Effects of war exposure on pubertal development in refugee children

Increasing research shows pubertal development accelerates following threats while it decelerates following deprivation. Yet, these environmental stressors are unlikely to occur in isolation. We investigated how war exposure and energetic stress impact pubertal development using data from the longitudinal Biological Pathways of Risk and Resilience in Syrian Refugee Children study. Our sample included 1,600 male and female Syrian refugee children and their caregivers who lived in temporary settlements in Lebanon. We hypothesized that (a) energetic stress suppresses pubertal development; (b) war exposure accelerates pubertal timing in boys and increases risk of menarche in girls, but only when energetic stress is low; and (c) when energetic stress is elevated, effects of war exposure on pubertal development will be attenuated. Among boys, we did not find support for Hypothesis 1, but Hypotheses 2 and 3 were supported. Exposure to morbidity/mortality threats accelerated pubertal timing; this effect was attenuated under conditions of elevated energetic stress. Among girls, we found support for Hypothesis 1, but not for Hypotheses 2 and 3. Elevated energetic stress decreased the risk of menarche in girls. Neither war exposure, nor any interactions with energetic stress, predicted risk of menarche. Sensitivity analyses revealed a significant interaction between bombing exposure and the amount of time since leaving Syria. Bombing decreased the risk of menarche, but only for girls who had left Syria four or more years prior to data collection. We discuss implications for translational efforts advocating for puberty screening in medical and mental health settings to identify trauma-exposed youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Applying Human-Centered Design in Global Mental Health to Improve Reach Among Underserved Populations in the United States and India

INTRODUCTION

Human-centered design (HCD) refers to a diverse suite of interactive processes that engage end users in the development of a desired outcome. We showcase how 2 global mental health research teams applied HCD to develop mobile health tools, each directed at reducing treatment gaps in underserved populations. CASE STUDY 1: Refugees face higher risks for mental health problems, yet these communities face structural and cultural barriers that reduce access to and use of services. To address these challenges, the Research Program on Children and Adversity at the Boston College School of Social Work, in partnership with resettled refugee communities in the northeastern United States, used codesign methodology to digitally adapt delivery of the Family Strengthening Intervention for Refugees-a program designed to improve mental health and family functioning among resettled families. We describe how codesign methods support the development of more feasible, acceptable, and sustainable interventions. CASE STUDY 2: Sangath, an NGO in India focused on mental health services research, in partnership with Harvard Medical School, designed and evaluated a digital training program for community health workers to deliver an evidence-based, brief psychological treatment for depression as part of primary care in Madhya Pradesh, India. We describe how HCD was applied to program development and discuss our approach to scaling up training and capacity-building to deliver evidence-based treatment for depression in primary care.

IMPLICATIONS

HCD involves a variety of techniques that can be flexibly adapted to engage end users in the conceptualization, implementation, scale-up, and sustainment of global mental health interventions. Community solutions generated using HCD offer important benefits for key stakeholders. We encourage widespread adoption of HCD within global mental health policy, research, and practice, especially for addressing mental health disparities with underserved populations.

Diet and irritable bowel syndrome: an update from a UK consensus meeting

There has been a renewed interest in the role of dietary therapies to manage irritable bowel syndrome (IBS), with diet high on the agenda for patients. Currently, interest has focussed on the use of traditional dietary advice (TDA), a gluten-free diet (GFD) and the low FODMAP diet (LFD). A consensus meeting was held to assess the role of these dietary therapies in IBS, in Sheffield, United Kingdom.Evidence for TDA is from case control studies and clinical experience. Randomised controlled trials (RCT) have demonstrated the benefit of soluble fibre in IBS. No studies have assessed TDA in comparison to a habitual or sham diet. There have been a number of RCTs demonstrating the efficacy of a GFD at short-term follow-up, with a lack of long-term outcomes. Whilst gluten may lead to symptom generation in IBS, other components of wheat may also play an important role, with recent interest in the role of fructans, wheat germ agglutinins, as well as alpha amylase trypsin inhibitors. There is good evidence for the use of a LFD at short-term follow-up, with emerging evidence demonstrating its efficacy at long-term follow-up. There is overlap between the LFD and GFD with IBS patients self-initiating gluten or wheat reduction as part of their LFD. Currently, there is a lack of evidence to suggest superiority of one diet over another, although TDA is more acceptable to patients.In view of this evidence, our consensus group recommends that dietary therapies for IBS should be offered by dietitians who first assess dietary triggers and then tailor the intervention according to patient choice. Given the lack of dietetic services, novel approaches such as employing group clinics and online webinars may maximise capacity and accessibility for patients. Further research is also required to assess the comparative efficacy of dietary therapies to other management strategies available to manage IBS.

Substance, History, and Politics

The aim of this article is to examine the relations between two approaches to the measurement of life history (LH) strategies: A traditional approach, termed here the biodemographic approach, measures developmental characteristics like birthweight, gestation length, interbirth intervals, pubertal timing, and sexual debut, and a psychological approach measures a suite of cognitive and behavioral traits such as altruism, sociosexual orientation, personality, mutualism, familial relationships, and religiosity. The biodemographic approach also tends not to invoke latent variables, whereas the psychological approach typically relies heavily upon them. Although a large body of literature supports both approaches, they are largely separate. This review examines the history and relations between biodemographic and psychological measures of LH, which remain murky at best. In doing so, we consider basic questions about the nature of LH strategies: What constitutes LH strategy (or perhaps more importantly, what does not constitute LH strategy)? What is gained or lost by including psychological measures in LH research? Must these measures remain independent or should they be used in conjunction as complementary tools to test tenets of LH theory? Although definitive answers will linger, we hope to catalyze an explicit discussion among LH researchers and to provoke novel research avenues that combine the strengths each approach brings to this burgeoning field.

Strategic differentiation and integration of genomic-level heritabilities facilitate individual differences in preparedness and plasticity of human life history

Life history (LH) strategies refer to the pattern of allocations of bioenergetic and material resources into different domains of fitness. While LH is known to have moderate to high population-level heritability in humans, both at the level of the high-order factor (Super-K) and the lower-order factors (K, Covitality, and the General Factor of Personality), several important questions remain unexplored. Here, we apply the Continuous Parameter Estimation Model to measure individual genomic-level heritabilities (termed transmissibilities). These transmissibility values were computed for the latent hierarchical structure and developmental dynamics of LH strategy, and demonstrate; (1) moderate to high heritability of factor loadings of Super-K on its lower-order factors, evidencing biological preparedness, genetic accommodation, and the gene-culture coevolution of biased epigenetic rules of development; (2) moderate to high heritability of the magnitudes of the effect of the higher-order factors upon their loadings on their constituent factors, evidencing genetic constraints upon phenotypic plasticity; and (3) that heritability of the LH factors, their factor loadings, and the magnitudes of the correlations among factors, are weaker among individuals with slower LH speeds. The results were obtained from an American sample of 316 monozygotic (MZ) and 274 dizygotic (DZ) twin dyads and a Swedish sample of 863 MZ and 475 DZ twin dyads, and indicate that inter-individual variation in transmissibility is a function of individual socioecological selection pressures. Our novel technique, opens new avenues for analyzing complex interactions among heritable traits inaccessible to standard structural equation methods.

Electrophysiological properties of dorsal lateral geniculate neurons in brain slices from ME7 scrapie-infected mice

Electrophysiological recordings using conventional intracellular techniques were obtained from dorsal lateral geniculate nucleus (dLGN) neurons in brain slices from ME7 scrapie-infected mice at specific time points throughout the incubation period of the disease. Comparisons were made with age-matched control mice. A number of dLGN neurons from control and scrapie-infected mice were injected with biocytin in order to examine their cellular morphology. Mice were infected with ME7 scrapie by an intraocular route and the mean (+/- SEM) incubation period of the disease was 276 +/- 3.5 days. Our results indicate that there were no differences in the electrophysiological or morphological parameters of neurons recorded in ME7 scrapie-infected and age-matched control mice at any stage of the disease up to 240 days postinoculation. After this time, however, no detectable electrical activity was recorded in the dLGN. This study demonstrates that in the ME7 scrapie-infected dLGN, relay neurons with normal physiological and morphological properties are present even at an advanced stage of the disease at a time when the dLGN is known to be subject to marked pathological changes and a profound neuronal loss.

Mosaic trisomy 22: a case presentation and literature review of trisomy 22 phenotypes

In a case of mosaic trisomy 22 the trisomic cells were detected primarily in fibroblasts. Results of initial lymphocyte chromosome analysis were normal. However, mosaicism was suspected because the patient had hypomelanosis of Ito, hemiatrophy, failure to thrive, and mental retardation. Mosaicism was confirmed in cultured fibroblasts. Repeat cytogenetic analysis of peripheral blood demonstrated a low level of trisomic metaphase cells, which was confirmed by interphase fluorescent in situ hybridization (FISH) analysis. Molecular studies supported maternal disomy in the child's disomic cells. The phenotype of this condition overlaps that of non-mosaic trisomy 22 chromosome mosaicism in general and to some extent the Ullrich-Turner syndrome phenotype. Improved cytogenetic and molecular techniques now allow better delineation of aneuploidy syndromes. Molecular and FISH studies added information about this case (mosaicism and uniparental disomy) not appreciated by routine cytogenetic analysis of lymphocytes. The detection of low-level mosaicism and/or uniparental disomy in such cases may change the clinical classification and our understanding of pathogenesis and recurrence risk of these disorders.

Rapid detection of respiratory syncytial virus by a biotin-enhanced immunoassay: test performance by laboratory technologists and housestaff

A biotin-enhanced enzyme immunoassay (EIA) for respiratory syncytial virus (RSV) antigen detection (TESTPACK RSV) was prospectively compared with virus isolation in cell culture and immunofluorescence. Of 156 nasopharyngeal swab specimens from infants with respiratory symptoms, 81 (52%) yielded RSV in culture. Compared with culture the sensitivity of the EIA was 95% and specificity was 92%; the specificity increased to 97% with a blocking assay. Compared with immunofluorescence the sensitivity of EIA was 92% and specificity was 93%. In order to assess the performance of TESTPACK RSV as a bedside test, nasopharyngeal swabs from 49 children were tested by EIA at the bedside by housestaff and by immunofluorescence in the laboratory; the sensitivity of the EIA was lower (78%) while specificity remained high (95%). Inclusion of older children may have resulted in diminished sensitivity. The TESTPACK RSV is a simple, rapid test that performs well and is easily adaptable to an office setting. Further evaluation of the test in older children may be required.