Developing an alcohol and other drug serious game for adolescents: Considerations for improving student engagement

Objectives: To explore perceptions of alcohol and other drug (AOD) education and digital game design preferences among Australian adolescents with the goal of identifying key factors to promote engagement in an AOD serious game for Australian secondary school students. Methods: Semi-structured focus groups were conducted with 36 adolescents aged between 13 and 18 years. Qualitative data was analysed using thematic analysis. Results: Participants described heightened engagement with AOD education that incorporated relatable and relevant real-life stories and interactive discussions. They also expressed a desire for learning to focus on practical strategies to reduce AOD harm and overcome social pressure to use AOD. Participants highlighted the importance of incorporating relatable characters and context-relevant scenarios in promoting engagement, and identified social elements, player choice, and optimal challenge as important game design considerations. Conclusions: A focus on meaningful realistic scenarios, relatable characters, relevant information and practical skills may promote high school aged students’ engagement with AOD educational content. Game designs incorporating social elements and decision-making opportunities may be conducive to promoting engagement and enhancing learning. Implications for public health: Findings from this study can be used by researchers and game designers for the development of future AOD serious games targeted at Australian adolescents

Sideffect GamePlan: Development of an alcohol and other drug serious game for high school students using a systematic and iterative user-centred game development framework

Serious games have shown to be effective in improving motivation to learn, knowledge and retention, thus are being increasingly used for alcohol and other drug (AOD) education. This paper outlines the development of an online AOD serious game for in-class use by Australian secondary school teachers for students in Years 9–10. Adapted from Edwards et al. (2018), the seven-step systematic and iterative user-centred development framework included: (1) Forming an expert multidisciplinary design team, (2) Defining the problem and establishing user preferences, (3) Incorporating the evidence base, (4) Serious game design, (5) Incorporating behavioural and psychological theory, (6) Developing a logic model and investigating causal pathways, and (7) User testing. High school students (n = 8), health and physical education teachers (n = 7), and parents (n = 8) were engaged throughout different stages of the development process to inform development and provide feedback on considerations for promoting engagement, acceptability, and usability of the game amongst both students and teachers. Overall, participants rated game acceptability and usability favourably and would recommend the game for learning about AOD. Constructive feedback and suggestions for improvements from user testing sessions were implemented to form the final version of the game and module. The next step is to test Sideffect GamePlan in a simulated classroom environment before piloting in school settings

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of big data (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA\u27s activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

ENIGMA and global neuroscience : a decade of large-scale studies of the brain in health and disease across more than 40 countries

CITATION: Thompson, Paul M. et al. 2020. ENIGMA and global neuroscience : a decade of large-scale studies of the brain in health and disease across more than 40 countries. Translational Psychiatry, 10:100, doi:10.1038/s41398-020-0705-1.The original publication is available at: https://www.nature.comThis review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of “big data” (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attentiondeficit/ hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA’s activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors.Publisher's versio

Structural brain alterations associated with suicidal thoughts and behaviors in young people: results from 21 international studies from the ENIGMA Suicidal Thoughts and Behaviours consortium

Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample of young people with mood disorders, in which STB were assessed using different instruments, MRI metrics were compared among healthy controls without STBs (HC; N = 519), clinical controls with a mood disorder but without STBs (CC; N = 246) and young people with current suicidal ideation (N = 223). In separate analyses, MRI metrics were compared among HCs (N = 253), CCs (N = 217), and suicide attempters (N = 64). Third, in a larger transdiagnostic sample with various assessment instruments (HC = 606; CC = 419; Ideation = 289; HC = 253; CC = 432; Attempt=91). In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts (N = 163) than those without a lifetime suicide attempt (N = 323; FDR-p = 0.035, Cohen's d = 0.34). No associations with suicidal ideation were found. When examining more heterogeneous samples, we did not observe significant associations. Lower frontal pole surface area may represent a vulnerability for a (non-interrupted and non-aborted) suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.This work was supported by the MQ Brighter Futures Award MQBFC/2 (LS, LC, LV, MRD, LvV, ALvH, HB) and the U.S. National Institute of Mental Health under Award Number R01MH117601 (LS, LvV, NJ). LvV received funding through the National Suicide Prevention Research Fund, managed by Suicide Prevention Australia. LS is supported by an NHMRC Career Development Fellowship (1140764). ALvH is funded through the Social Safety and Resilience program of Leiden University. SA, NB, FP, and GS acknowledge that data collected in IRCCS Santa Lucia Foundation, Rome, Italy was funded by a study funded by the Italian Ministry of Health grant RC17-18-19-20-21/A. ZB, KC, B K-D acknowledge data collected at the University of Minnesota was funded by the National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women’s Health Seed Grant, University of Minnesota. HB acknowledges data collected at the Yale School of Medicine, New Haven, CT, USA, was funded by: MQ Brighter Futures, R61MH111929RC1MH088366, R01MH070902, R01MH069747, American Foundation for Suicide Prevention, International Bipolar Foundation, Brain and Behavior Research Foundation, For the Love of Travis Foundation and Women’s Health Research at Yale. LC is supported by Interdisziplinäres Zentrum für Klinische Forschung, UKJ. BCD was funded by a CJ Martin Fellowship (NHMRC app 1161356). BCD research leading to these results has received funding from the program “Investissements d’avenir” ANR-10-IAIHU-06. CGD and BJH acknowledge that data collected in Melbourne, Australia, was supported by Australian National Health and Medical Research Council of Australia (NHMRC) Project Grants 1064643 (principal investigator, BJH) and 1024570 (principal investigator, CGD). BJH and CGD were supported by NHMRC Career Development Fellowships (1124472 and 1061757, respectively). UD and TH acknowledge data collected at the FOR2107-Münster was funded by the German Research Foundation (DFG, grant FOR2107-DA1151/5-1 and DA1151/5-2 to UD, and DFG grants HA7070/2-2, HA7070/3, HA7070/4 to TH). AJ and TK acknowledges data collected at the FOR2107-Marburg was funded by the German Research Foundation (DFG, grant FOR2107-JA 1890/7-1 and JA 1890/7-2 to AJ, and DFG, grant FOR2107-KI588/14-1 and FOR2107-KI588/14-2 to TK). KD acknowledges data collected for the Münster Neuroimaging Cohort was funded by the Medical Faculty Münster, Innovative Medizinische Forschung (Grant IMF KO 1218 06 to KD). JMF, PBM, BJO, and GR acknowledge that the “Kids and Sibs” Study was supported by the Australian National Medical and Health Research Council (Program Grant 1037196 and Investigator Grant 1177991 to PBM, Project Grant 1066177 to JMF), the Lansdowne Foundation, Good Talk and the Keith Pettigrew Family Bequest (PM). JMF gratefully acknowledges the Janette Mary O’Neil Research Fellowship. IHG is supported in part by R37MH101495. Support for TAD comes from the National Institute of Mental Health (K01MH106805). TH acknowledges support for TIGER includes the Klingenstein Third Generation Foundation, the National Institute of Mental Health (K01MH117442), the Stanford Maternal Child Health Research Institute, and the Stanford Center for Cognitive and Neurobiological Imaging. TCH receives partial support from the Ray and Dagmar Dolby Family Fund. KAM, ABM, MAS acknowledge data collected at Harvard University was funded by the National Institute of Mental Health (R01-MH103291). IN is supported by grants of the Deutsche Forschungsgemeinschaft (DFG grants NE2254/1-2, NE2254/3-1, NE2254/4-1).This study was supported by the NationalCenter for Complementary and Integrative Health (NCCIH) R21AT009173 and R61AT009864 to TTY; by the National Center for Advancing Translational Sciences(CTSI), National Institutes of Health, through UCSF-CTSI UL1TR001872 to TTY; bythe American Foundation for Suicide Prevention (AFSP) SRG-1-141-18 to TTY; byUCSF Research Evaluation and Allocation Committee (REAC) and J. Jacobson Fundto TTY; by the National Institute of Mental Health (NIMH) R01MH085734 and the Brain and Behavior Research Foundation (formerly NARSAD) to TTY. YC acknowledges the Medical Leader Foundation of Yunnan Province (L2019011) and FamousDoctors Project of Yunnan Province Plan (YNWR-MY-2018-041). DTG, BCF and RAAwish to thank all PAFIP patients and family members who participated in the studyas well as PAFIP´s research team and Instituto de Investigación Marqués deValdecilla. Work by the PAFIP group has been funded by Instituto de Salud Carlos III through the projects PI14/00639, PI14/00918 and PI17/01056 (Co-funded byEuropean Regional Development Fund/European Social Fund “Investing in yourfuture”) and Fundación Instituto de Investigación Marqués de Valdecilla(NCT0235832 and NCT02534363). MER received support from the AustralianNational Health and Medical Research Council (NHMRC) Centre for ResearchExcellence on Suicide Prevention (CRESP) [GNT1042580]. ETCL is supported bygrants from NIAAA (K01AA027573, R21AA027884) and the American Foundationfor Suicide Prevention. All authors thank the participants for volunteering theirtime and supporting our research. Open Access funding enabled and organized by CAUL and its Member Institutions

Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India.

OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site. RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting. CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries.

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

ENIGMA-Sleep:Challenges, opportunities, and the road map

Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large-scale multi-centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre-registered well-established protocols. The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA-Sleep working group with the collaboration of several institutes from 15 countries to perform large-scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population-based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA-Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine