Brief relationship support as a selective suicide prevention intervention: Piloting the Relationship Checkup in veteran couples with relationship and mental health concerns

Introduction: Close relationship problems play a key role in many contemporary theories of suicide. However, the potential of relationship support in suicide prevention is understudied. This study explores the feasibility, safety, acceptability, and promise of utilizing the 3-session Relationship Checkup (RC) in veterans with mental health and romantic relationship concerns. Methods: We conducted a single-arm pilot of telehealth RC in veterans with a positive mental health screen and their romantic partners. Couples completed baseline and post-treatment assessments of study outcomes. Results: Feasibility analyses showed we were able to recruit an elevated-risk sample (30% history of attempts or interrupted attempts), take them through the service (90% treatment completion), and had minimal harm events (no suicidal behavior, no physical harm in arguments). Multimethod acceptability analyses suggested high satisfaction with the program, though some desired more intensive services. Couples reported improvements in relationship functioning, emotional intimacy, thwarted belongingness, depression, and posttraumatic stress. Perceived burdensomeness only improved for identified patients and drinking did not change for either partner. Conclusion: The RC is a feasible, safe, and acceptable strategy for providing relationship support to couples at elevated risk. Although further randomized trials are needed, RC shows promise to reduce relationship-level and individual-level suicide risk factors

A GABAergic projection from the centromedial nuclei of the amygdala to ventromedial prefrontal cortex modulates reward behavior

The neural circuitry underlying mammalian reward behaviors involves several distinct nuclei throughout the brain. It is widely accepted that the midbrain dopamine (DA) neurons are critical for the reward-related behaviors. Recent studies have shown that the centromedial nucleus of the amygdala (CeMA) has a distinct role in regulating reward-related behaviors. However, the CeMA and ventromedial PFC (vmPFC) interaction in reward regulation remains poorly understood. Here, we identify and dissect a GABAergic projection that originates in the CeMA and terminates in the vmPFC (VGat-Cre(CeMA-vmPFC)) using viral-vector-mediated, cell-type-specific optogenetic techniques in mice. Pathway-specific optogenetic activation of the VGat-Cre(CeMA-vmPFC) circuit in awake, behaving animals produced a positive, reward-like phenotype in real-time place preference and increased locomotor activity in open-field testing. In sucrose operant conditioning, the photoactivation of these terminals increased nose-poking effort with no effect on licking behavior and robustly facilitated the extinction of operant behavior. However, photoactivation of these terminals did not induce self-stimulation in the absence of an external reward. The results described here suggest that the VGat-Cre(CeMA-vmPFC) projection acts to modulate existing reward-related behaviors. SIGNIFICANCE STATEMENT Many studies have shown that the interactions between the centromedial nucleus of the amygdala (CeMA) and ventromedial PFC (vmPFC) have critical roles for emotional regulation. However, most studies have associated this circuit with fear and anxiety behaviors and emphasized top-down processing from vmPFC to CeMA. Here, we provide new evidence for bottom-up CeMA to vmPFC influence on reward-related behaviors. Although previous work implicated the CeMA in incentive salience, our results isolate the investigation to a specific CeMA GABAergic projection to the vmPFC. This long-range GABAergic interaction between amygdala and frontal cortex adds a new dimension to the complex regulation of reward-related behaviors

Stressed Fracture: The Relationship Between Coping Strategies and Workload in Secondary School Athletic Trainers

Purpose: The work environment for an athletic trainer (AT) working in a secondary school is typified by heavy workloads and job-related stress. Occupational stress can have negative effects on productivity, absenteeism, employee turnover, and quality of life. Research suggests that personal and situational factors can influence the coping process adopted by an individual. The approach-avoidance framework suggests that people cope with a stressor by either attempting to reduce it or removing oneself from that stressor. Previous research on other healthcare professionals suggested that use of avoidance coping was correlated with higher levels of job stress and those who perceived greater social support possessed lower work-related stress. However, the relationship between coping strategies and perceived social support has not been examined in ATs. The purpose of this study was to examine the relationship among coping strategies, perceived social support, and workload in secondary school ATs. Method: This was a cross-sectional study completed via an online survey. Three hundred, ninety-two (392) secondary school athletic trainers (35.7 ± 11.1 years old) from all NATA districts responded to the survey. Outcomes included the Brief COPE, Multidimensional Scale of Perceived Social Support, and average hours worked. Results: The average workload reported was 44.10 ± 12.96 hours a week over the school year (i.e., fall and spring). The regression model showed that avoidant coping (B=0.34, 95% CI=0.12, 0.56, p=.005) was directly associated with the average number of hours worked (adjusted R2=.07). Approach coping (B=-0.28, 95% CI=-0.43, -0.12, p=.007) was indirectly associated with the average numbers of hours worked. However, perceived social support did not display a significant association with any variable of interest. Conclusions: Our findings suggest that a relationship between average workload and coping strategies adopted by secondary school ATs may exist. Increased workloads were related to increases in avoidance coping strategies. Further research in this area is needed to determine how coping strategies affect patient care

Influence of Acute Turkesterone Dosing on Serum Insulin-like Growth Factor 1 (IGF-1) and Subjective Digestibility Scores in Recreationally-active Males

Turkesterone is a relatively novel phytoecdysteroid compound that has become increasingly popular amongst recreationally active demographics. Despite prior in vitro data suggesting that this compound may support enhanced body composition via both insulin-like growth factor 1 (IGF-1)-mediated protein synthesis, no human evidence exists in this regard nor how well its digestibility is tolerated. PURPOSE: To determine the effect of multiple turkesterone doses on serum IGF-1 and to report any gastrointestinal (GI) distress symptoms in a healthy human sample. METHODS: Eleven recreationally active males (23.3±2.2y) visited the laboratory on three occasions separated by at least seven days and were randomized in single-blind, placebo-controlled, and counter-balanced crossover fashion to either 2000mg cellulose placebo (PLA), 1000mg turkesterone + 1000mg placebo, (1000T) or 2000mg (2000T) turkesterone. Venous blood was sampled to determine serum IGF-1 concentrations and a GI distress questionnaire was (nausea, vomiting, heartburn symptoms, etc.) administered both at baseline (PRE), as well as 3-hours (POST3H) and 24-hours (POST24H) post-acute supplementation at each visit. Serum IGF-1 was analyzed using a two-way (condition [PLA, 1000T, 2000T] x time [PRE, POST3H, POST24H]) ANOVA with repeated measures at a significance level of pRESULTS: Analyses failed to reveal any significant condition (p=.180; ηp2=0.228), time (p=0.227; ηp2=.390), nor interaction effects (p=0.547; ηp2=0.211) for serum IGF-1. Moreover, no participants reported any GI distress symptoms across any condition and/or time permutation. CONCLUSION: Although the current study did not find any significant IGF-1-associated serum alterations to multiple acute turkesterone doses in the times assessed, there were fortunately no adverse GI symptoms experienced by the participants across any dose throughout the investigation. Nevertheless, these data support turkesterone supplementation is well tolerated and thus future research should build upon our analysis by employing a longitudinal supplementation regimen alongside an exercise intervention to elucidate the potential long-term and anabolism-permissive impacts of this compound on the presently-explored and additional associated parameters

The Ability of Cardiac Autonomic Modulations Stress Index to Independently Predict VO2max in Cardiometabolically Healthy Individuals

Cardiac autonomic modulation (CAM) is crucial for heart health, mediated by the sympathetic and autonomic systems (SAS). The link between CAM and aerobic exercise underscores the importance of aerobic fitness assessments in optimizing training to enhance performance. Heart rate variability (HRV) assesses CAM in various healthy populations, with the Stress Index (SI) identified as key in determining the SAS regulation involvement in performance and recovery outcomes. The SI may provide a quick and non-invasive metric to assess aerobic performance. PURPOSE: To determine if the SI can accurately predict aerobic performance via VO2max in healthy individuals free of metabolic diseases. METHODS: fifty cardiometabolically healthy individuals (n = 30 males, n = 20 females; Age 37.8 + 12.7 years, %BF 24.9 + 4.0) completed a single maximal treadmill exercise protocol to determine VO2max. HRV was measured for 5 minutes in the supine position prior to performing the exercise protocol using an elastic belt and Bluetooth monitor (Polar H7). CardioMood software was used to process HRV indices; SI, high frequency (HF), low frequency (LF), and total power (TP) were assessed for the frequency domain, and standard deviation of all NN intervals (SDNN) and the square root of the mean of the squares of successive R-R interval differences (RMSSD) for the time domain. The data was analyzed using a multiple correlation and linear regression between HRV indices and VO2max to determine the relationship between the two. All analyses were performed using SAS (v. 28.0.1.1). RESULTS: HRV indices SI was not significantly correlated to VO2max (r = -0.118, p = 0.414). Additionally, SI and all other HRV indices were not able to independently or combined predict VO2max (R2 = 0.014, p = 0.414). CONCLUSION: The utilization of HRV to assess CAM has proven beneficial in multiple clinical and athletic settings. However, the utilization of the SI to predict aerobic performance via VO2max does not appear to be significant. Thus, there are potential limitations to HRV to non-invasively assess aerobic performance

Parental predictors of children's executive functioning from ages 6 to 10.

According to prominent models of child development, parental factors may contribute to individual differences in children's executive functioning (EF). Here, we examine the relative importance of parents' socio-economic status, mental health, and parenting as predictors of EF development, drawing on a large (n = 1,070) community sample of Norwegian children who received biennial EF assessments from 6 to 10 years of age. We measure EF by means of the Behavior Rating Inventory of Executive Function. We assess parenting through observer ratings of parent-child interactions and parental mental health via the Beck Anxiety Inventory, Beck Depression Inventory, and Hopkins Symptom Checklist. When we adjust for all time-invariant unmeasured confounders, higher parental education predicts superior EF development, whereas harsh parenting forecasts poorer EF development. However, parenting does not mediate the effect of parental education. These results indicate that harsh parenting should be targeted in interventions aimed at improving EF. Statement of contribution What is already known on this subject? Parental factors seem to affect child development of executive functions (EF). Specifically, parental socio-economic status, mental health, and their parenting seem to influence the developmental course of child EF. What does this study add? To what degree the parental influence on EF development is likely to be driven by time-invariant factors, for example, genetics. The relative influence of positive and negative parenting on EF development

Effects of Acute Bouts of Aerobic Exercise on Adipokines in Individuals with Mid-Spectrum Chronic Kidney Disease

Adipokines have been known to influence various health-related complications such as chronic kidney disease (CKD) and cardiovascular diseases. Fluctuations in adipokines are commonly seen from changes in body composition, however, some evidence shows acute changes may be seen from exercise. Individuals with CKD are commonly characterized by a decline in renal filtration and systemic inflammation. It may be possible that an acute bout of aerobic exercise may improve pro- and anti-inflammatory adipokine concentrations typically seen in individuals with moderate stages of CKD. PURPOSE: To determine the acute effects of aerobic exercise on adipokine concentrations in individuals with moderate stages of CKD. METHODS: Fourteen participants (8 females and 6 males, age = 58.7 ± 9.3 yrs., and %BF = 36.0 ± 9.6) were classified as having moderate stages of CKD (stages G3 and G4). Participants completed 30 min of steady-state moderate intensity exercise (SSE) at 65% VO2 reserve and high-intensity interval training (HIIE) at a 90% VO2 reserve separated by 2 min of slow walking (20% VO2 reserve) in a randomized, crossover design fashion. Venous blood samples were obtained at baseline, 1 h, and 24 h post-exercise. Data were analyzed using a repeated measures ANOVA (p \u3c 0.05) and a paired t-test. If any significant main or interaction effects were found, a post-hoc test was performed. RESULTS: There were no significant differences in adiponectin and leptin levels within treatments. However, significant differences were seen between baseline and 24 h omentin concentrations when performing HIIE (F(2,26) = 5.001, p = .015). Omentin rose significantly 24 h after an acute bout of HIIE (214.69 ± 83.28 to 252.04 ± 91.22, p = .034). A paired t-test showed no significant differences between SSE and HIIE for adiponectin and leptin. Although, there was a significant difference between 24 h omentin concentrations for SSE and HIIE (t = -2.327, p \u3c .037). Omentin concentrations were significantly higher when performing HIIE (252.04 ± 91.22) as opposed to SSE (218.70 ± 82.00, p \u3c .001). CONCLUSION: Omentin plays an anti-inflammatory role in chronic diseases. Thus, individuals experiencing systemic inflammation from moderate stages of CKD may see benefits after performing an acute bout of HIIE due to the up-regulated release of omentin 24 h post-exercise

Association between Total Body Composition and VO2max in Individuals with Mid-Spectrum Chronic Kidney Disease

Total body composition (TBC), a measure of body fat percentage (%BF), lean body mass (LBM), and bone mineral content (BMC), can be used as a predictor of cardiovascular fitness. Prior studies have established a relationship between TBC and VO2max in healthy individuals over 35 years of age. However, this relationship is poorly understood in chronic disease populations. PURPOSE: To assess the relationship between TBC and cardiovascular fitness in a clinical population of adults with mid-spectrum (stages G2, G3a, and G3b) chronic kidney disease (CKD). METHODS: A cross-sectional analysis was conducted among 24 subjects diagnosed with mid-spectrum CKD. Nine males and 15 females with an average age of 62.25±9.2 years and a glomerular filtration rate (GFR) of 54.38±9.04 ml/min/1.73m2 completed the study. Subjects completed a health screening, dual-energy x-ray absorptiometry (DEXA) scan, and underwent VO2max testing on a treadmill using a modified Bruce protocol. Normality tests, descriptive statistics, Pearson’s correlations, t-tests, and ANOVAs were conducted in SAS v.9.4. RESULTS: The average %BF was 36.28±8.47%, LBM was 117.16±31.32lbs., BMC was 2308.74±735.19g., and VO2max was 20.13±5.04ml/kg/min. VO2max was positively correlated with BMC and LBM (r=0.65, p=0.001 and r=0.75, p\u3c0.001, respectively) and negatively correlated with %BF (r= -0.80, p\u3c0.001). Individuals in later stages of CKD had lower LBM, BMC, and VO2max (p=0.017, p=0.001, and p=0.007, respectively), yet there was no association of CKD stage with %BF or age (p=0.210 and p=0.107). CONCLUSION: TBC was found to be significantly associated with cardiovascular fitness in the study sample. Higher BMD and LBM values were associated with higher VO2max whereas higher %BF was associated with a lower VO2max in individuals with mid-spectrum CKD. Progression of CKD stage was associated with lower LBM, BMC, and VO2max values, indicating a graded effect of CKD stage on cardiovascular fitness

Pilot evaluation of the Fiscal Mapping Process for sustainable financing of evidence-based youth mental health treatments: A comparative case study analysis

Background Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health impacts of youth mental health problems, but is complicated by the limited and fragmented funding available to youth mental health service agencies. Supports are needed that can guide service agencies in accessing sustainable funding for EBTs. We conducted a pilot evaluation of the Fiscal Mapping Process, an Excel-based strategic planning tool that helps service agency leaders identify and coordinate financing strategies for their EBT programs. Method Pilot testing of the Fiscal Mapping Process was completed with 10 youth mental health service agencies over a 12-month period, using trauma-focused cognitive-behavioral therapy or parent–child interaction therapy programs. Service agency representatives received initial training and monthly coaching in using the tool. We used case study methods to synthesize all available data (surveys, focus groups, coaching notes, document review) and contrast agency experiences to identify key findings through explanation building. Results Key evaluation findings related to the process and outcomes of using the Fiscal Mapping Process, as well as contextual influences. Process evaluation findings helped clarify the primary use case for the tool and identified the importance—and challenges—of engaging external collaborators. Outcome evaluation findings documented the impacts of the Fiscal Mapping Process on agency-reported sustainment capacities (strategic planning, funding stability), which fully explained reported improvements in outcomes (extent and likelihood)—although these impacts were incremental. Findings on contextual factors documented the influence of environmental and organizational capacities on engagement with the tool and concerns about equitable impacts, but also the view that the process could usefully generalize to other EBTs. Conclusions Our pilot evaluation of the Fiscal Mapping Process was promising. In future work, we plan to integrate the tool into EBT implementation initiatives and test its impact on long-term sustainment outcomes across various EBTs, while increasing attention to equity considerations

Vitamin D Association with Renal Health and Filtration in Healthy Individuals Free of Cardiometabolic Diseases: A Pilot Study

The effect of vitamin D (VITD) on bone, muscle, and over health is well know in renal failure and chronic kidney disease (CKD). However, the influence of VITD on renal health and filtration (RHF) in healthy individuals is unclear. Currently, only serum creatinine concentration (sCr) methods are used to assess renal status in health individuals. However, newer biomarkers like serum Cystatin C (CyC) and urine epidermal growth factor (uEGF) show promise in evaluating baseline RHF. The impact of Vitamin D on filtration in healthy individuals of various ages is still unknown. PURPOSE: To determine the impact of VITD on RHF in healthy individuals of middle-aged status. METHODS: Thirty-six participants (n = 22 men; n = 14 women; age 37.6 + 12.4 yr; BF% 19.2 + 7.1%) agreed to participate in the research study. Blood and urine samples were obtained under standardized conditions for all individuals. VITD, CyC, uEGF, urine creatinine (uCr), uCr/uEGF ratio, sCR, and multiple estimates of glomerular filtration rate (eGFR) - modification of diet in renal disease (MDRD), CKD-EPI, CyC equations (CyC only and CyC combined with sCr) were assessed as a whole cohort and grouped (young = 20-39 yrs. (n = 22), older = 40-60 yrs. (n = 14)). Analysis was done using a paired sample t-tests, Pearson Correlation to compare VITD concentrations and markers of RHF. Linear regression analyses was performed to examine the relationship between VITD ability to predict RHF. All analyses were performed using SPSS (v. 28.0.1.1). RESULTS: There was no significant correlations found between VITD and markers of RHF in the entire cohort. Therefore, no predictive model was performed. The younger group showed strong negative correlation between VITD and MDRD (r = -0.575, p = 0.008), and that VITD was able to predict MDRD (R2 = 0.331, p = 0.008). No significant correlation observed in older group. CONCLUSIONS: VITD was correlated and able to predict a marker of RHF in healthy younger individuals, but not in older individuals. Based on the sample size and overall outcomes, continued research is needed to more accurately determine VITD effects on RHF in healthy populations