Hop,Skip … No! Explaining Adolescent Girls’ Disinclination for Physical Activity

Purpose  

This study aimed to develop and validate the Girls’ Disinclination for Physical Activity Scale (G-DAS) and implement the scale along with an objective measure of physical activity (PA) in a longitudinal sample of adolescent girls.     

Levels of Imperviousness in the Schizophrenic’s Family

Abstract

Amidst the still limited literature on survivors of suicide, and the particularly scanty literature on children of parental suicide, little focal attention has been given to the special issues surrounding surviving parents telling the children that their deceased parent's death was a suicide. Those few papers that deal with this topic have primarily emphasized the destructive consequences of not telling of the suicidal nature of the death, with imperatives to tell the children the whole truth and do so promptly post-death. Based primarily on clinical and preventive work with children of suicide, this absolutism and one-size-fits-all approach is questioned, the difference between being told and knowing accented and illustrated, and the nature and effects of surviving parent explanatory frameworks for the suicide—the ‘why’ of it—explored.     

The Analyst’s Participation in the Treatment of an Adolescent

Objective: The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. Method: A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Results: Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Conclusions: Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents’ prior history of stressful events.     

Comparison of Eating Attitudes between Adolescent Girls with and without Asperger Syndrome: Daughters’ and Mothers’ Reports

Despite the evidence that individuals with Asperger syndrome (AS) have a propensity for being underweight or having comorbid eating disorders, no previous research has compared the eating attitudes of adolescent girls with AS to typically developing peers. This study compared reports of eating problems provided by the adolescent girls themselves (56 with and 56 without AS) and their mothers on the EAT-26. Results indicated that adolescent girls with AS are at a higher risk for eating problems than their typically developing peers according to their reports and the reports of their mothers. Moreover, it was found that although the agreement between mothers’ and daughter’s reports is very satisfactory, mothers of girls with AS report statistically less eating-disordered behaviors than their daughters.     

The Environment and Staff of Residential Facilities: Findings from the Italian ‘Progres’ National Survey

We administered structured interviews to managers and staff of a random sample of 265 Italian psychiatric Residential Facilities (RFs). Most are independent buildings, located in urban and suburban areas. The median number of residents is 10. The few RFs (5.7%) with more than 20 beds have a higher rate of drop-outs and escapes. The average indoor space per resident is 36 square meters, there is often a garden, and residents generally live in two-bed rooms. Most facilities are located within walking distance of shopping centers or recreational facilities. Three-quarters have 24-hour staff coverage. On average, each facility has about 10 full-time equivalent workers, with a staff:resident ratio of 0.92. Most of the professional input is provided by nurses and auxiliary staff. Critical issues to be considered in planning facilities include the physical environment, the size, and the staffing patterns. Angelo Picardi, Giovanni de Girolamo, and Pierluigi Morosini are affiliated with the National Mental Health Project, Italian National Institute of Health, Rome, Italy.Giovanni Santone is affiliated with the Psychiatric Clinic, United Hospitals of Ancona and University of Marche, Ancona, Italy.Ian Falloon is affiliated with the University of Auckland, Auckland, New Zealand.Angelo Fioritti is affiliated with the Program on Mental Health and Pathological Dependence, AUSL of Rimini, Rimini, Italy.Rocco Micciolo is affiliated with the Chair of Biostatistics, University of Trento, Trento, Italy.Enrico Zanalda is affiliated with the Department of Mental Health, Turin, Italy.The PROGRES Group includes: National Coordinators: G. de Girolamo, M.D., A. Picardi, M.D., P. Morosini, M.D. (National Mental Health Project, National Institute of Health, Rome); Biostatistician: R. Micciolo, M.D. (University of Trento); Regional Coordinators: P. Argentino, M.D., G. Borsetti, M.D., M. Casacchia, M.D., P. Ciliberti, M.D., G. Civenti, M.S.W., A. Colotto, M.D., G. Dell’Acqua, M.D., W. Di Munzio, M.D., G. Fagnano, D.Psyc., A. Fioritti, M.D., N. Longhin, M.D., M. Miceli, M.D., M. Nicotera, M.D., M. Pisetta, R. Putzolu, E. Rossi, M.D., M.E. Rotunno, M.D., D. Semisa, M.D., R. Tomasi, M.D., P. Tulli, D.Psyc., E. Zanalda, M.D.     

The Role of Schools in Early Adolescents’ Mental Health: Findings From the MYRIAD Study

ObjectiveRecent studies suggest mental health in youths is deteriorating. The current policy in the United Kingdom emphasizes the role of schools for mental health promotion and prevention, but little data exist on what aspects of schools influence mental health in pupils. This study explored school-level influences on the mental health of young people in a large school-based sample from the United Kingdom.MethodBaseline data from a large cluster randomized controlled trial collected between 2016 and 2018 from mainstream secondary schools selected to be representative in relation to their quality rating, size, deprivation, mixed or single-sex pupil population, and country were analyzed. Participants were pupils in their first or second year of secondary school. The study assessed whether school-level factors were associated with pupil mental health.ResultsThe study included 26,885 pupils (response rate = 90%; age range, 11‒14 years; 55% female) attending 85 schools in the United Kingdom. Schools accounted for 2.4% (95% CI: 2.0%‒2.8%; p < .0001) of the variation in psychopathology, 1.6% (95% CI: 1.2%‒2.1%; p < .0001) of depression, and 1.4% (95% CI: 1.0%‒1.7%; p < .0001) of well-being. Schools in urban locations, with a higher percentage of free school meals and of White British, were associated with poorer pupil mental health. A more positive school climate was associated with better mental health.ConclusionSchool-level variables, primarily related to contextual factors, characteristics of pupil population, and school climate, explain a small but significant amount of variability in mental health of young people. This information might be used to identify schools that are in need of more resources to support mental health of young people.Clinical trial registration informationMYRIAD: My Resilience in Adolescence, a Study Examining the Effectiveness and Cost-Effectiveness of a Mindfulness Training Programme in Schools Compared With Normal School Provision; https://www.isrctn.com/; 86619085.     

How can we Improve the Physical and Social Environment of the School to Promote Student Resilience? Evidence from the Resilient Children and Communities Project in China

Debate on the relationship between mental health and environment is of long standing. Resilience, as a core aspect of mental health promotion, has been described as the interaction between risk and protective factors present in the environment (Rutter, 1987). Central to the concept is that protective factors — those factors in the individual or the environment that enhance an individual's ability to resist problems and deal with life's stresses — can be fostered and promoted. The paper specifies aspects of the school environment in a holistic, or ecological setting, drawing on a multi-strategy health promotion project in primary schools in Hefei and Nanjing in China. A prospective intervention study design was used to collect data in pre-intervention and post-intervention phases, and to analyse it to establish the effectiveness of the intervention in improving the health-promoting environment in Chinese primary schools. The results indicate a significant intervention effect on the physical and social school environment in primary schools, and these results can be used in forthcoming comprehensive work to improve school mental health and well-being.     

Promoting and Building Resilience in Primary School Communities: Evidence from a Comprehensive ‘Health Promoting School’ Approach

This paper reports on the first phase of a multi-strategy health promotion project which uses a whole-school approach to promote resilience in children of primary school age in school, family and community settings in urban and rural/remote locations in Queensland, Australia. The study population comprised students from Years 3, 5, and 7 (ages 8, 10, 12 years), their parents/care-givers and staff in 20 primary schools. Evidence emerging from this phase of the project confirms that the school environment makes a major contribution to the development of psychological resilience in children. Schools in which students reported more positive adult and peer social networks and feelings of connectedness to adults and peers, and a strong sense of autonomy, were associated with higher self-ratings of resilience in the students. There was also high concurrence by parents and caregivers regarding perceptions of the school environment. These schools rated more highly on ‘health promoting school’ (HPS) attributes and principles. Characteristics of such schools included features like shared decision-making and planning, community participation, a supportive physical and social environment, good school-community relations, clearly articulated health policies and access to appropriate health services.     

Modifications of Neuroactive Steroid Levels in an Experimental Model of Nigrostriatal Degeneration: Potential Relevance to the Pathophysiology of Parkinson’s Disease

An important link between neuroactive steroids and neurodegenerative disorders has recently been suggested. Indeed, in several neurodegenerative experimental models the levels of neuroactive steroids are affected and their administration exerts neuroprotective effects. However, scarce information has so far been obtained on the neuroactive steroid levels present in Parkinson’s disease. To this aim, using an experimental model of loss of nigrostriatal dopaminergic neurons obtained by stereotaxic injection of the neurotoxin 6-hydroxydopamine (6-OHDA), we evaluated by liquid chromatography tandem mass spectrometry the levels of several neuroactive steroids in the striatum and cerebral cortex of 6-OHDA-lesioned male rats. Among the neuroactive steroid levels assessed (i.e., pregnenolone, progesterone, dihydroprogesterone, tetrahydroprogesterone, isopregnanolone, testosterone, dihydrotestosterone, 3α-diol, dehydroepiandrosterone, 17α-estradiol, and 17β-estradiol), we observed a significant decrease of pregnenolone in the striatum. A similar effect was also observed on the levels of dihydroprogesterone present in this cerebral area and also in the cerebral cortex. Interestingly, an increase of isopregnanolone also occurred in the striatum and in the cerebral cortex. Altogether, these results suggesting that progesterone metabolism is affected in an experimental model of Parkinson’s disease further highlight the link between neuroactive steroids and the neurodegenerative diseases.     

Predictive Modeling of Quality of Life,Family Dynamics,and School Violence in Adolescent Students from Medellín,Colombia, 2014

The purpose of this study was to develop a predictive population model with respect to quality of life, school violence, and family dynamics in adolescent students from Medellín, Colombia. Cross-sectional, explanatory study was realized with 3460 adolescents using probability sampling for selection. Structural equation modeling was performed. The results of this study showed that the quality of life of adolescents is determined based on physical health, psychology, leisure time, relationship with parents, peer support, and perception of academic well-being. School violence negatively affects quality of life; bullying is the factor with the least predictive capacity, and relationship with teachers is the most predictive factor. The improvement of family dynamics is associated with an improvement in quality of life. The results show lines of action to guide the design of intersectoral and interdisciplinary policies aimed at family dynamics and the school environment as primary support networks for improving adolescents’ quality of life.     

Who Benefits from Diabetes Self-Management Interventions? The Influence of Depression in the Latinos en Control Trial

Background

Depressive symptoms are common among adults with diabetes. Depression and social support may influence diabetes self-management.

Purpose

This study aimed to examine change in depressive symptoms and the role of depression and support on clinical and dietary outcomes among Latinos with type 2 diabetes participating in a diabetes self-management intervention.

Methods

Participants (N?=?252) were randomized to the intervention or usual care. Mixed effects models were used to examine interaction effects between intervention status and depressive symptoms (Centers for Epidemiologic Studies Depression (CES-D) score) and support for diabetes self-management behaviors at baseline. Outcomes were measured at baseline and 4 and 12 months and included dietary quality, physical activity, depressive symptoms, and hemoglobin A1c levels.

Results

Intervention participants had lower CES-D scores at follow-up than control participants. An interaction effect between intervention status and CES-D scores predicted diet quality.

Conclusion

Latinos with depressive symptoms may derive the greatest benefits from diabetes self-management interventions. Additional research on support during diabetes self-management interventions is warranted.     

Rapid Bedside Evaluation of Seizures in the ICU by Listening to the Sound of Brainwaves: A Prospective Observational Clinical Trial of Ceribell’s Brain Stethoscope Function

Background

Patients suffering from non-convulsive seizures experience delays in diagnosis and treatment due to limitations in acquiring and interpreting electroencephalography (EEG) data. The Ceribell EEG System offers rapid EEG acquisition and conversion of EEG signals to sound (sonification) using a proprietary algorithm. This study was designed to test the performance of this EEG system in an intensive care unit (ICU) setting and measure its impact on clinician treatment decision.

Methods

Encephalopathic ICU patients at Stanford University Hospital were enrolled if clinical suspicion for seizures warranted EEG monitoring. Treating physicians rated suspicion for seizure and decided if the patient needed antiepileptic drug (AED) treatment at the time of bedside evaluation. After listening to 30 s of EEG from each hemisphere in each patient, they reevaluated their suspicion for seizure and decision for additional treatment. The EEG waveforms recorded with Ceribell EEG were subsequently analyzed by three blinded epileptologists to assess the presence or absence of seizures within and outside the sonification window. Study outcomes were EEG set up time, ease of use of the device, change in clinician seizure suspicion, and change in decision to treat with AED before and after sonification.

Results

Thirty-five cases of EEG sonification were performed. Mean EEG setup time was 6?±?3 min, and time to obtain sonified EEG was significantly faster than conventional EEG (p?<?0.001). One patient had non-convulsive seizure during sonification and another had rhythmic activity that was followed by seizure shortly after sonification. Change in treatment decision after sonification occurred in approximately 40% of patients and resulted in a significant net reduction in unnecessary additional treatments (p?=?0.01). Ceribell EEG System was consistently rated easy to use.

Conclusion

The Ceribell EEG System enabled rapid acquisition of EEG in patients at risk for non-convulsive seizures and aided clinicians in their evaluation of encephalopathic ICU patients. The ease of use and speed of EEG acquisition and interpretation by EEG-untrained individuals has the potential to improve emergent clinical decision making by quickly detecting non-convulsive seizures in the ICU.

     

Promoting Children’s Prosocial Behaviors in School: Impact of the “Roots of Empathy” Program on the Social and Emotional Competence of School-Aged Children

This study examines the effects of the Roots of Empathy (ROE) program on children’s social-emotional competence. ROE is a theoretically derived universal preventive program that focuses on decreasing children’s aggression and facilitating the development of their social-emotional understanding and prosocial behaviors. The program has as its cornerstone monthly visits by an infant and his/her parent(s) that serve as a springboard for lessons on emotion understanding, perspective taking, caring for others, and infant development. The study included a quasi-experimental control-group pretest–posttest, multi-informant design with 585 4th- to 7th-grade children from 28 classrooms. Outcome measures included self-reports of understanding of infant distress, empathy, and perspective taking, and peer and teacher reports of prosocial and aggressive behaviors. Measures assessing implementation were also included. Children in the ROE intervention classrooms showed significant improvement across several of the domains assessed: self-reports of causes for infant crying, peer nominations of prosocial behaviors, and teacher reports of proactive and relational aggression. Self-reported empathy and perspective taking showed no significant changes. According to ROE instructors’ diaries assessing implementation, students in the experimental condition were exposed to all or most of the ROE curriculum. These findings support and extend recent research examining the positive impacts of classroom-based social and emotional learning (SEL) programs on children’s social development and behavioral adjustment.     

Vertical nystagmus in Wernicke’s encephalopathy: pathogenesis and role of central processing of information from the otoliths

Patients with Wernicke’s encephalopathy (WE) often have unusual patterns of vertical nystagmus. Initially there is often a spontaneous upbeating nystagmus that may change to downbeat nystagmus with a change in the direction of gaze, convergence or with vestibular stimuli. Patients also often show a profound loss of the horizontal but not the vertical vestibulo-ocular reflex (VOR). Furthermore, the acute upbeat nystagmus may change to a chronic downbeat nystagmus. We present hypotheses for these features based on (1) the location of vertical gaze-holding networks near the area postrema of the dorsomedial medulla where the blood–brain barrier is located, which we suggest becomes compromised in WE, (2) the location of the vestibular nuclei in the brainstem, medially for the horizontal VOR, and laterally for the vertical VOR, (3) neuronal circuits differ in susceptibility to and in the ability to recover from thiamine deficiency, and (4) impaired processing of otolith information in WE, normally used to modulate translational vestibulo-ocular reflexes, leads to some of the characteristics of the spontaneous vertical nystagmus including the peculiar reversal in its direction with a change in gaze or convergence.

     

Synaptic Depression and Aberrant Excitatory Network Activity in Alzheimer’s Disease: Two Faces of the Same Coin?

Neurodegenerative diseases, including Alzheimer’s disease (AD), target specific and functionally connected neuronal networks, raising the possibility that neurodegeneration may spread through abnormal patterns of neural network activity. AD is associated with high levels of amyloid-β (Aβ) peptides in the brain, synaptic depression, aberrant excitatory neuronal activity, and cognitive decline. However, the relationships among these alterations and their underlying mechanisms are poorly understood. In experimental models of AD, high concentrations of pathogenic Aβ assemblies reduce glutamatergic transmission and enhance long-term depression at the synaptic level. At the network level, they cause dysrhythmias, including neuronal synchronization, epileptiform activity, seizures, and postictal suppression. Both synaptic depression and aberrant network synchronization likely interfere with activity-dependent synaptic regulation, which is critical for learning and memory. Abnormal patterns of neuronal activity across functionally connected brain regions may also trigger and perpetuate trans-synaptic mechanisms of neurodegeneration. It remains to be determined if synaptic depression and network dysrhythmias are mechanistically related, which of them is primary or secondary, and whether normalization of one will prevent the other as well as cognitive dysfunction in AD.