, (2) anpassningar för att utjämna ojämlikheter och (3) stötta de som behöver. Trots de goda exempel som lyfts i denna artikel, behöver undervisningspraktiker vidareutvecklas som inte bara hanterar utan även kan utmana och förändra rådande normer och värderingar i ämnet. ENGLISH: Socially just and inclusive teaching practices in physical education and health The purpose of the study that forms the basis of the article was to increase the understanding of how physical education and health teachers can teach in more inclusive and socially just ways. The study was carried out within the framework of an international collaborative project that examined how teachers of physical education and health handle issues of inclusion, equity and social justice in practice This article reports results from observations of physical education and health lessons in grades 7 to 9 in Sweden and follow-up interviews with five teachers in this subject. The results show that the teachers used several different strategies related to three main themes: (1) creating good relationships with and between students, (2) adaptations to equalise inequalities and (3) supporting those who need it. Despite the good examples highlighted in this article, teaching practices need to be further developed that not only deal with but can also challenge and change prevailing norms and values in the subject. Keywords: Physical education and health, Social justice, Inclusion, Equity

In this paper, we describe and reflect on the Critical Incident Technique (CIT) methodology used to explore how secondary school health and physical education (HPE) teachers address social justice in their teaching practice. The paper is informed by data generated as part of an ongoing three-year international research project involving eight physical education teacher education (PETE) researchers from three different countries. One of the general aims of the project was to develop teaching strategies to assist HPE teachers to refine and develop their practices so that they may become more inclusive and engaging for all students, thus helping contribute to more equitable educational outcomes. The specific aim of this paper is twofold: to describe the methodological framework of the research project and, secondly, to reflect on the challenges encountered in the research process along with the limitations and further potential of this research approach. We argue that the use of CIT methodology has allowed us to document rich descriptions of examples of teaching for social justice and to identify teacher practices that resonate with critical perspectives, or what we have come to call 'social justice pedagogies'. We conclude by asserting that our use of CIT methodology in this project serves as a political quest to reaffirm the social justice agenda in HPE practice through providing teachers with examples of social justice pedagogies. It is not an attempt to espouse a one-size-fits-all social justice model for HPE since social justice teaching strategies are enabled and constrained by the contexts in which they are practised.

In a world of increasing diversity in which many established democracies are now consumed by capitalist individualism and protectionist ideals, a focus on equity and social justice is particularly pertinent. For many years, scholars have proposed that schools have the educational responsibility to prepare children for peaceful living in a heterogeneous society and claimed that health and physical education (HPE) activities at school can enhance interpersonal relations, and social cohesion. This paper explores the definition of social cohesion, as well as theories that support its inclusion in school practices before drawing on observational and interview data from of an international project that reveal how HPE teachers across three different countries teach for social cohesion. In our analysis of the data, we employ Allport's 'Contact Theory' (1954) and Pettigrew's (1998) extension of this theory to conceptualise and interpret the teaching for social cohesion in HPE practice. Within the overarching theme of teaching for social cohesion we present and discuss five sub-themes as examples of the teachers' pedagogies: (1) a focus on inclusiveness; (2) the inclusion of culturally inclusive practices; (3) building teacher/student and student/student relationships; (4) planning and structuring activities for students to work together in heterogeneous teams while focusing on cooperation; and (5) focusing on personal and social responsibility by encouraging adherence to the principles of fair play and democratically determined rules. We conclude by stating that HPE should be recognised for its role in creating opportunities for constructive social interaction between students of difference, which can contribute to greater inclusion, social cohesion and ultimately social justice in society.

Background: A focus on equity, democracy and social justice in HPE is pertinent in an era where there are growing concerns about the impact of neoliberal globalisation and precariousness of society (Kirk 2020). Although there is advocacy for teaching approaches in HPE that address issues of social justice, there is limited empirical research of teachers enacting critical pedagogies in HPE classrooms. Purpose: To identify school HPE teaching practices that promote social justice through practical enactment across three different participating countries. Participants and Setting: The investigation involved classroom observations of and post-lesson interviews with 13 purposively selected high school health and physical education teachers from three different countries. A total of 20 HPE lessons were observed. The participants included seven male and six female teachers ranging in age from 25 to 55 years with between 3- and 25-years teaching experience. The setting for data collection was compulsory co-educational practical HPE classes with 13-15-year-old students in four schools in New Zealand, four schools in Sweden and three schools in Norway. Data Collection and Analysis: This study employed Critical Incident Technique (CIT) methodology (Flanagan 1954), involving data collection through exploratory observations and stimulated-recall interviews (Lyle 2003). The classroom observations focused on identifying incidents that appeared to be addressing issues of social justice. The use of a multi-national observer team was a key principle of the study and was based on the proposition that local researchers familiar with context come with taken-for-granted assumptions about teachers' practices. Data were analysed through a six-phase thematic analysis approach (Braun and Clarke 2013). This involved three stages: individually, collectively by the researchers in each country, and finally through the whole multi-national research team. Findings: The data analysis resulted in three primary themes; (1) relationships, (2) teaching for social cohesion, and (3) explicitly teaching about and acting on social inequities. This paper uses critical pedagogy as a lens to report on the third theme. In this paper, we present three subthemes; (1) Teaching as 'equity not equality', (2) promoting marginalised groups (3) and teacher critical reflection as examples of explicit critical pedagogies taking action for social justice in HPE. Conclusions/Implications: Although, the findings presented in this paper are examples of explicit teacher actions that aim to address social inequity, we suggest that teaching for social justice requires teachers to "take action" on social inequities and also to "teach about social injustice" to prepare students to become agents for change and act on social inequities themselves, beyond HPE.

Aim: To investigate the safety of skin-to-skin contact initiated immediately after birth on cardiorespiratory parameters in unstable low birth weight infants. Methods: A randomized clinical trial was conducted in tertiary newborn units in Ghana, India, Malawi, Nigeria and Tanzania in 2017–2020, in infants with birth weight 1.0–1.799 kg. The intervention was Kangaroo mother care initiated immediately after birth and continued until discharge compared to conventional care with Kangaroo mother care initiated after meeting stability criteria. The results of the primary study showed that immediate Kangaroo mother care reduced neonatal mortality by 25% and the results have been published previously. The post-hoc outcomes of this study were mean heart rate, respiratory rate, oxygen saturation during the first four days and the need of respiratory support. Results: 1,602 infants were allocated to control and 1,609 to intervention. Mean birth weight was 1.5 kg (SD 0.2) and mean gestational age was 32.6 weeks (SD 2.9). Infants in the control group had a mean heart rate 1.4 beats per minute higher (95% CI -0.3–3.1, p = 0.097), a mean respiratory rate 0.4 breaths per minute higher (-0.7–1.5, p = 0.48) and a mean oxygen saturation 0.3% higher (95% CI -0.1–0.7, p = 0.14) than infants in the intervention group. Conclusion: There were no significant differences in cardiorespiratory parameters during the first four postnatal days. Skin-to-skin contact starting immediately after birth is safe in low birth weight infants in limited-resource settings.

The Health and Physical Education (HPE) profession has increasingly advocated for caring teacher-student relationships. In this paper, we draw on data from an international research project called 'EDUHEALTH' [Education for Equitable Health Outcomes -- The Promise of School Health and Physical Education] to explore caring teaching and the complexity of building good relationships as pedagogies for social justice in HPE. The data reported on in this paper were generated through 20 HPE lesson observations and interviews with 13 HPE teachers across schools in Sweden, Norway and New Zealand. In our analysis of the data, we employed Nel Noddings 'Care Theory' [(1984. "Caring, a feminine approach to ethics & moral education." Berkeley, CA: University of California Press; 1997). Pedagogisk filosofi [Philosophy of education]. Oslo: Ad Notam Gyldendal] to study the constitution of relationships and caring teaching in HPE practice. The findings demonstrate that caring teaching is inevitably built on developing good relationships, and that developing such good relationships is a complex process influenced by three key elements. First, teachers have to develop knowledge about their students on a societal, group and personal level; second, teachers have to reflect on the individual, environmental and relational aspects required for building good relationships; and third, teachers have to implement caring teaching strategies, such as planning, caring actions and doing 'the little things'. Drawing on Nodding's care theory, we conclude that pedagogies for social justice are enacted when teachers use their own knowledge and knowledge about the students, together with reflection and caring teaching strategies, to arrange a learning environment that promotes inclusion and equitable outcomes for all students.