Cognition and mental health in children and young people.

Background: Mental health difficulties are highly prevalent across adolescence and can change over the course of adolescent development. Left untreated, such difficulties can significantly impact an individual’s health, income, and interpersonal relationships later in life, and create an enormous burden on social, healthcare, and economic systems. The factors implicated in the onset and maintenance of mental health problems include cognitive factors due to their importance in regulating emotions and behaviour. Method: A systematic review and meta-analyses were conducted investigating the relationship between anxiety and attention and memory in children and young people. A data-driven approach with a large secondary data set was then used to explore changes in mental health profiles between mid- and late adolescence and their association with cognitive factors. Results: The meta-analysis identified a significant bias towards threat when using an affective Stroop task, but not the dot probe task. The empirical paper found distinct profiles of mental health are identifiable and largely stable between mid- and late adolescence. An impaired ability to adjust risk-taking behaviours in response to contextual information was linked to profiles of persistent externalising symptoms and social difficulties. Poor spatial working memory was associated with persisting externalising problems. Conclusions: Aspects of cognitive function are related to youth mental health difficulties. Childhood and adolescent anxiety are associated with attentional biases both towards and away from threat, and greater symptomology is possibly linked with biases towards recalling negative information over the long-term but not the short-term. These data suggest that mental health and cognition interact across development; anxiety can impact on the cognitive processing of information, and cognitive control in mid-adolescence contributes to persistent patterns of mental health difficulties

Peacemaking: Conflict resolution using Cool Clues for elementary students

It is recommended that violence prevention interventions start early for students and include conflict resolution education and social-emotional skills training components. Although school-based programs have shown some promise, community-based or out-of-school time programs require more study. A social-emotional learning-focused conflict resolution intervention using role-play and puppetry was implemented in a small afterschool program as an exploratory study. Student participants’ conflict resolution knowledge and after-school teacher observation of their pro-social skill behaviors were assessed pre- and post- program. Although many participants scored high in conflict resolution knowledge pre-program, they appeared to gain some additional knowledge, specifically on disagreements between friends and empathy for other’s feelings. After-school teachers, however, observed no significant overall differences in their pro-social behaviors pre- and post- program. All in all, as an exploratory study, the slight positive changes in knowledge provide data to suggest continuing the curriculum with more emphasis on the weakest topics as well as more role-play or puppet play about friendship and sharing behaviors

Conflict Minerals

This presentation will include an extensive review of literature of Conflict Minerals, particularly situations occurring in the Democratic Republic of Congo. Conflict minerals, as defined by Salem Press Encyclopedia are raw minerals that derive from areas of armed conflict. The presentation will examine the history of the Democratic Republic of the Congo, conflict minerals and its intersection with militant groups and the recovery process. We seek to portray historical events that led to this conflict and discuss current initiatives to combat this important social issue. Our goal is to raise awareness of the far reaching impact of this conflict on the Congolese people and other nations. We also aim to educate about ways to affect change

Calcification of Biomaterials and Diseased States

Calcification is one of the most common issues that arise concerning biocompatibility, known to affect many systems in the body. It is often associated with an increase in free phosphate and calcium particles in the serum that leads to mineral deposition. Calcification is problematic both in the naturally occurring state of the body, as well as when it exists as result of biomaterial implants. While calcification is prominent in many different forms, not all mechanisms and processes associated with the phenomenon are completely understood. In this chapter, materials affected by calcification, potential mechanisms of action, and potential treatments will be discussed. Both bioprosthetic and polymer heart valves and urinary implants will be evaluated for material composition, application, and failure. Current research on the assessment of these materials will be reported, with the associated chemical and biological mechanisms explained. The chapter will also detail diseased states of the arteries that induce calcification and what treatments can be used for both arterial and bioprosthetic calcification. Finally, the chapter will conclude by detailing future designs for biomaterials to prevent and treat calcification in both natural and synthetic applications

Coach and player rating of perceived challenge (RPC) as a technical skill monitoring tool in Rugby Union

Objective: To determine the relationship between player and coach rating of perceived challenge (RPC) for different training sessions over a competitive rugby union season. A secondary aim was to explore the relationship between player RPC and player session rating of perceived exertion (RPE). Methods: We used an observational longitudinal study design to monitor 51 male highly-trained under 21 rugby union players and four coaches over an 11-week competitive rugby season (a total of 1798 training session observations). Player RPC (0 to 10 arbitrary units (AU)) and RPE ratings (0 to 10 AU) were collected after team sessions (a technical and tactical field-based session with all players training together), split sessions (a technical and tactical field-based session where players trained separately according to their positional grouping (forward and backs)) and gym sessions (non-field-based session with all players training together). Coach RPC ratings were only collected after team sessions and split sessions. Results: A weak positive relationship (rho = 0.26; 95% CI: 0.09–0.42; p <.001) was found for split sessions (player RPC: 4.40; 95% CI: 3.87–4.87 AU; coach RPC: 4.25; 95% CI: 3.92–4.60 AU), while a moderate positive relationship (rho = 0.37; 95% CI: 0.31–0.43; p <.001) was found between player RPC (4.29; 95% CI: 4.00–4.55) and coach RPC (4.96; 95% CI: 4.89–5.05) for team sessions. Forwards had a higher RPC (5.33; 95% CI: 4.50–5.65) compared to backs (3.45; 95% CI: 2.88–4.00) for split (p <.001) and team sessions (forward's RPC: 4.66; 95% CI: 4.37–4.94; back's RPC: 3.84; 95% CI: 3.38–4.26; p <.001). Conclusions: In conclusion, using a rating to quantify the perceived challenge of training, we found coaches may be overestimating how challenging their training sessions are. Forwards-rated field sessions more challenging than backs, which likely represents their additional technical and tactical demands from training scrums, line-outs and mauls. While the RPC has strong theoretical justification as a rating tool to potentially fulfil the gap of quantifying the perceived challenge of training, thoughtful validity studies are yet to be conducted on the scale, which are the required next steps if the RPC is going form part of a coach's and practitioner's toolbox to optimise skill training

Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents - a meta-analysis of randomized controlled trials.

BACKGROUND: Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design. METHODS: A systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition. RESULTS: Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen's d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only. CONCLUSIONS: This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action

Exploring the feasibility of a 6-week electric-bike intervention with behavioural support in Australia.

Background: Physical inactivity increases the risk of non-communicable disease development and healthcare-associated burden. Research suggests electric bikes (e-bikes) can support individuals in meeting recommended physical activity (PA) guidelines. This study assessed the feasibility of an e-bike plus a tailored behavioural support intervention for physically inactive overweight or obese adults. Methods: This non-randomized single-group pre-post study saw participants provided with an e-bike free of charge for six weeks. Feasibility was assessed across five domains: 1) feasibility of recruitment, 2) participant retention, 3) intervention adherence, 4) acceptability of questionnaires and lab-based outcome measures and 5) intervention acceptability. Participants completed self-reported measures of PA and self-efficacy for exercise. Lab-based measurements were completed pre-and post-intervention, this included blood pressure, body composition [anthropometrics and dual-energy X-ray absorptiometry (DEXA)], venous blood glucose, insulin, cholesterol, triglycerides, and cardiorespiratory fitness. Results: Our recruitment strategy saw a total of eight participants (three males and five females) complete the intervention (88.9% retention rate). Participants utilised the e-bike for the intervention duration and rode a mean distance of 299.8 km (SD ± 172.2) over the 6-week intervention period. Participants completed all outcomes with minimal data points missing. Participants’ moderate PA levels and self-efficacy for exercise increased post intervention. Lab-based measures showed a downward trend in body fat percentage, fasting blood glucose and brachial diastolic blood pressure. Conclusion: The recruitment strategy, retention, adherence and acceptability of this study support future research. E-bikes are an acceptable way to help people who are physically inactive increase their PA levels. Furthermore, sustained use may contribute to health benefits and improve overall self-efficacy for exercise

Multilevel challenges to engagement in HIV care after prison release: a theory-informed qualitative study comparing prisoners’ perspectives before and after community reentry

Abstract Background Although prison provides the opportunity for HIV diagnosis and access to in-prison care, following release, many HIV-infected inmates experience clinical setbacks, including nonadherence to antiretrovirals, elevations in viral load, and HIV disease progression. HIV-infected former inmates face numerous barriers to successful community reentry and to accessing healthcare. However, little is known about the outcome expectations of HIV-infected inmates for release, how their post-release lives align with pre-release expectations, and how these processes influence engagement in HIV care following release from prison. Methods We conducted semi-structured interviews (24 pre- and 13 post-release) with HIV-infected inmates enrolled in a randomized controlled trial of a case management intervention to enhance post-release linkage to care. Two researchers independently coded data using a common codebook. Intercoder reliability was strong (kappa = 0.86). We analyzed data using Grounded Theory methodology and Applied Thematic Analysis. We collected and compared baseline sociodemographic and behavioral characteristics of all cohort participants who did and did not participate in the qualitative interviews using Fisher’s Exact Tests for categorical measures and Wilcoxon rank-sum tests for continuous measures. Results Most participants were heterosexual, middle-aged, single, African American men and women with histories of substance use. Substudy participants were more likely to anticipate living with family/friends and needing income assistance post-release. Most were taking antiretrovirals prior to release and anticipated needing help securing health benefits and medications post-release. Before release, most participants felt confident they would be able to manage their HIV. However, upon release, many experienced intermittent or prolonged periods of antiretroviral nonadherence, largely due to substance use relapse or delays in care initiation. Substance use was precipitated by stressful life experiences, including stigma, and contact with drug-using social networks. As informed by the Social Cognitive Theory and HIV Stigma Framework, findings illustrate the reciprocal relationships among substance use, experiences of stigma, pre- and post-release environments, and skills needed to engage in HIV care. Conclusion These findings underscore the need for comprehensive evidence-based interventions to prepare inmates to transition from incarceration to freedom, particularly those that strengthen linkage to HIV care and focus on realities of reentry, including stigma, meeting basic needs, preventing substance abuse, and identifying community resources

Clinical trials in amyotrophic lateral sclerosis:a systematic review and perspective

Amyotrophic lateral sclerosis is a progressive and devastating neurodegenerative disease. Despite decades of clinical trials, effective disease modifying drugs remain scarce. To understand the challenges of trial design and delivery, we performed a systematic review of phase II, phase II/III and phase III amyotrophic lateral sclerosis clinical drug trials on trial registries and PubMed between 2008 and 2019. We identified 125 trials, investigating 76 drugs and recruiting more than 15000 people with amyotrophic lateral sclerosis. 90% of trials used traditional fixed designs. The limitations in understanding of disease biology, outcome measures, resources and barriers to trial participation in a rapidly progressive, disabling and heterogenous disease hindered timely and definitive evaluation of drugs in two-arm trials. Innovative trial designs, especially adaptive platform trials may offer significant efficiency gains to this end. We propose a flexible and scalable multi-arm, multi-stage trial platform where opportunities to participate in a clinical trial can become the default for people with amyotrophic lateral sclerosis

Variation in human herpesvirus 6B telomeric integration, excision and transmission between tissues and individuals

Human herpesviruses 6A and 6B (HHV-6A/6B) are ubiquitous pathogens that persist lifelong in latent form and can cause severe conditions upon reactivation. They are spread by community-acquired infection of free virus (acqHHV6A/6B) and by germline transmission of inherited chromosomally-integrated HHV-6A/6B (iciHHV-6A/6B) in telomeres. We exploited a hypervariable region of the HHV-6B genome to investigate the relationship between acquired and inherited virus and revealed predominantly maternal transmission of acqHHV-6B in families. Remarkably, we demonstrate that some copies of acqHHV-6B in saliva from healthy adults gained a telomere, indicative of integration and latency, and that the frequency of viral genome excision from telomeres in iciHHV-6B carriers is surprisingly high and varies between tissues. In addition, newly formed short telomeres generated by partial viral genome release are frequently lengthened, particularly in telomerase-expressing pluripotent cells. Consequently, iciHHV-6B carriers are mosaic for different iciHHV-6B structures, including circular extra-chromosomal forms that have the potential to reactivate. Finally, we show transmission of an HHV-6B strain from an iciHHV-6B mother to her non-iciHHV-6B son. Altogether we demonstrate that iciHHV-6B can readily transition between telomere-integrated and free virus forms