The community nurse's role on the promotion of papillomavirus vaccination among young students: A study protocol

Vaccination is the principal strategy for primary prevention of infection by Human Papilloma Virus (HPV), which causes different pathological conditions, up to cancer, in both males and females. However, to date, knowledge among adolescents and their parents about the HPV vaccine is still low. The aim of this quasi-experimental, multicenter study is to assess the effectiveness of a digital educational intervention, conducted by a multidisciplinary health-care team including a Community Nurse, to increase adolescents' HPV vaccination uptake, their knowledge, self-efficacy, feelings and involvement in HPV vaccine decision-making, and parents' vaccination hesitancy. The study will be carried out among a population of students (and their parents), aged between 11 and 13, at secondary schools in Italy. Validated questionnaires will be administered to both students and parents at baseline (T0) and 3 months after a digital educational intervention (T1). The findings may be useful in evaluating and deepening a methodology for designing and implementing educational interventions, embedded in the school setting, that could promote the achievement of outcomes within the broader process of youth's health promotion.

Psychological responses to political hostility: a study on aggression, bullying, and well-being in Qatar

In 2017, the Gulf crisis led to a blockade that severely restricted Qatar's air, land, and sea access. This political crisis had far-reaching consequences, particularly affecting cross-national families and children. This qualitative analysis explores the effects of the blockade's political instability on individuals and families, specifically for Qatari citizens married to non-Qatari spouses and their cross-national children. Applying the General Aggression Model and Social Learning Theory, we interviewed 24 individuals residing in Qatar from nations directly affected by the crisis (Bahrain, Egypt, Saudi Arabia, and the United Arab Emirates). Two main themes emerged: first, the characteristics of aggressive and bullying behaviour, and second, the impacts on the well-being of cross-national families. The results showed that Qatari women and their children suffered disproportionately due to gender-based citizenship rights issues. The impacts on their well-being included heightened anxiety, depression, feelings of danger, uncertainty, and division within individuals, families, and communities. Recommendations include increasing collaborative efforts between governments, educational institutions, and community-based organizations, which are crucial to addressing aggressive and bullying behaviour across all age groups fostering a more harmonious and resilient society.

Attenuation of implicit motor learning with consecutive exposure to visual errors

Visual errors induced by movement drive implicit corrections of that movement. When similar errors are experienced consecutively, does sensitivity to the error remain consistent each time? This study aimed to investigate the modulation of implicit error sensitivity through continuous exposure to the same errors. In the reaching task using visual error-clamp feedback, participants were presented with the same error in direction and magnitude for four consecutive trials. We found that implicit error sensitivity decreased after exposure to the second error. These results indicate that when visual errors occur consecutively, the sensorimotor system exhibits different responses, even for identical errors. The continuity of errors may be a factor that modulates error sensitivity.

Exploring scientific misconduct in Morocco based on an analysis of plagiarism perception in a cohort of 1,220 researchers and students

Plagiarism is widely regarded as an issue of low- and middle-income countries because of several factors such as the lack of ethics policy and poor research training. In Morocco, plagiarism and its perception by academics has not been investigated on a large scale. In this study, we evaluated different aspects of plagiarism among scholars based on a 23-question cross-sectional survey. Factors associated with plagiarism were explored using contingency tables and logistic regression. The survey results covered all public universities (n=12) and included 1,220 recorded responses. The academic level was significantly associated with plagiarism (p<0.001). Having publication records was statistically associated with a reduced plagiarism (p=0.002). Notably, the ability of participants to correctly define plagiarism was also significantly associated with a reduced plagiarism misconduct (p<0.001). Unintentional plagiarism (p<0.001), time constraint to write an original text (p<0.001), and inability of participants to paraphrase (p<0.001) were associated factors with plagiarism. Moreover, participants that considered plagiarism as a serious issue in academic research had significantly committed less plagiarism (p<0.001). The current study showed that various actionable factors associated with plagiarism can be targeted by educational interventions, and therefore, it provided the rationale to build training programs on research integrity in Morocco.

Inflammatory biomarkers and psychological variables to assess quality of life in patients with inflammatory bowel disease: a cross-sectional study

BACKGROUND

Inflammatory bowel disease (IBD) is a chronic gastrointestinal condition. While inflammatory biomarkers are valuable for diagnosing and monitoring the disease, their correlation with patients' quality of life (QoL) is not well-established.

PURPOSE

This study aims to investigate the correlations between inflammatory biomarkers and the quality of life (QoL) variables of individuals diagnosed with IBD in clinical remission.

METHODS

The sample of this cross-sectional study included 74 patients (80% women; 45 ± 11 years old) diagnosed with IBD. Outcome variables included faecal calprotectin (FC), C-reactive protein (CRP), cortisol levels from hair samples, and anxiety and depression assessed using the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), alongside QoL evaluated with the Inflammatory Bowel Disease Questionnaire 32 (IBDQ-32). Bivariate correlations were calculated using the Pearson correlation coefficient, and stepwise linear regression analyses were conducted to identify independent factors contributing to IBDQ-32 scores.

RESULTS

The IBDQ-32 did not significantly correlate with any biomarkers. However, it exhibited a large and statistically significant negative correlation with HADS-A (r = -0.651) and HADS-D (r = -0.611) scores (p < 0.001). Stepwise linear regression analyses indicated that HADS-A was a significant and independent predictor for IBDQ-32 scores (Adjusted R2 = 0.41, β = -0.65, p < 0.001).

CONCLUSIONS

Inflammatory markers such as CRP, FC, or cortisol in hair do not play a decisive role in assessing the QoL of IBD patients. These findings emphasize the significance of considering psychological factors in evaluating and managing QoL in IBD patients in order to identify severity, suggesting that instruments like HADS should be integral to comprehensive patient assessments.

Healthcare and social care professionals' experiences of respite care: a critical incident study

INTRODUCTION

Aging in place is favoured among older persons and supported by research in Sweden, although it poses challenges for overburdened informal caregivers. While respite care can offer support, its accessibility is hindered by organizational challenges and informal caregivers' delays in using it. The experiences of informal caregivers are well-studied, but the professionals' experiences of respite care quality and critical incident management are underexplored.

AIM

To explore professionals' experiences of critical incidents in respite care, consequences for the persons being cared for, and strategies to manage critical incidents.

MATERIALS AND METHODS

A qualitative, critical incident technique was used, and three group interviews with a total of 16 professionals were conducted.

RESULTS

Barriers to quality respite care included communication gaps during care transitions, environmental shortcomings in respite care facilities, lack of support for informal caregivers, and inadequacies in respite care decisions. Strategies to manage critical incidents included individualized care, continuity and communication in care transitions, a conducive environment, support for informal caregivers, and care professionals' positive approach.

CONCLUSIONS

The study emphasizes the need for focused efforts on communication, continuity, and a supportive environment. Addressing identified challenges and applying suggested strategies will be key to maximizing the potential of respite care as a vital support for care recipients and their informal caregivers.

Digital health outreach to promote postpartum screening after gestational diabetes: A randomized factorial pilot study

Objective

We examined the acceptability and feasibility of a multi-component digital health outreach intervention to promote uptake of guideline-recommended postpartum screening for type 2 diabetes among patients with gestational diabetes (GDM).

Methods

We conducted a 24 randomized factorial experiment as part of the Multiphase Optimization Strategy (MOST) preparation phase for developing behavioral interventions. Participants with current or recent GDM in an integrated healthcare system were randomized to receive an outreach message with up to four intervention components, designed to be self-administered in about 10 min and efficiently delivered online via REDCap: a streamlined values affirmation, personalized information on diabetes risk, an interactive motivational interviewing-based component, and an interactive action planning component. Patient-reported acceptability and feasibility outcomes were assessed via survey.

Results

Among 162 participants, 72% self-identified with a racial/ethnic minority group. Across components, acceptability scores averaged 3.9/5; ≥91% of participants read most or all of the outreach message; ≥89% perceived the amount of information as "about right"; and ≥ 87% completed ≥1 interactive prompt.

Conclusion

Each intervention component was acceptable to diverse patients and feasible to deliver in a brief, self-directed, online format.

Innovation

These novel components target unaddressed barriers to patient engagement in guideline-recommended postpartum diabetes screening and adapt theory-based behavior change techniques for large-scale use.

Serotonergic neuromodulation of synaptic plasticity

Synaptic plasticity constitutes a fundamental process in the reorganization of neural networks that underlie memory, cognition, emotional responses, and behavioral planning. At the core of this phenomenon lie Hebbian mechanisms, wherein frequent synaptic stimulation induces long-term potentiation (LTP), while less activation leads to long-term depression (LTD). The synaptic reorganization of neuronal networks is regulated by serotonin (5-HT), a neuromodulator capable of modify synaptic plasticity to appropriately respond to mental and behavioral states, such as alertness, attention, concentration, motivation, and mood. Lately, understanding the serotonergic Neuromodulation of synaptic plasticity has become imperative for unraveling its impact on cognitive, emotional, and behavioral functions. Through a comparative analysis across three main forebrain structures-the hippocampus, amygdala, and prefrontal cortex, this review discusses the actions of 5-HT on synaptic plasticity, offering insights into its role as a neuromodulator involved in emotional and cognitive functions. By distinguishing between plastic and metaplastic effects, we provide a comprehensive overview about the mechanisms of 5-HT neuromodulation of synaptic plasticity and associated functions across different brain regions.

Engineered modular neuronal networks-on-chip represent structure-function relationship

Brain function is substantially linked to the highly organized modular structure of neuronal networks. However, the structure of in vitro assembled neuronal circuits often exhibits variability, complicating the consistent recording of network functional output and its correlation to network structure. Therefore, engineering neuronal structures with predefined geometry and reproducible functional features is essential to precisely model in vivo neuronal circuits. Here, we engineered microchannel devices to assemble 2D and 3D modular networks. The microchannel devices were coupled with a multi-electrode array (MEA) electrophysiology system to enable recordings from circuits. Each network consisted of 64 modules connected to their adjacent modules by micron-sized channels. Modular circuits within microchannel devices showed enhanced activity and functional connectivity traits. This includes metrics such as connection weights, clustering coefficient, global efficiency, and the number of hub neurons with higher betweenness centrality. In addition, modular networks demonstrated an increased functional modularity score compared to the randomly formed circuits. Neurons within individual modules displayed uniform network characteristics and predominantly participated in their respective functional communities within the same or neighboring physical modules. These observations highlight that the modular network structure promotes the development of segregated functional connectivity traits while simultaneously enhancing the efficiency of overall network connectivity. Our findings emphasize the significant impact of physical constraints on the activity patterns and functional organization within engineered modular networks. These circuits, characterized by stable modular architecture and intricate functional dynamics-key features of the brain networks-offer a robust in vitro model for advancing neuroscience research.

Modifiable factors mediating the effects of educational attainment on gestational diabetes mellitus: A two-step Mendelian randomization study

BACKGROUND

Although there is currently a wealth of evidence to indicate that maternal educational attainment is associated with gestational diabetes mellitus (GDM), the specific modifiable risk factors that mediate the causal relationship between these two variables have yet to be identified.

AIM

To identify the specific modifiable risk factors that mediate the causal relationship between the level of maternal education and GDM.

METHODS

Mendelian randomization (MR) was conducted using data from genome-wide association studies of European populations. We initially performed a two-sample MR analysis using data on genetic variants associated with the duration of education as instruments, and subsequently adopted a two-step MR approach using metabolic and lifestyle factors as mediators to examine the mechanisms underlying the relationship between the level of maternal education and risk of developing GDM. In addition, we calculated the proportions of total causal effects mediated by identified metabolic and lifestyle factors.

RESULTS

A genetically predicted higher educational attainment was found to be associated with a lower risk of developing GDM (OR: 0.71, 95%CI: 0.60-0.84). Among the metabolic factors assessed, four emerged as potential mediators of the education-GDM association, which, ranked by mediated proportions, were as follows: Waist-to-hip-ratio (31.56%, 95%CI: 12.38%-50.70%), body mass index (19.20%, 95%CI: 12.03%-26.42%), high-density lipoprotein cholesterol (12.81%, 95%CI: 8.65%-17.05%), and apolipoprotein A-1 (7.70%, 95%CI: 4.32%-11.05%). These findings proved to be robust to sensitivity analyses.

CONCLUSION

Our findings indicate a causal relationship between lower levels of maternal education and the risk of developing GDM can be partly explained by adverse metabolic profiles.

Sleep, event appraisal, and affect: An ecological momentary assessment study

BACKGROUND

Appraisal theory posits that emotions result from cognitive appraisals of events and situations. Experimental work suggests that sleep influences cognitive processes and event appraisal, which the present study examines in real life. Poor sleep influences brain regions involved in the appraisal-to-emotion process, and tired participants showed more conservative appraisal and reported less positive and more negative affect. In the present study, we tested whether sleep duration and/or quality predicted more pleasant event appraisal and whether sleep moderated the association between event appraisal and affect.

METHODS

Participants (N = 892) from the general Dutch population reported thrice daily on event appraisal and various emotions for 30 days and once daily on sleep duration and quality. We constructed multilevel models to account for the nested structure of our data (observations within participants).

RESULTS

Multilevel regression analyses showed that on days when participants reported having slept longer and better than their average, their event appraisal was more positive. Subjective sleep duration and quality did not influence the relationship between event appraisal and affect. Hence, poor sleep predicted changes in cognitive functioning, as people appraised situations as more unpleasant.

LIMITATIONS

We measured subjective sleep duration and quality with two single items and focused on only pleasantness dimension of event appraisal.

CONCLUSIONS

Results match perspectives on emotions as multicomponent systems involving appraisal processes. Understanding the elements of event appraisal may help unravel the detrimental effects of poor sleep on mental health and well-being.

Orbitostriatal encoding of reward delayed gratification and impulsivity in chronic pain

Central robust network functional rearrangement is a characteristic of several neurological conditions, including chronic pain. Preclinical and clinical studies have shown the importance of pain-induced dysfunction in both orbitofrontal cortex (OFC) and nucleus accumbens (NAc) brain regions for the emergence of cognitive deficits. Outcome information processing recruits the orbitostriatal circuitry, a pivotal pathway regarding context-dependent reward value encoding. The current literature reveals the existence of structural and functional changes in the orbitostriatal crosstalk in chronic pain conditions, which have emerged as a possible underlying cause for reward and time discrimination impairments observed in individuals affected by such disturbances. However, more comprehensive investigations are needed to elucidate the underlying disturbances that underpin disease development. In this review article, we aim to provide a comprehensive view of the orbitostriatal mechanisms underlying time-reward dependent behaviors, and integrate previous findings on local and network malplasticity under the framework of the chronic pain sphere.

Spelling principles matter: An ERP study investigating the processing of different types of pseudohomophones

Spelling in any writing system is governed by fundamental principles. We examined the processing of two types of pseudohomophones constructed from words whose spellings are based on different principles - on the traditional principle of writing, requiring memorization of their spelling, and on the morphological principle, allowing the determination of their spelling from another word with the same morpheme (root) to examine the dependence of the occurrence of orthography-phonology conflict on spelling principles. Event-related potentials were recorded from 22 volunteers during silent reading. Pseudohomophones based on the morphological principle increased the N400 amplitude, emphasizing semantic and morphological processing importance. The P600 component showed significant effects for differentiating words and pseudohomophones based on the traditional principle, predominantly indicating the involvement of memory and reanalysis processes. Source reconstruction demonstrates that both pseudohomophones activate the left inferior frontal gyrus. However, pseudohomophones based on the traditional principle additionally activate the right and left postcentral gyrus, indicating the involvement of additional areas in the differentiation process. The earlier differences for stimuli based on the morphological principle indicate access to smaller units (morphemes), whereas stimuli based on the traditional principle require whole word processing. Our findings underscore the significant role of spelling principles in orthographic processing.

Evaluating a maladaptive personality-informed model of social support and post-traumatic stress disorder

BACKGROUND

Social support is a robust predictor of post-traumatic stress disorder (PTSD). Although the inverse relationship between perceived social support and PTSD (social causation model) is supported, less is understood about the antecedents of the social causation model. Further, there is limited research in non-Western psychiatric populations that experience elevated rates of trauma and PTSD (e.g., mood disorders). The present study evaluated whether cumulative traumatic life events influenced current PTSD symptoms through maladaptive personality traits and perceptions of social support among Asian patients with mood disorders.

METHODS

A total of 200 Asian patients (77.5 % Chinese) with mood disorders were assessed for maladaptive personality traits, perceptions of social support, cumulative traumatic life events, PTSD, and depressive symptoms. Structural equation modelling was conducted to evaluate the extended social causation model.

RESULTS

The extended social causation model demonstrated acceptable fit to the data (Comparative Fit Index [CFI] = 0.90; absolute Root Mean Square Error of Approximation [RMSEA] = 0.08). There were significant indirect effects of cumulative traumatic life events on current PTSD symptoms (β = 0.29, p < .001; 85 % variance explained) and depressive symptoms (β = 0.28, p < .001; 69 % variance explained).

LIMITATIONS

Results may not be generalizable beyond the Singapore population due to the socio-cultural and environmental context.

CONCLUSIONS

The present findings provide conceptual support for a maladaptive personality-informed model of social support and PTSD, which could better inform trauma-focused interventions in preventing and treating the debilitating effects of PTSD in psychiatric populations.

Machine learning identifies different related factors associated with depression and suicidal ideation in Chinese children and adolescents

BACKGROUND

Depression and suicidal ideation often co-occur in children and adolescents, yet they possess distinct characteristics. This study sought to identify the different related factors associated with depression and suicidal ideation.

METHODS

A nationwide cross-sectional survey collected data from Chinese children and adolescents aged 8 to 18 (N = 160,962; 48.91 % girls). The survey included inquiries about demographics, depression, suicidal ideation, anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, bullying, and being bullied. Fifteen machine learning algorithms were conducted to identify the different related factors associated with depression and suicidal ideation. Additionally, we conducted external validation on an independent sample of 1,812,889 children and adolescents.

RESULTS

Our findings revealed seven related factors linked to depression and six associated with suicidal ideation, with average accuracy rates of 86.86 % and 85.82 %, respectively. For depression, the most influential factors were anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, experience of bullying, and age. Similarly, anxiety, non-suicidal self-injury, perceived stress, internet addiction, academic burnout, and age emerged as paramount factors for suicidal ideation. Moreover, these related factors showed notable variations in their predictive capacities for depression and suicidal ideation across different subgroups.

CONCLUSION

Anxiety emerged as the predominant shared factor for both depression and suicidal ideation, whereas the other related factors displayed distinct predictive patterns for each condition. These findings highlight the critical need for tailored strategies from public mental health service providers and policymakers to address the pressing concerns of depression and suicidal ideation.

Problematic social media use and psychological distress in pregnancy: The mediating role of social comparisons and body dissatisfaction

BACKGROUND

Pregnancy can be experienced as a significant transition for many women with associated body dissatisfaction, depression, pregnancy-related anxiety, and disordered eating attitudes. Problematic Social Media Use (PSMU) creates abundant opportunities for women to compare themselves with others and expose themselves to sociocultural influences which may increase body dissatisfaction and psychological distress.

AIMS

This study examined whether the relationship between PSMU and psychological distress (defined as depression, pregnancy-related anxiety and disordered eating attitudes) was mediated by negative social comparisons and body dissatisfaction.

METHOD

A sample of 225 pregnant Australian women (Mage = 31.91 years, SDage = 4.39) recruited online, completed self-report measures related to the variables of interest.

RESULTS

PSMU was associated with higher levels of depression, pregnancy-related anxiety, and disordered eating attitudes. Negative social comparisons and body dissatisfaction partially mediated the relationship between PSMU and pregnancy-related anxiety and depression, and fully mediated the relationship between PSMU and disordered eating attitudes.

LIMITATIONS

Cross-sectional nature of the study limited our ability to determine the direction of the relationships. Moreover, the recruitment method via social media led to high rates of non-completion.

CONCLUSION

The findings of this study suggest that problematic social media usage during pregnancy may increase depression, pregnancy-related anxiety and disordered eating attitudes. This study identified potential pathways that may explain this relationship, (via social comparisons and body dissatisfaction). This study highlights the potentially negative impact of social media use amongst expectant mothers and the importance of screening for body dissatisfaction in routine antenatal care.

Concerning neuromodulation as treatment of neurological and neuropsychiatric disorder: Insights gained from selective targeting of the subthalamic nucleus, para-subthalamic nucleus and zona incerta in rodents

Neuromodulation such as deep brain stimulation (DBS) is advancing as a clinical intervention in several neurological and neuropsychiatric disorders, including Parkinson's disease, dystonia, tremor, and obsessive-compulsive disorder (OCD) for which DBS is already applied to alleviate severely afflicted individuals of symptoms. Tourette syndrome and drug addiction are two additional disorders for which DBS is in trial or proposed as treatment. However, some major remaining obstacles prevent this intervention from reaching its full therapeutic potential. Side-effects have been reported, and not all DBS-treated individuals are relieved of their symptoms. One major target area for DBS electrodes is the subthalamic nucleus (STN) which plays important roles in motor, affective and associative functions, with impact on for example movement, motivation, impulsivity, compulsivity, as well as both reward and aversion. The multifunctionality of the STN is complex. Decoding the anatomical-functional organization of the STN could enhance strategic targeting in human patients. The STN is located in close proximity to zona incerta (ZI) and the para-subthalamic nucleus (pSTN). Together, the STN, pSTN and ZI form a highly heterogeneous and clinically important brain area. Rodent-based experimental studies, including opto- and chemogenetics as well as viral-genetic tract tracings, provide unique insight into complex neuronal circuitries and their impact on behavior with high spatial and temporal precision. This research field has advanced tremendously over the past few years. Here, we provide an inclusive review of current literature in the pre-clinical research fields centered around STN, pSTN and ZI in laboratory mice and rats; the three highly heterogeneous and enigmatic structures brought together in the context of relevance for treatment strategies. Specific emphasis is placed on methods of manipulation and behavioral impact.

Inconsistency in psychological resilience and social support with mental health in early adolescents: A multilevel response surface analysis approach

BACKGROUND

Given the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health.

METHODS

We used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis.

RESULTS

The higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = -1.83, P < 0.001; depression: a1 = -2.44, P < 0.001; and perceived stress: a1 = -1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls' mental health (anxiety: a1 = -1.97, P < 0.001; depression: a1 = -2.71, P < 0.001; perceived stress: a1 = -1.23, P < 0.001).

LIMITATIONS

The cross-sectional study design limited the inference of causal relationships between variables.

CONCLUSIONS

These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

Association between outdoor light at night exposure and executive function in Chinese children

BACKGROUND

Recent evidences highlight the potential impact of outdoor Light at Night (LAN) on executive function. However, few studies have investigated the association between outdoor LAN exposure and executive function.

METHODS

We employed data from 48,502 Chinese children aged 5-12 years in a cross-sectional study conducted in Guangdong province during 2020-2021, to examine the association between outdoor LAN and executive function assessed using the validated parent-completed Behavior Rating Inventory of Executive Function. We assessed children's outdoor LAN exposure using the night-time satellite images based on the residential addresses. We used generalized linear mixed models to estimate the association between outdoor LAN exposure and executive function scores and executive dysfunction.

RESULTS

After adjusting for potential covariates, higher quintiles of outdoor LAN exposure were associated with poorer executive function. Compared to the lowest quintile (Q1), all higher quintiles of exposure showed a significant increased global executive composite (GEC) score with β (95% confidence intervals, CI) of 0.58 (0.28, 0.88) in Q2, 0.59 (0.28, 0.9) in Q3, 0.85 (0.54, 1.16) in Q4, and 0.76 (0.43, 1.09) in Q5. Higher quintiles of exposure were also associated with higher risks for GEC dysfunction with odd ratios (ORs) (95% CI) of 1.34 (1.18, 1.52) in Q2, 1.40 (1.24, 1.59) in Q3, 1.40 (1.23, 1.59) in Q4, and 1.39 (1.22, 1.58) in Q5. And stronger associations were observed in children aged 10-12 years.

CONCLUSIONS

Our study suggested that high outdoor LAN exposure was associated with poor executive function in children. These findings suggested that future studies should determine whether interventions to reduce outdoor LAN exposure can have a positive effect on executive function.

A preliminary investigation of physical and mental health features of cannabis & nicotine co-use among adolescents and young adults by sex

INTRODUCTION

Cannabis and nicotine/tobacco products (NTP) are commonly co-used in adolescence and young adulthood; however, limited research has been done on predictive health behaviors to co-use. The current study is a preliminary investigation into the relationships of modifiable health behaviors on cannabis and NTP co-use in adolescents and young adults.

METHOD

221 participants (ages 16-22) were characterized into cannabis use only (N = 55), NTP use only (N = 20), cannabis and NTP co-use (used cannabis and NTP; N = 96) and control (no use; N = 50) groups based on past 30-day use. Self-report measures for physical activity, sleep quality, mental health, and reward responsivity were utilized. Participants were given a comprehensive neurocognitive battery. Logistic regressions of self-report measures and fluid intelligence composite scores on substance use group status were run stratified by sex.

RESULTS

Higher approach reward sensitivity traits were associated with increased likelihood of cannabis use only (Odds Ratio (OR) = 1.15, p = .036) in female participants. Increased aerobic activity was associated with decreased likelihood of cannabis use only (OR = 0.91, p = .047) and cannabis and NTP co-use (OR = 0.88, p = .007) in female participants. Higher anxiety was associated with increased likelihood of cannabis NTP co-use (OR = 1.51, p = 0.025) in male participants.

DISCUSSION

Several health behaviors were linked with cannabis use and cannabis and NTP co-use in both females and male adolescents and young adults. Health markers differed by sex suggesting differing mechanisms of substance co-use. This study informs targetable health behaviors for prevention and intervention efforts.

Associations of Household and Neighborhood Contexts and Hair Cortisol Among Mexican-Origin Adolescents From Low-Income Immigrant Families

Although neighborhood contexts serve as upstream determinants of health, it remains unclear how these contexts "get under the skin" of Mexican-origin youth, who are disproportionately concentrated in highly disadvantaged yet co-ethnic neighborhoods. The current study examines the associations between household and neighborhood socioeconomic status (SES), neighborhood racial-ethnic and immigrant composition, and hair cortisol concentration (HCC)-a physiological index of chronic stress response-among Mexican-origin adolescents from low-income immigrant families in the United States. A total of 297 (54.20% female; mage = 17.61, SD = 0.93) Mexican-origin adolescents had their hair cortisol collected, and their residential addresses were geocoded and merged with the American Community Survey. Neighborhoods with higher Hispanic-origin and foreign-born residents were associated with higher neighborhood disadvantage, whereas neighborhoods with higher non-Hispanic White and domestic-born residents were associated with higher neighborhood affluence. Mexican-origin adolescents living in neighborhoods with a higher proportion of Hispanic-origin residents showed lower levels of HCC, consistent with the role of the ethnic enclave. In contrast, adolescents living in more affluent neighborhoods showed higher levels of HCC, possibly reflecting a physiological toll. No association was found between household SES and HCC. Our findings underscore the importance of taking sociocultural contexts and person-environment fit into consideration when understanding how neighborhoods influence adolescents' stress physiology.

Lifespan differences in hippocampal subregion connectivity patterns during movie watching

Age-related episodic memory decline is attributed to functional alternations in the hippocampus. Less clear is how aging affects the functional connections of the hippocampus to the rest of the brain during episodic memory processing. We examined fMRI data from the CamCAN dataset, in which a large cohort of participants watched a movie (N = 643; 18-88 years), a proxy for naturalistic episodic memory encoding. We examined connectivity profiles across the lifespan both within the hippocampus (anterior, posterior), and between the hippocampal subregions and cortical networks. Aging was associated with reductions in contralateral (left, right) but not ipsilateral (anterior, posterior) hippocampal subregion connectivity. Aging was primarily associated with increased coupling between the anterior hippocampus and regions affiliated with Control, Dorsal Attention and Default Mode networks, yet decreased coupling between the posterior hippocampus and a selection of these regions. Differences in age-related hippocampal-cortical, but not within-hippocampus circuitry selectively predicted worse memory performance. Our findings comprehensively characterize hippocampal functional topography in relation to cognition in older age, suggesting that shifts in cortico-hippocampal connectivity may be sensitive markers of age-related episodic memory decline.

When rules are over-ruled: Virtual bargaining as a contractualist method of moral judgment

Rules help guide our behavior-particularly in complex social contexts. But rules sometimes give us the "wrong" answer. How do we know when it is okay to break the rules? In this paper, we argue that we sometimes use contractualist (agreement-based) mechanisms to determine when a rule can be broken. Our model draws on a theory of social interactions - "virtual bargaining" - that assumes that actors engage in a simulated bargaining process when navigating the social world. We present experimental data which suggests that rule-breaking decisions are sometimes driven by virtual bargaining and show that these data cannot be explained by more traditional rule-based or outcome-based approaches.

Challenging Misconceptions about Race in Undergraduate Genetics

Racial biases, which harm marginalized and excluded communities, may be combatted by clarifying misconceptions about race during biology lessons. We developed a human genetics laboratory activity that challenges the misconception that race is biological (biological essentialism). We assessed the relationship between this activity and student outcomes using a survey of students' attitudes about biological essentialism and color-evasive ideology and a concept inventory about phylogeny and human diversity. Students in the human genetics laboratory activity showed a significant decrease in their acceptance of biological essentialism compared with a control group, but did not show changes in color-evasive ideology. Students in both groups exhibited increased knowledge in both areas of the concept inventory, but the gains were larger in the human genetics laboratory. In the second iteration of this activity, we found that only white students' decreases in biological essentialist beliefs were significant and the activity failed to decrease color-evasive ideologies for all students. Concept inventory gains were similar and significant for both white and non-white students in this iteration. Our findings underscore the effectiveness of addressing misconceptions about the biological origins of race and encourage more research on ways to effectively change damaging student attitudes about race in undergraduate genetics education.

Perceived stress and associations between physical activity, sedentary time, and interstitial glucose in healthy adolescents

BACKGROUND

Less moderate to vigorous physical activity (MVPA), more sedentary time (ST), and higher perceived stress are related to type 2 diabetes mellitus (T2DM) occurrence, but observational evidence addressing the interaction of these factors is lacking in youth. This pilot study investigated momentary stress as a moderator in the acute associations of MVPA and ST with subsequent glucose in healthy adolescents.

METHODS

Participants (N=15, Mage=13.1±1.0 years, 10 girls, 5 with overweight/obesity) simultaneously wore a continuous glucose monitor (CGM), thigh-mounted accelerometer, and reported momentary stress via random ecological momentary assessments (EMA; Time T) for 7-14 days. MVPA and ST (min) were calculated for 60- and 120-minute time windows before each EMA prompt (Time T-1). Mean CGM-measured interstitial glucose (mg/dL) was calculated after each prompt (Mmin=120.0±25.4; Time T+1). Multilevel models assessed whether within-subject MVPA and ST (Time T-1) predicted mean glucose (Time T+1), with momentary stress as a moderator (Time T).

RESULTS

There were 513 time-matched EMA reports of stress, accelerometer, and CGM data. Momentary stress moderated the effects of MVPA 60 (β=-0.22, p=.001) and 120 min (β=-0.08, p=.02) before the prompt on subsequent glucose levels. When youth spent more time in MVPA than their average and when momentary stress was higher than their average, subsequent glucose was lower. Stress did not moderate associations of ST with glucose (p>.05).

CONCLUSIONS

Higher momentary stress may interact with higher MVPA to lower subsequent glucose in youth. Accelerometers, EMA, and CGMs can be integrated in future studies to further understand these associations in free-living environments.

Effectiveness and uptake of a transdiagnostic emotion regulation mobile intervention among university students: Protocol for a randomized controlled trial

Background

Going to university is a major life event, which can be stressful and negatively affect mental health. However, it also presents an opportunity to establish a foundation for positive life trajectories. To support university students, a mobile transdiagnostic emotion regulation (ER) intervention has been developed, offering both broad-based (universal) and targeted (indicated) preventative support. ER, a transdiagnostic factor underlying various mental health problems, is a critical intervention target in students, a demographic particularly susceptible to mental health issues. Cultivating ER can help manage immediate stressors and foster long-term wellbeing. This paper describes the study protocol for a Randomized Controlled Trial (RCT) evaluating the effectiveness and uptake of such mobile transdiagnostic ER intervention.

Method

The superiority parallel-group RCT involves 250 participants randomized to either the intervention condition (i.e., full access to the mobile intervention, (n = 125) or to a waitlist control condition (n = 125). Primary outcomes include ER skills and stress symptoms. Secondary outcomes include mental health parameters (anxiety, depression, resilience) and intervention uptake (i.e., objective engagement, subjective engagement, ER skills application in real life). Outcomes are assessed at baseline, week 3, 8 and 12, with continuous log-data collection for user engagement.

Discussion

This study evaluates the effectiveness and uptake of a transdiagnostic ER mobile intervention for the student population addressing their ER developmental needs. If successful, the results will validate our approach to intervention development and whether focusing on learning transfer (i.e., application of the learnt skills in real-life) and personalization using a recommendation system, can boost the real-world application of skills and intervention impact.

Loneliness and social isolation are not associated with executive functioning in a cross-sectional study of cognitively healthy older adults

The literature on the relationship between social interaction and executive functions (EF) in older age is mixed, perhaps stemming from differences in EF measures and the conceptualization/measurement of social interaction. We investigated the relationship between social interaction and EF in 102 cognitively unimpaired older adults (ages 65-90). Participants received an EF battery to measure working memory, inhibition, shifting, and global EF. We measured loneliness subjectively through survey and social isolation objectively through naturalistic observation. Loneliness was not significantly related to any EF measure (p-values = .13-.65), nor was social isolation (p-values = .11-.69). Bayes factors indicated moderate to extremely strong evidence (BF01 = 8.70 to BF01 = 119.49) in support of no relationship..   Overall, these findings suggest that, among cognitively healthy older adults, there may not be a robust cross-sectional relationship between EF and subjective loneliness or objective social isolation.

Lights, Sirens, and Load: Anticipatory emergency medical treatment planning causes cognitive load during emergency response driving among paramedicine students

Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator. We recruited 28 non-paramedic participants to complete a simulated baseline drive with no task and a cognitive load manipulation using the 1-back task. We also recruited 18 paramedicine students who completed a drive while considering two cases they were travelling to: cardiac arrest and infant seizure, representing varying difficulty in required treatment. The results indicated that both cases imposed considerable cognitive load, as indicated by NASA Task Load Index responses, comparable to the 1-back task and significantly higher than driving with no load. These findings suggest that contemplating cases and treatment plans may impact the safety of novice paramedics driving ambulances for emergency response. Further research should explore the influence of experience and the presence of a second individual in the vehicle to generalise to broader emergency response driving contexts.

Ability to Maintain and Improve Health and Socio-Demographic Correlates among Children in Albania

Objective

Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans.

Methods

A cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12-15 years. A structured self-administered and anonymous questionnaire inquired about the children's attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children's ability to maintain health.

Results

Overall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0-1.3), middle/low maternal education (OR=1.2, 95%CI=1.1-1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2-1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1-1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4-2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1-1.4).

Conclusions

Almost 1/3rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.

Student Perspectives of Success and Failure in Biology Lecture: Multifaceted Definitions and Misalignments

Investigating definitions of success and failure among introductory biology students is essential for understanding what underlies their self-efficacy; a student who gets a B on an exam may lose self-efficacy if they define failure as anything less than an A. Yet, whether students have the same definitions for success as they have for failure in these classes is unknown, nor how those definitions relate to course performance. To better understand student definitions for success and failure and their implications, this mixed-methods study collected survey data from students in two introductory biology courses about their definitions of success and failure and their self-reported grades. Coding of open-ended responses revealed four broad themes related to both success and failure: Performance, Content, Preparation, and Attitude. Although there were common themes in how students defined success and failure overall, individual students often (65%) described success or failure in relation to different standards. We also found some definitions of success and failure were predicted by grades. These results highlight the complexity of building self-efficacy in introductory biology and suggest the need for greater awareness and acknowledgment of the different standards students use to judge their success and failure.

Applying the Family Stress Model to responsive feeding and early obesity prevention

Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.

Midbrain sensitivity to auditory motion studied with dichotic sweeps of broadband noise

Many neurons in the central nucleus of the inferior colliculus (IC) show sensitivity to interaural time differences (ITDs), which is thought to be relayed from the brainstem. However, studies with interaural phase modulation of pure tones showed that IC neurons have a sensitivity to changes in ITD that is not present at the level of the brainstem. This sensitivity has been interpreted as a form of sensitivity to motion. A new type of stimulus is used here to study the sensitivity of IC neurons to dynamic changes in ITD, in which broad- or narrowband stimuli are swept through a range of ITDs with arbitrary start-ITD, end-ITD, speed, and direction. Extracellular recordings were obtained under barbiturate anesthesia in the cat. We applied the same analyses as previously introduced for the study of responses to tones. We find effects of motion which are similar to those described in response to interaural phase modulation of tones. The size of the effects strongly depended on the motion parameters but was overall smaller than reported for tones. We found that the effects of motion could largely be explained by the temporal response pattern of the neuron such as adaptation and build-up. Our data add to previous evidence questioning true coding of motion at the level of the IC.

Children's representation of coincidence

People relish thinking about coincidences-we puzzle over their meanings and delight in conveying our experiences of them to others. But whereas some research has begun to explore how coincidences are represented by adults, little is known about the early development of these representations. Here we explored factors influencing coincidence representations in both adults and children. Across two experiments, participants read stories describing co-occurring events and then judged whether these constituted coincidences. In Experiment 1 we found that adults' coincidence judgments were highly sensitive to the presence or absence of plausible explanations: as expected, adults were more likely to judge co-occurrences as a coincidence when no explanation was available. Importantly, their coincidence judgments were also modulated by the number of events that co-occurred. Adults tended to reject scenarios involving too many co-occurring events as coincidences regardless of whether an explanation was present, suggesting that observing suspiciously many co-occurrences triggered them to infer their own underlying explanation (and thus blocking the events' interpretation as a coincidence). In Experiment 2 we found that 4- to 10-year-old children also represent coincidences, and identify them via the absence of plausible explanations. Older children, like adults, rejected suspiciously large numbers of co-occurring events as coincidental, whereas younger children did not exhibit this sensitivity. Overall, these results suggest that representation of coincidence is available from early in life, but undergoes developmental change during the early school-age years.

Prediction of adolescent idiopathic scoliosis with machine learning algorithms using brain volumetric measurements

Background

It is known that neuroanatomical and neurofunctional changes observed in the brain, brainstem and cerebellum play a role in the etiology of adolescent idiopathic scoliosis (AIS). This study aimed to investigate whether volumetric measurements of brain regions can be used as predictive indicators for AIS through machine learning techniques.

Methods

Patients with a severe degree of curvature in AIS (n = 32) and healthy individuals (n = 31) were enrolled in the study. Volumetric data from 169 brain regions, acquired from magnetic resonance imaging (MRI) of these individuals, were utilized as predictive factors. A comprehensive analysis was conducted using the twelve most prevalent machine learning algorithms, encompassing thorough parameter adjustments and cross-validation processes. Furthermore, the findings related to variable significance are presented.

Results

Among all the algorithms evaluated, the random forest algorithm produced the most favorable results in terms of various classification metrics, including accuracy (0.9083), AUC (0.993), f1-score (0.970), and Brier score (0.1256). Additionally, the most critical variables were identified as the volumetric measurements of the right corticospinal tract, right corpus callosum body, right corpus callosum splenium, right cerebellum, and right pons, respectively.

Conclusion

The outcomes of this study indicate that volumetric measurements of specific brain regions can serve as reliable indicators of AIS. In conclusion, the developed model and the significant variables discovered hold promise for predicting scoliosis development, particularly in high-risk individuals.

Related metacognitions, desire thinking and identity differentially predict compulsion and withdrawal symptoms in problematic Instagram use

Work has identified that metacognitive thought results in desire-based thinking and perpetuates the magnitude and severity of maladaptive behaviour including problematic social media use, and also that one's ingroup identity is related to increasing problematic behaviour. No evidence has ascertained the relative contribution of these as related differential factors in the experience of problematic social media use. The current study explored the comparative importance of components of desire thinking, positive and negative metacognitions and dimensions of ingroup identity on degree of problematic use among 147 current Instagram users. Results showed that for predicting general problematic Instagram use negative metacognitive beliefs and the verbal perseverance component of desire-based thinking were significant. Importantly, however, different factors appeared to be important for predicting distinct aspects of problematic Instagram. For compulsivity indicators, negative metacognitions and verbal perseveration were essential, whereas for the withdrawal component identity centrality (and no other dimensions of identity) and imaginal prefiguration emerge as the sole independent predictors.

Sexual objectification versus empowerment: Examining the effects of sexualized women's facial expression on viewers' evaluations of social cognition and self-objectification

Objectification scholarship highlights how traditional media portrayals oftentimes direct attention toward women's bodies and away from their faces which communicate important social information. This study sought to investigate how thin-ideal, white women's facial expression potentially attenuates the negative effects of appearing in a sexually objectifying manner using validated imagery. In a 2 × 3 between-subjects experiment (N = 1001 U.S. adult women; Mage = 42.56, SDage = 12.72), portraits of women varied in their sexualization (non-sexualized vs. sexualized) and facial expression (neutral expression, low-intensity smiling, high-intensity smiling) to better understand how these factors influence dimensions of social cognition (competence, warmth, authenticity), self-promotional attributions, and viewers' own self-objectification. Results revealed that viewers rated sexualized (vs. non-sexualized) women lower in competence and authenticity, as well ascribed more self-promotional explanations for their behavior. Moreover, exposure to sexualized women heightened viewers' self-objectification, regardless of facial expression. Results also indicated that smiling intensity positively influenced viewers' ratings of social cognition. However, there is little evidence that smiling intensity overrides the negative effects of sexualization. Implications for the sexual objectification of women are discussed.

The association of socioeconomic status with the success of chat-based online counseling for children and youth: A latent change score modeling approach

Children and youth from lower subjective socioeconomic status (SES) backgrounds are at a heightened risk of mental disorders. Online counseling is a valuable tool to reach those less likely to seek professional help, but its success across different SES backgrounds remains unclear. This study explores the association between subjective SES and online counseling outcomes. Children and youth (N = 2139) between 10 and 24 years-of-age received chat-based online counseling and reported on SES, negative feelings before and after the chat, and perceived helpfulness of the chat via an online assessment tool. The results of a latent change score model showed a significant association between SES and negative feelings before chatting, indicating that lower SES predicted more negative feelings (r = -0.26, p < .001). Further, SES was indirectly associated with the change in negative feelings from before to after counseling, mediated by the extent of negative feelings before the chat (β = 0.07, 95%CFI = [0.05-0.10]). Current findings extend research on online counseling programs in the context of SES. Despite higher counseling needs among low SES individuals, they do not benefit proportionally from existing online services in this sample. Future research should investigate barriers to help-seeking and implement specialized counselor training programs.

Breadth of substance use is associated with the selection of a larger food portion size via elevated impulsivity

Substance use is associated with altered or elevated food consumption and disordered eating. In the present study we examined whether breadth (variety) of drug use was associated with elevated portion size in a general population sample as it was in persons in recovery from substance use disorder. Furthermore, measures of emotional eating, impulsivity, food misuse, food craving were taken as possible mediators and reward responsiveness was examined as a potential moderator of this association. 444 adults (48.6 % women, mean age of 47.8 years) completed an online study in which they were asked to make judgements of ideal portion size for 6 different foods using a validated online tool that allowed participants to adjust the portion size of images of foods. Ideal portion size has been identified as a strong predictor of actual consumption. Participants were also asked to report the number of substances used in the past and provide anthropometric information. The results confirmed that breadth of drug use was associated with selection of higher portion size. Reward responsiveness was not a moderator of this relationship. Of the tested mediators, only impulsivity mediated the association between breadth of drug use and portion size. The results show that impulsivity may underlie the association between eating and substance use.

Behavioural interference at event boundaries reduces long-term memory performance in the virtual water maze task without affecting working memory performance

Narrative episodic memory of movie clips can be retroactively impaired by presenting unrelated stimuli coinciding with event boundaries. This effect has been linked with rapid hippocampal processes triggered by the offset of the event, that are alternatively related either to memory consolidation or with working memory processes. Here we tested whether this effect extended to spatial memory, the temporal specificity and extent of the interference, and its effect on working- vs long-term memory. In three computerized adaptations of the Morris Water Maze, participants learned the location of an invisible target over three trials each. A second spatial navigation task was presented either immediately after finding the target, after a 10-s delay, or no second task was presented (control condition). A recall session, in which participants indicated the learned target location with 10 'pin-drop' trials for each condition, was performed after a 1-h or a 24-h break. Spatial memory was measured by the mean distance between pins and the true location. Results indicated that the immediate presentation of the second task led to worse memory performance, for both break durations, compared to the delayed condition. There was no difference in performance between the delayed presentation and the control condition. Despite this long-term memory effect, we found no difference in the rate of performance improvement during the learning session, indicating no effect of the second task on working memory. Our findings are in line with a rapid process, linked to the offset of an event, that is involved in the early stages of memory consolidation.

Ego depletion does not negatively impact novice sprinters' start performance during a timed 20m all-out sprint

Temporary reductions in self-control due to previous cognitive effort, also known as 'ego depletion', have been shown to negatively impact performance in subsequent tasks requiring self-control. Various theoretical accounts suggest that high levels of task motivation may prevent negative behavioural effects of ego depletion. Against this background, the current study performed a conceptual replication of a previous study examining the effects of ego depletion on sprint start performance (i.e., Englert et al., 2015) and implemented additional monetary incentives to manipulate task motivation. Using a pretest-intervention-posttest design, ninety-six novice sprinters performed a sprinting task that required them to complete a series of 20-m sprints. In between pretest and posttest, participants performed a letter writing task either under high cognitive demand (depletion group) or low cognitive demand (non-depletion control group). Subsequently, and prior to starting the posttest, participants were presented either with a monetary incentive or no incentive. Manipulation checks confirmed that the letter writing task successfully manipulated perceived regulatory demand and that task motivation at the posttest was higher for participants who were offered a monetary incentive. The number of false starts decreased significantly with ego depletion, while sprint start reaction times and sprint finish times remained unaffected. Regardless of ego depletion, sprint finish times significantly improved with monetary incentives. These results suggest that brief engagement in a demanding cognitive task is unlikely to impair novice sprinters' ability to self-regulate during the start of a subsequent, maximal sprinting effort for which they are highly motivated.

FGF21 as a mediator of adaptive changes in food intake and macronutrient preference in response to protein restriction

Free-feeding animals navigate complex nutritional landscapes in which food availability, cost, and nutritional value can vary markedly. Animals have thus developed neural mechanisms that enable the detection of nutrient restriction, and these mechanisms engage adaptive physiological and behavioral responses that limit or reverse this nutrient restriction. This review focuses specifically on dietary protein as an essential and independently defended nutrient. Adequate protein intake is required for life, and ample evidence exists to support an active defense of protein that involves behavioral changes in food intake, food preference, and food motivation, likely mediated by neural changes that increase the reward value of protein foods. Available evidence also suggests that the circulating hormone fibroblast growth factor 21 (FGF21) acts in the brain to coordinate these adaptive changes in food intake, making it a unique endocrine signal that drives changes in macronutrient preference in the context of protein restriction. This article is part of the Special Issue on "Food intake and feeding states".

Differentiating monogenic and syndromic obesities from polygenic obesity: Assessment, diagnosis, and management

Background

Obesity is a multifactorial neurohormonal disease that results from dysfunction within energy regulation pathways and is associated with increased morbidity, mortality, and reduced quality of life. The most common form is polygenic obesity, which results from interactions between multiple gene variants and environmental factors. Highly penetrant monogenic and syndromic obesities result from rare genetic variants with minimal environmental influence and can be differentiated from polygenic obesity depending on key symptoms, including hyperphagia; early-onset, severe obesity; and suboptimal responses to nontargeted therapies. Timely diagnosis of monogenic or syndromic obesity is critical to inform management strategies and reduce disease burden. We outline the physiology of weight regulation, role of genetics in obesity, and differentiating characteristics between polygenic and rare genetic obesity to facilitate diagnosis and transition toward targeted therapies.

Methods

In this narrative review, we focused on case reports, case studies, and natural history studies of patients with monogenic and syndromic obesities and clinical trials examining the efficacy, safety, and quality of life impact of nontargeted and targeted therapies in these populations. We also provide comprehensive algorithms for diagnosis of patients with suspected rare genetic causes of obesity.

Results

Patients with monogenic and syndromic obesities commonly present with hyperphagia (ie, pathologic, insatiable hunger) and early-onset, severe obesity, and the presence of hallmark characteristics can inform genetic testing and diagnostic approach. Following diagnosis, specialized care teams can address complex symptoms, and hyperphagia is managed behaviorally. Various pharmacotherapies show promise in these patient populations, including setmelanotide and glucagon-like peptide-1 receptor agonists.

Conclusion

Understanding the pathophysiology and differentiating characteristics of monogenic and syndromic obesities can facilitate diagnosis and management and has led to development of targeted pharmacotherapies with demonstrated efficacy for reducing body weight and hunger in the affected populations.

Value-based decision-making in regular alcohol consumers following experimental manipulation of alcohol value

BACKGROUND

Devaluation of alcohol leads to reductions in alcohol choice and consumption; however, the cognitive mechanisms that underpin this relationship are not well-understood. In this study we applied a computational model of value-based decision-making (VBDM) to decisions made about alcohol and alcohol-unrelated cues following experimental manipulation of alcohol value.

METHOD

Using a pre-registered within-subject design, thirty-six regular alcohol consumers (≥14 UK units per week) completed a two-alternative forced choice task where they chose between two alcohol images (in one block) or two soft drink images (in a different block) after watching videos that emphasised the positive (alcohol value), and separately, the negative (alcohol devalue) consequences of alcohol. On each block, participants pressed a key to select the image depicting the drink they would rather consume. A drift-diffusion model (DDM) was fitted to reaction time and choice data to estimate evidence accumulation (EA) processes and response thresholds during the different blocks in each experimental condition.

FINDINGS

In the alcohol devalue condition, soft drink EA rates were significantly higher compared to alcohol EA rates (p = 0.04, d = 0.31), and compared to soft drink EA rates in the alcohol value condition (p = 0.01, d = 0.38). However, EA rates for alcoholic drinks and response thresholds (for either drink type) were unaffected by the experimental manipulation.

CONCLUSIONS

In line with behavioural economic models of addiction that emphasise the important role of alternative reinforcement, experimentally manipulating alcohol value is associated with changes in the internal cognitive processes that precede soft drink choice.

Assigned group work is associated with increased student motivation and perceptions of belonging in an asynchronous online physiology laboratory course

With the rise of online instruction, a better understanding of the factors that contribute to belonging and motivation in these contexts is essential to creating optimal learning environments. Although group work is known to be beneficial to student success, few studies have investigated its role in the context of asynchronous online courses. The present study addresses this gap through a survey of 146 undergraduate students in an asynchronous online physiology lab over two semesters, one with required group work and one without group work. Students were surveyed to evaluate the influence of group work on their motivation and sense of belonging, as well as their perceptions of inclusive and exclusive features of the course. Students assigned to groups had a higher sense of belonging (P = 0.006) and beliefs about their competence (P = 0.002) and perceived lower effort and psychological costs associated with the course (P = 0.04 and 0.04, respectively) compared to students not assigned to groups. Students assigned to groups reported that peer interactions made them feel included in the course (70% of coded responses) while those not assigned to groups valued instructor interactions (51% of coded responses) as inclusive. Negative peer interactions were commonly reported as exclusive by students assigned to groups (28% of coded responses) while a lack of peer interactions (23% of coded responses) made students not assigned to groups feel excluded. These data indicate that assigning groups in asynchronous online courses is an effective way to increase student motivation and perceptions of belonging.NEW & NOTEWORTHY This study explores the effect of assigned group work in an asynchronous online physiology laboratory course on student motivation and belonging. Students' perceptions of belonging and competence-related beliefs were higher, and effort and psychological costs were lower, when assigned to groups compared to students not assigned to groups. Students assigned to groups noted peer interactions as the most inclusive aspect of the course, whereas instructor interactions were noted as inclusive by those not assigned group work.

Social impediments to meat-eaters' adherence to critical calls for a meat-free diet: An experimental test of social norm and message source effects

Reducing meat consumption is highly effective for reducing personal carbon emissions, yet most people in Western nations still eat meat. We build on recent research highlighting that group boundaries may impede dietary change by (a) promoting pro-meat norms and (b) prohibiting critical calls for a veg* diet (vegetarian and vegan, i.e., meat-free). Past research relied on self-reports and behavioural measures of engagement, leaving open whether these effects extend to food consumption settings and ad-hoc meal choice. We conducted two pre-registered experiments in which meat-eaters read critical calls to adopt a veg* diet, either by a vegan (outgroup) or a meat-eater (ingroup). In Experiment 2, participants moreover read an article either highlighting a veg* or a meat-eating norm. We then assessed actual (Experiment 1) or hypothetical (Experiment 2) meal choice as dependent variables. As predicted, intergroup criticism (i.e., voiced by veg*s) consistently led to message rejection in comparison to the same criticism voiced by meat eaters, but we did not observe effects on meal choice. Norms neither had a main nor interaction effect on self-reports and behaviour. We discuss potential intermediary processes between engagement with and adoption of a vegan diet and derive evidence-based recommendations for constructive communication across group boundaries.

Endogenous Control and Reward-based Mechanisms Shape Infants' Attention Biases to Caregiver Faces

Infants rely on developing attention skills to identify relevant stimuli in their environments. Although caregivers are socially rewarding and a critical source of information, they are also one of many stimuli that compete for infants' attention. Young infants preferentially hold attention on caregiver faces, but it is unknown whether they also preferentially orient to caregivers and the extent to which these attention biases reflect reward-based attention mechanisms. To address these questions, we measured 4- to 10-month-old infants' (N = 64) frequency of orienting and duration of looking to caregiver and stranger faces within multi-item arrays. We also assessed whether infants' attention to these faces related to individual differences in Surgency, an indirect index of reward sensitivity. Although infants did not show biased attention to caregiver versus stranger faces at the group level, infants were increasingly biased to orient to stranger faces with age and infants with higher Surgency scores showed more robust attention orienting and attention holding biases to caregiver faces. These effects varied based on the selective attention demands of the task, suggesting that infants' attention biases to caregiver faces may reflect both developing attention control skills and reward-based attention mechanisms.

Childhood Maltreatment and Biological Aging in Middle Adulthood: The Role of Psychiatric Symptoms

Background

Childhood maltreatment and psychiatric morbidity have each been associated with accelerated biological aging primarily through cross-sectional studies. Using data from a prospective longitudinal study of individuals with histories of childhood maltreatment and control participants followed into midlife, we tested 2 hypotheses examining whether 1) psychiatric symptoms mediate the relationship between childhood maltreatment and biological aging and 2) psychiatric symptoms of anxiety, depression, or posttraumatic stress disorder (PTSD) act in conjunction with childhood maltreatment to exacerbate the association of child maltreatment to aging.

Methods

Children (ages 0-11 years) with documented histories of maltreatment and demographically matched control children were followed into adulthood (N = 607) and interviewed over several waves of the study. Depression, anxiety, and PTSD symptoms were assessed at mean ages of 29 (interview 1) and 40 (interview 2) years. Biological age was measured from blood chemistries collected later (mean age = 41 years) using the Klemera-Doubal method. Hypotheses were tested using linear regressions and path analyses.

Results

Adults with documented histories of childhood maltreatment showed more symptoms of depression, PTSD, and anxiety at both interviews and more advanced biological aging, compared with control participants. PTSD symptoms at both interviews and depression and anxiety symptoms only at interview 2 predicted accelerated biological aging. There was no evidence of mediation; however, anxiety and depression moderated the relationship between childhood maltreatment and biological aging.

Conclusions

These new findings reveal the shorter- and longer-term longitudinal impact of PTSD on biological aging and the amplifying effect of anxiety and depression on the relationship between child maltreatment and biological aging.

Intervention to promote adolescents' communication and engagement in diabetes clinic encounters: A pilot randomized controlled trial

AIM

To conduct a pilot randomized trial of an intervention to improve adolescent question-asking and provider education during paediatric diabetes visits.

METHODS

Adolescents aged 11 to 17 with type 1 diabetes and their parents were enrolled from two urban tertiary paediatric clinics. Adolescents were randomised to the intervention group or control group. Adolescent consultations were audio-recorded, their HbA1c level was recorded, and they completed surveys after three clinic appointments. The intervention group completed a question prompt list and watched a video on a tablet with their parents before meeting their doctor and completed a short evaluation after each visit.

RESULTS

Six consultant endocrinologists and ninety-nine adolescents and their parents participated. The intervention increased adolescents' question asking and provider education in diabetes encounters. Total patient question-asking across the 3 consultations and a higher baseline HbA1c at time one was significantly associated with HbA1c at time three.

CONCLUSIONS

Question prompt lists and an educational video are useful tools to increase adolescents' question-asking and communication between adolescents and their providers.

PRACTICE IMPLICATIONS

Interventions that encourage adolescents' question-asking in healthcare encounters may lead to more meaningful providers-adolescents' communication and tailored education. Interventions to improve professionals' listening, communication and educational skills are also required.

Gender differences in risk and resilience for suicidal thoughts and behaviors: A national longitudinal survey study of United States veterans with a recent suicide attempt

BACKGROUND

This study reports on gender differences in psychosocial symptoms and suicidal thoughts and behaviors from the first longitudinal, national survey of veterans with a recent nonfatal suicide attempt to inform women-tailored suicide prevention.

METHODS

We recruited all female veterans with a documented nonfatal suicide attempt between October 2018 and September 2019 and a stratified matched sample of males. Surveys were administered at baseline, month 6, and month 12; 968 veterans completed the baseline survey with valid gender data. Surveys assessed psychosocial constructs, suicidal ideation severity, and suicidal behavior. Administrative datasets provided healthcare and suicide attempt data during the one year follow up.

RESULTS

Women retained higher social rejection and institutional betrayal, and lower self-compassion and autonomy than men over follow up. Higher overall self-compassion was associated with lower baseline suicide ideation for both women and men; however, this association was stronger for women (Δ = -0.19; 95 % CI = -0.31, -0.07; d = -0.15). Individuals with higher overall psychological distress had greater odds of a subsequent suicide attempt (AOR = 2.20, 95 % CI = 1.56, 3.11). Social rejection had the strongest association with worsening psychological distress, both within individuals (b = 0.18; 95 % CI = 0.14, 0.23; d = 0.23) and between individuals (b = 0.07; 95 % CI = 0.04, 0.10; d = 0.09).

LIMITATIONS

Results may not generalize beyond a VHA-utilizing veteran population.

CONCLUSIONS

Findings from this study inform potential therapeutic targets and topics for future research on tailoring suicide prevention for women veterans. While all veterans may need support reducing distress, women may need additional support in multiple other areas.

High frequency heart rate variability is associated with sensitivity to affective touch

C-tactile afferents (CTs) are a class of unmyelinated, mechanosensitive nerve fibre that respond optimally to skin temperature, slow moving touch typical of a caress. They are hypothesised to signal the rewarding value of affiliative tactile interactions. While CT firing frequency is positively correlated with subjective ratings of touch pleasantness, trait differences in sensitivity to the specific hedonic value of CT targeted touch have been reported. Inter-individual differences in vagally mediated, high frequency heart rate variability (HF-HRV) have been linked to variation in visual social cognition. Thus, the aim of the present study was to examine the relationship between resting state HF-HRV and sensitivity to socially relevant CT targeted touch. 58 healthy participants first had a 5-minute electrocardiogram. They then rated the pleasantness of 5 randomly presented velocities of robotically delivered touch. Three velocities fell within (1, 3, 10 cm/s) and two outside (0.3, 30 cm/s) the CT optimal range. Each velocity was delivered twice. On a group level, affective touch ratings were described by a negative quadratic function, with CT optimal velocities rated as more pleasant than slower and faster speeds. Simple regression analysis confirmed participants' HF-HRV was significantly predicted by the quadratic curve fit of their touch ratings, with higher HF-HRV associated with a better quadratic fit. These findings indicate that, in line with previous observations that higher HF-HRV is associated with enhanced sensitivity to visual social cues, trait differences in autonomic control could account for previously reported individual differences in CT sensitivity.