Therapeutic Benefits of Online Psychological Screening for Depressive Symptomology

Research has suggested that participating in in-person psychological testing is related to therapeutic benefits including: reduction in depressive symptomology, self-awareness, self-verification, self-esteem, and hope (Allen, 2001; Poston & Hanson, 2010). This study explored whether these findings applied with a more accessible asynchronous computerized format and examined the effects of computerized testing procedures (i.e., rapport-building video, self-disclosing personal information on questionnaires, receiving a feedback report) on therapeutic benefits (i.e., self-esteem, hope, self-awareness, self-verification, reduction in depressive symptomology). In addition, this study compared participants’ experiences receiving a computerized feedback format and an in-person feedback format. Undergraduate students aged 17 to 45 years (N = 126) participated in a two-part concurrent triangulation design study. In Part 1, participants watched a rapport-building video, completed online screening tools for depression, and measures of therapeutic benefits. For Part 2, participants came into the lab one week later and watched a second rapport-building video before receiving a feedback report (i.e., a summary of their reported symptomology on the screening tools). The test administrator showed 63 participants a paper copy of their feedback report and read it to them. The remaining participants (n = 63) received a computerized feedback report and read through it independently. Participants then completed the measures of therapeutic benefits again in addition to qualitative questions about their experience answering the screening questions and receiving feedback. Quantitative analyses revealed that, after receiving the feedback report, participants reported significant gains in new self-awareness and reductions in depressive symptomology, anxiety, and stress. The feedback format did not contribute to score differences for most measures administered. When specific groups of participants were examined, those with high feedback satisfaction reported less hopelessness than those with low feedback satisfaction. Participants with high self-verification reported greater gains in self-esteem and reductions in hopelessness in Part 2. Similarly, those with high new awareness and high rapport with the test administrator reported less hopelessness over time. Potential reasons for these changes in scores were examined using thematic analysis of qualitative responses. Participants reported on their self-disclosure tendencies; feelings and experiences participating in the current study; gains in new awareness; self-verification and perceived accuracy of the feedback; and perceptions of the test administrator. Findings suggest that completing online screening tools for depressive symptomology and receiving feedback has the potential to be a useful format for intervention. Additional practical applications and participant preferences regarding the use of online screening tools are discussed

Establishment of Asynchronous Rapport with Test Administrator: A Comparison of Online and In-Person Testing Procedures

Rapport is often established with clients prior to psychological testing to facilitate self-disclosure and ease anxiety. Test administrators need to find ways to build rapport with clients prior to online tests. The present study examined whether asynchronous rapport, a positive relationship established without real-time interaction, could form between an online test administrator and participants. This study examined the effects of a rapport-building procedure prior to, and consistency of scores on, online and offline measures. Separated by a one-week interval, undergraduate students completed both online and paper-and-pencil versions of measures of perceived rapport, self-disclosure, social and state anxiety. Participants were randomly assigned to either an asynchronous rapport condition (an online video and in-person script presented by the test administrator to foster rapport) or no rapport condition. Results suggest that asynchronous rapport-building, online test administration, and social anxiety were related to amount of self-disclosure. Implications for online test delivery are discussed

Targeting sexual health services in primary care: a systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

BACKGROUND: Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age. METHODS: We searched bibliographic databases for probability surveys of women aged 16-44years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014. RESULTS: Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships. CONCLUSION: Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply

Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children’s dietary intake. Childcare settings vary in organizational structure – childcare centers (CCCs) vs. family childcare homes (FCCHs) – and in geographical location – urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p \u3c .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations

The influence of baseline sleep on exercise-induced cognitive change in cognitively unimpaired older adults: A randomised clinical trial

Objectives: Observational studies consistently demonstrate that physical activity is associated with elevated cognitive function, however, there remains significant heterogeneity in cognitive outcomes from randomized exercise interventions. Individual variation in sleep behaviours may be a source of variability in the effectiveness of exercise-induced cognitive change, however this has not yet been investigated. The current study aimed to (1) investigate the influence of a 6-month exercise intervention on sleep, assessed pre- and post-intervention and, (2) investigate whether baseline sleep measures moderate exercise-induced cognitive changes. Methods: We utilised data from the Intense Physical Activity and Cognition (IPAC) study (n = 89), a 6-month moderate intensity and high intensity exercise intervention, in cognitively unimpaired community-dwelling older adults aged 60–80 (68.76 ± 5.32). Exercise was supervised and completed on a stationary exercise bicycle, and cognitive function was measured using a comprehensive neuropsychological battery administered pre- and post-intervention. Sleep was measured using the Pittsburgh sleep quality index. There was no effect of the exercise intervention on any sleep outcomes from pre- to post-intervention. Results: There was a significant moderating effect of baseline sleep efficiency on both episodic memory and global cognition within the moderate intensity exercise group, such that those with poorer sleep efficiency at baseline showed greater exercise-induced improvements in episodic memory. Conclusions: These results suggest that those with poorer sleep may have the greatest exercise-induced cognitive benefits and that baseline sleep behaviours may be an important source of heterogeneity in previous exercise interventions targeting cognitive outcomes

High-intensity exercise and cognitive function in cognitively normal older adults: A pilot randomised clinical trial

© 2021, The Author(s). Background: Physical inactivity has been consistently linked to increased risk of cognitive decline; however, studies examining the impact of exercise interventions on cognition have produced inconsistent findings. Some observational studies suggest exercise intensity may be important for inducing cognitive improvements; however, this has yet to be thoroughly examined in older adult cohorts. The objective of the current study was to evaluate the effect of systematically manipulated high-intensity and moderate-intensity exercise interventions on cognition. Methods: This multi-arm pilot randomised clinical trial investigated the effects of 6 months of high-intensity exercise and moderate-intensity exercise, compared with an inactive control, on cognition. Outcome measures were assessed at pre- (baseline), post- (6 months), and 12 months post-intervention. Ninety-nine cognitively normal men and women (aged 60–80 years) were enrolled from October 2016 to November 2017. Participants that were allocated to an exercise group (i.e. high-intensity or moderate-intensity) engaged in cycle-based exercise two times per week for 6 months. Cognition was assessed using a comprehensive neuropsychological test battery. Cardiorespiratory fitness was evaluated by a graded exercise test. Results: There was a dose-dependent effect of exercise intensity on cardiorespiratory fitness, whereby the high-intensity group experienced greater increases in fitness than the moderate-intensity and control groups. However, there was no direct effect of exercise on cognition. Conclusions: We did not observe a direct effect of exercise on cognition. Future work in this field should be appropriately designed and powered to examine factors that may contribute to individual variability in response to intervention. Trial registration: This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000643370). Registered on 3 May 2017—retrospectively registered. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=37278

High-intensity exercise and cognitive function in cognitively normal older adults: A pilot randomised clinical trial

© 2021, The Author(s). Background: Physical inactivity has been consistently linked to increased risk of cognitive decline; however, studies examining the impact of exercise interventions on cognition have produced inconsistent findings. Some observational studies suggest exercise intensity may be important for inducing cognitive improvements; however, this has yet to be thoroughly examined in older adult cohorts. The objective of the current study was to evaluate the effect of systematically manipulated high-intensity and moderate-intensity exercise interventions on cognition. Methods: This multi-arm pilot randomised clinical trial investigated the effects of 6 months of high-intensity exercise and moderate-intensity exercise, compared with an inactive control, on cognition. Outcome measures were assessed at pre- (baseline), post- (6 months), and 12 months post-intervention. Ninety-nine cognitively normal men and women (aged 60–80 years) were enrolled from October 2016 to November 2017. Participants that were allocated to an exercise group (i.e. high-intensity or moderate-intensity) engaged in cycle-based exercise two times per week for 6 months. Cognition was assessed using a comprehensive neuropsychological test battery. Cardiorespiratory fitness was evaluated by a graded exercise test. Results: There was a dose-dependent effect of exercise intensity on cardiorespiratory fitness, whereby the high-intensity group experienced greater increases in fitness than the moderate-intensity and control groups. However, there was no direct effect of exercise on cognition. Conclusions: We did not observe a direct effect of exercise on cognition. Future work in this field should be appropriately designed and powered to examine factors that may contribute to individual variability in response to intervention. Trial registration: This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000643370). Registered on 3 May 2017—retrospectively registered. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=37278

Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children’s dietary intake. Childcare settings vary in organizational structure – childcare centers (CCCs) vs. family childcare homes (FCCHs) – and in geographical location – urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p \u3c .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations

Pneumococcal within-host diversity during colonization, transmission and treatment

Characterizing the genetic diversity of pathogens within the host promises to greatly improve surveillance and reconstruction of transmission chains. For bacteria, it also informs our understanding of inter-strain competition and how this shapes the distribution of resistant and sensitive bacteria. Here we study the genetic diversity of Streptococcus pneumoniae within 468 infants and 145 of their mothers by deep sequencing whole pneumococcal populations from 3,761 longitudinal nasopharyngeal samples. We demonstrate that deep sequencing has unsurpassed sensitivity for detecting multiple colonization, doubling the rate at which highly invasive serotype 1 bacteria were detected in carriage compared with gold-standard methods. The greater resolution identified an elevated rate of transmission from mothers to their children in the first year of the child's life. Comprehensive treatment data demonstrated that infants were at an elevated risk of both the acquisition and persistent colonization of a multidrug-resistant bacterium following antimicrobial treatment. Some alleles were enriched after antimicrobial treatment, suggesting that they aided persistence, but generally purifying selection dominated within-host evolution. Rates of co-colonization imply that in the absence of treatment, susceptible lineages outcompeted resistant lineages within the host. These results demonstrate the many benefits of deep sequencing for the genomic surveillance of bacterial pathogens. Longitudinal population deep sequencing of Streptococcus pneumoniae sampled from infants and their mothers improves our understanding of the dynamics of colonization, transmission, inter-strain competition and the impact of antibiotic treatment.Peer reviewe