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BackgroundCaregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. ObjectiveThis study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. MethodsIn a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. ResultsIn total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library.

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library.

Background: SHANK3, a gene encoding a synaptic scaffolding protein, is implicated in autism spectrum disorder (ASD) and is disrupted in Phelan-McDermid syndrome (PMS). Despite evidence of regression or worsening of ASD-like symptoms in individuals with PMS, the underlying mechanisms remain unclear. Although Shank3 is highly expressed in the cerebellar cortical granule cells, its role in cerebellar function and contribution to behavioral deficits in ASD models are unknown. This study investigates behavioral changes and cerebellar synaptic alterations in Shank3Δex4–22 mice at two developmental stages. Methods: Shank3Δex4–22 wildtype, heterozygous, and homozygous knockout mice lacking exons 4–22 (all functional isoforms) were subjected to a behavioral battery in both juvenile (5–7 weeks old) and adult (3–5 months old) mouse cohorts of both sexes. Immunostaining was used to show the expression of Shank3 in the cerebellar cortex. Spontaneous excitatory postsynaptic currents (sEPSCs) from cerebellar granule cells (CGCs) were recorded by whole-cell patch-clamp electrophysiology. Results: Deletion of Shank3 caused deficits in motor function, heightened anxiety, and repetitive behaviors. These genotype-dependent behavioral alterations were more prominent in adult mice than in juveniles. Reduced social preference was only identified in adult Shank3Δex4–22 knockout male mice, while self-grooming was uniquely elevated in males across both age groups. Heterozygous mice showed little to no changes in behavioral phenotypes in most behavioral tests. Immunofluorescence staining indicated the presence of Shank3 predominantly in the dendrite-containing rosette-like structures in CGCs, colocalizing with presynaptic markers of glutamatergic mossy fiber. Electrophysiological findings identified a parallel relationship between the age-related exacerbation of behavioral impairments and the enhancement of sEPSC amplitude in CGCs. Limitations: Other behavioral tests of muscle strength (grip strength test), memory (Barnes/water maze), and communication (ultrasonic vocalization), were not performed. Further study is necessary to elucidate how Shank3 modulates synaptic function at the mossy fiber-granule cell synapse in the cerebellum and whether these changes shape the behavioral phenotype. Conclusions: Our findings reveal an age-related exacerbation of behavioral impairments in Shank3Δex4–22 mutant mice. These results suggest that Shank3 may alter the function of glutamatergic receptors at the mossy fiber-cerebellar granule cell synapse as a potential mechanism causing cerebellar disruption in ASD. [ABSTRACT FROM AUTHOR]

Background: Despite agreement that restrictive intervention (RI) should only be used as a last resort and for as long as required, little is known about long-term RI among individuals with a disability. This study examines long-term RI use. Method: From the Restrictive Intervention Data System dataset from Victoria, Australia, a cohort of 1,414 people reported to be restrained or secluded between July 2008 and June 2010 were identified. The primary outcome was restraint during the follow-up period (July 2013-June 2015). Measures of the secondary outcome, reasons for restraint cessation, were assessed via a self-report survey completed by 54 service providers. Results: At follow up, 74% of the cohort was still subject to RI. Antipsychotic medication use, a diagnosis of autism, and communication difficulties were associated with the use of restrictive interventions at follow up. Conclusions Long-term RI is prevalent, but can be minimised by positive behaviour support.

Background: Mechanical restraint refers to the use of materials or devices to restrict the behaviours of a person with a disability, where the restraint is neither for therapeutic purposes or required by law. The inappropriate use of mechanical restraint is recognised in legislation and policy as a violation of people's human rights, and a risk to their health and wellbeing. Understanding who is at risk of mechanical restraint may assist service providers to better support people with a disability. Method: State-wide data collected between July 2012 to June 2013 were sourced. Odds ratios were used to describe the associations between individual characteristics and whether an individual was subjected to mechanical restraint. Results: Individuals with certain characteristics, such as the presence of a hearing, physical, neurological, communication or visual impairment, and autism spectrum disorder had an increased likelihood of being mechanically restrained. Conclusion: Initiatives to reduce mechanical restraint should pay particular attention to the support needs of those with sensory impairments and complex communication support needs including those with autism spectrum disorder and those with a physical impairment.

While there has been research into the provision of "distance" and "off-campus" education, both in relation to technology and to curriculum, little attention has been given to the experiences of students studying in geographically remote locations, where the remoteness has been an aspect of investigation. This study aimed to investigate the experiences of such students, and to suggest strategies to support them. The students recruited for this project were undergraduate and postgraduate students from remote locations around Australia who had studied at Deakin University between 2003 through 2007. They were interviewed by telephone. The three key issues identified by participants were a sense of isolation, the attitudes and knowledge of the teaching staff; and students' knowledge and use of learning technologies. (Contains 3 tables.)

Traumatic stress, particularly during critical developmental periods such as adolescence, has been strongly linked to an increased propensity and severity of aggression. Existing literature underscores that being a victim of abuse can exacerbate aggressive behaviors, with the amygdala playing a pivotal role in mediating these effects. Historically, animal models have demonstrated that traumatic stressors can increase attack behavior, implicating various amygdala nuclei. Building on this foundation, our previous work has highlighted how traumatic stress invokes long-lasting aggression via an excitatory pathway within the posterior ventral medial amygdala (MeApv). In the current study, we sought to further delineate this mechanism by examining the effects of acute social defeat during adolescence on aggressive behaviors and neural activation in mice. Using a common social defeat paradigm, we first established that acute social defeat during late adolescence indeed promotes long-lasting aggression, measured as attack behavior 7 days after the defeat session. Immunolabeling with c-Fos demonstrated that acute social defeat activates the MeApv and ventrolateral aspect of the ventromedial hypothalamus (VmHvl), consistent with our previous studies that used foot shock as an acute stressor. Finally, chemogenetically inhibiting excitatory MeApv neurons during social defeat significantly mitigated the aggression increase without affecting non-aggressive social behavior. These results strongly suggest that the MeApv plays a critical role in the onset of aggression following traumatic social experience, and offer the MeA as a potential target for therapeutic interventions. [ABSTRACT FROM AUTHOR]

Academic literature on the trade-labour linkage has tended to operate within a methodological nationalism that reifies the nation-state as the unit of analysis and treats labour rights as universally applicable. This paper instead starts from the premise that the linkage spotlights certain types of work and worker, resulting in geographically differentiated modes of labour governance. Focusing on the post-Brexit reconstitution of trade policy in the UK and its party political discourse, the paper details how labour provisions were written into free trade agreements, export finance arrangements, supply chain reporting requirements and unilateral preference schemes. Its argument is that these were constructed and contested through distinctions made between leading and laggard states; acceptable and unacceptable exploitation; and desirable and undesirable exploitation – each of which had a spatial politics in shaping where and how labour ought to be governed. [ABSTRACT FROM AUTHOR]

This article brings feminist critiques of capitalism into conversation with race-conscious International Political Economy to highlight the place of social reproduction in the colonial global economy. It does so by taking a provincial perspective, using Royal Leamington Spa as a case study to reveal how the provision of care for the elderly and the ill sustained colonial elites across the life course, while religious and educational practices helped transmit cultural values across generations and reproduce imperialism as an institutionalised social order. Whereas the finance houses of London, the factories of Manchester, and the ports of Liverpool and Bristol constitute nodal points for imperial circuits of capital, the spa town condenses the everyday practices through which bourgeois metropolitan empire was lived and made liveable. These findings point to a functional differentiation of economic space within the metropole and offer a critical reinterpretation of Middle England as a Whitened site of middle-class respectability. [ABSTRACT FROM AUTHOR]