Infant/Early Childhood Mental Health and Collaborative Partnerships: Beyond the NICU

The NICU experience impacts all family dynamics not just during the intensive care unit stay but in the months and years afterwards. For each family, the first experiences with their baby, whether in the home or the intensive care unit, can set the trajectory for the long-term parent–child relationship and the parent's perspective of their parent roles. These difficult experiences have the potential to be addressed through infant and early childhood mental health (I/ECMH) methods. In this article we review the need for a wide range of social and emotional supports that present in intensive care and continue as families and infants transition to home and community. The potential for addressing these ongoing issues by a variety of providers within many different settings using Infant and Early Childhood Mental Health (I/ECMH) approaches is discussed and examples of successful programs are provided. Finally, we make recommendations for infusing I/ECMH across programs that serve intensive care unit graduates and their families, from the hospital to the home, with primary care providers and other community support programs

Spiral cleavage and early embryology of a loxosomatid entoproct and the usefulness of spiralian apical cross patterns for phylogenetic inferences

Background: Among the four major bilaterian clades, Deuterostomia, Acoelomorpha, Ecdysozoa, and Lophotrochozoa, the latter shows an astonishing diversity of bodyplans. While the largest lophotrochozoan assemblage, the Spiralia, which at least comprises Annelida, Mollusca, Entoprocta, Platyhelminthes, and Nemertea, show a spiral cleavage pattern, Ectoprocta, Brachiopoda and Phoronida (the Lophophorata) cleave radially. Despite a vast amount of recent molecular phylogenetic analyses, the interrelationships of lophotrochozoan phyla remain largely unresolved. Thereby, Entoprocta play a key role, because they have frequently been assigned to the Ectoprocta, despite their differently cleaving embryos. However, developmental data on entoprocts employing modern methods are virtually non-existent and the data available rely exclusively on sketch drawings, thus calling for thorough re-investigation. Results: By applying fluorescence staining in combination with confocal microscopy and 3D-imaging techniques, we analyzed early embryonic development of a basal loxosomatid entoproct. We found that cleavage is asynchronous, equal, and spiral. An apical rosette, typical for most spiralian embryos, is formed. We also identified two cross-like cellular arrangements that bear similarities to both, a "molluscan-like" as well as an "annelid-like" cross, respectively. Conclusions: A broad comparison of cleavage types and apical cross patterns across Lophotrochozoa shows high plasticity of these character sets and we therefore argue that these developmental traits should be treated and interpreted carefully when used for phylogenetic inferences

Prediction of biopore- and matrix-dominated flow from X-ray CT-derived macropore network characteristics

Peer reviewedPublisher PD

mHealth Interventions to Reduce Physical Inactivity and Sedentary Behavior in Children and Adolescents: Systematic Review and Meta-analysis of Randomized Controlled Trials

Background: Children and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions. Objective: This review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization. Methods: PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed. Results: On the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=−0.06; 95% CI −0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=−0.11; 95% CI −0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ$^{2}$1=4.0; P=.04; I$^{2}$=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered. Conclusions: Evidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other

The effects of cognitive-motor training interventions on executive functions in older people: A systematic review and meta-analysis

Background: Ageing is associated with physical and cognitive decline, affecting independence and quality of life in older people. Recent studies show that in particular executive functions are important for daily-life function and mobility. This systematic review investigated the effectiveness of cognitive-motor training including exergaming on executive function (EF, set-shifting, working memory, inhibitory control) in healthy older people. Methods: An electronic database search for randomised controlled trials (RCT), controlled clinical trials (CCT) and parallel group trials was performed using MEDLINE, EMBASE, and PsychINFO following PRISMA guidelines. Inclusion criteria were: (1) community-dwelling participants 60 years without a medical condition or medical treatment, (2) reporting at least one cognitive-motor intervention while standing or walking, (3) use of dual-task interventions using traditional methods or modern technology to deliver a cognitive-motor task, (4) inclusion of at least one cognitive outcome. The PEDro scale was used for quality assessment. Results: A total of 1557 studies were retrieved, of which 25 studies were included in this review. Eleven studies used a technology-based dual-task intervention, while 14 trials conducted a general cognitive-motor training. The age range of the cohort was 69 to 87 years. The interventions demonstrated positive effects on global cognitive function [mean difference 0.6, 95% CI 0.29-0.90] and inhibitory control [mean difference 0.61, 95% CI 0.28-0.94]. Effects were heterogeneous (I2 range: 60-95) and did not remain after a sensitivity analysis. Processing speed and dual-task costs also improved, but meta-analysis was not possible. Conclusion: Cognitive-motor and technology-based interventions had a positive impact on some cognitive functions. Dual-task interventions led to improvements of domains related global cognitive functions and inhibitory control. Likewise, technology-based exergame interventions improved functions related to processing speed, attentional and inhibitory control. Training interventions with a certain level of exercise load such as progression in difficulty and task specificity were more effective to gain task-related adaptations on cognitive functions

Differences in Cognitive-Motor Interference in Older Adults While Walking and Performing a Visual-Verbal Stroop Task

Objectives: Studies using the dual-task (DT) paradigm to explain age-related performance decline due to cognitive-motor interference (CMI) which causes DT costs (DTCs) revealed contradictory results for performances under DT conditions. This cross-sectional study analyzed whether differences in demographics, physical functioning, concerns of falling (CoF), and other mental factors can explain positive and negative DTCs in older adults while walking in DT situations.Methodology: N = 222 participants (57–89 years) performed a single task (ST) and a DT walking condition (visual-verbal Stroop task) in randomized order on a treadmill. Gait parameters (step length, step width) were measured at a constant self-selected walking speed. Demographics [age, Mini Mental Status Examination (MMSE)], physical functioning (hand grip strength), CoF [Falls Efficacy Scale International (FES-I)], and mental factors [Short Form-12 (SF-12)] were assessed. An analysis of variance (ANOVA) was used to reveal subgroup differences. A four-step hierarchical regression analysis was conducted to identify which variables determine the DTC.Results: Three subgroups were identified: (1) participants (n = 53) with positive DTCs (improvements under DT conditions); (2) participants with negative DTCs (n = 60) in all gait parameters; and (3) participants (n = 109) who revealed non-uniform DTCs. Baseline characteristics between the subgroups showed differences in age (F(2,215) = 4.953; p = 0.008; η2 = 0.044). The regression analysis revealed that physical functioning was associated with positive DTC and CoF with negative DTC.Conclusion: The results confirmed a huge inter-individual variability in older adults. They lead us to suggest that factors causing performance differences in DTCs needs to be reassessed. Functional age seems to determine DTCs rather than calendric age. Psychological variables particularly seem to negatively influence DT performance