Workplace violence and associations with health outcomes in public health administration agencies in Taiwan: a survey during the COVID-19 pandemic

Objectives: To investigate the prevalence of workplace violence in public health administration agencies and its effects on health outcomes. Methods: A survey was conducted in March 2022. Staff who had been working for at least one year in the Ministry of Health and Welfare or its subordinate agencies, the Department of Health, or in public health centers were recruited. Data were collected anonymously with a structured, online questionnaire. A total of 492 valid questionnaires were collected. Results: A total of 48.17% participants reported having experienced workplace violence (physical, psychological, verbal, or sexual). The most common type of violence was verbal (43.50%), followed by psychological (31.71%). Supervisors were the primary perpetrators of verbal and psychological violence, followed by clients and colleagues. Staff reported long working hours and high levels of psychological and physical stress. Furthermore, 22.97% of workers reported poor self-rated health, 60.57% had personal burnout levels higher than 50, and 63.41% reported poor mental health. Regression analyses showed that low workplace justice was most strongly associated with internal verbal and psychological violence, whereas routine work requiring interaction with the public was most strongly associated with external verbal violence. Staff who had experienced workplace violence in the past year had significantly higher risks of poor self-rated health, mental health, and personal burnout, and poor health was more strongly associated with workplace violence that originated inside the organization than with workplace violence that originated from outside the organization. Conclusions: This survey was conducted on-line anonymously, so the representativeness of our findings might be limited. However, heavy workloads and workplace violence in public health administration agencies during the COVID-19 pandemic are important issues deserving urgent attention. (Taiwan J Public Health. 2023;42(1) :42-61)

Localizing Responses to Gender-Based Violence: The Case of Women-Led Community-Based Organizations in Jordan

While the rationale for localizing humanitarian health response is well established at the level of policy rhetoric, the operationalization of the concept and its mainstreaming into concrete practice still require clearer intentionality. With COVID-19 pushing more people further into vulnerability, placing local communities at the heart of humanitarian and development health efforts has never been more urgent. Focusing on Jordan, this essay brings attention to the significant toll of violence against women and girls in conflict-affected communities and the importance of empowering local actors with community knowledge and resources to prevent and respond to gender-based violence. The essay follows on from the research conducted for CARE Jordan's She Is a Humanitarian report (2022) and draws on interviews I conducted with the heads of women's organizations in the summer of 2022. The essay explores the role of local women humanitarian actors as frontline responders, the challenges that hinder their role, and the advantages such actors enjoy, which, if harnessed, can achieve gains in accountability, health service quality, and gender equality.

Dynamic modelling of changes in emotional and behavioural problems in children and adolescents during the COVID-19 pandemic

Aims: Children and adolescents were affected in various ways by the measures due to COVID-19 pandemic. The aims of this study were to investigate and compare the effects on mental health across age, to identify latent class trajectories of emotional and behavioural problems over 12-months and to examine the association of classes of trajectories with baseline demographic and clinical predictors. Method(s): Children (n = 1854) and adolescents (n = 1243) from the general population were assessed baseline, at 6-, 9-, and 12-month follow-up. They were eligible if they were residents in Austria, Germany, or Switzerland, were parents/caregivers of a child aged between 7 and 10 years or adolescents >=11 years, had sufficient German language skills and provided informed consent. Results and Conclusion(s): Significant age-effects were found regarding type and frequency of problems. While children had the largest increase in aggressive behaviours, adolescents reported the largest increase in emotional problems. Sociodemographic variables, exposure to and appraisal of COVID-19, psychotherapy before COVID-19 and parental mental health significantly predicted change in problemscores (F >= 3.69, p <= .001). Using growth mixture modelling, a oneclass solution was detected for the trajectory of aggressive behaviours and a two- and three-class solution for withdrawn/depression and anxiety/depression. A substantial proportion of children and adolescents experienced age-related mental health problems during the different stages of the COVID-19 pandemic. These results suggest that psychological problems of specific sub-groups should be monitored over the longer-term and interventions to improve communication, emotion regulation, and appraisal style should be offered to risk groups.

The psychoneuroendocrine response of aggression due to COVID-19 social isolation

The pandemic caused by the SARS-COV-2 virus in the years 2020-2022 altered the emotional behavior of humans. The restrictive feeling caused by the isolation and the change of life habits that demanded a social separation promoted anxiety, distress, apathy, domestic violence, educational problems, and economic instability, among other aspects. Erroneous statistics, and social media information about the number of people infected by the coronavirus SARS-COV-2, aggravated human anxiety and depression. This review compares the main psychological effects caused by pandemic isolation compared to other isolated social contexts. We studied the primary central nervous system areas involved in human reactive aggressiveness behavior. We examine this behavior in relationship with catecholamines and hormones during social isolation. We do not measure or analyze any hormone in our laboratory and only describe the circuits involved in the neuroendocrine response to the aggressive behavior. (English) [ FROM AUTHOR] La pandemia causada por el virus Sars-Cov-2 durante los años 2020 a 2022, alteró la conducta emocional de los humanos. El sentimiento de restricción causado por el aislamiento y el cambio de hábitos de vida que demandaron una separación social promovieron: ansiedad, estrés, apatía, violencia doméstica, problemas educativos e inestabilidad económica, entre otros aspectos. Estadísticas erróneas y de los medios de información acerca del número de personas infectadas por el Coronavirus Sars-Cov-2 agravaron la ansiedad y la depresión humana. Esta revisión compara los principales efectos psicológicos causados por el aislamiento durante la pandemia comparado con otros contextos de aislamiento social. Nosotros estudiamos las áreas primarias involucradas en la conducta de agresión reactiva en los humanos y analizamos esta conducta en relación con las catecolaminas y hormonas durante el aislamiento social. No medimos ni analizamos ninguna hormona en nuestro laboratorio solo describimos los circuitos involucrados en la respuesta neuroendocrina a la conducta agresiva. (Spanish) [ FROM AUTHOR] Copyright of Revista Mexicana de Neurociencia is the property of Academia Mexicana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Financial markets and price increases in Europe after the russian-Ukrainian War

The research relevance is predefined by the fact that the European financial market has suffered a direct negative impact due to the russian aggression and violation of the territorial integrity of Ukraine. All these processes are accompanied by several previously formed and unfavourable trends for socio-economic and financial development, which have become even more severe due to the hostilities. In particular, COVID-19, environmental degradation, rising inflation, deglobalization, insufficient social development of individual countries, as well as fuel and food shortages. The research aims to conclude a comparative analysis of financial policy in European countries and individual countries of the Balkan Peninsula, as well as substantiation of the financial risk management features and the formation of a forecast model of economic stabilization. To achieve the set objectives, scientific methods were used, including analysis method, analogy method, and modelling method. The article analyses expert reports and the results of scientific research on the current state of the financial market and monetary policy in Europe as a result of the russian-Ukrainian war, in particular in the Balkans and Kosovo. The analogy of the directions of financial policy in the period before the russian invasion of the territory of Ukraine with the period of direct aggression of the russian federation is conducted. The fundamental reasons for changes in pricing policy, in particular pricing mechanisms, are characterized. The determining factors of financial risks, tools for assessing the consequences, as well as generalization of management methods for their reduction and elimination in the future are substantiated. The directions of European financial support aimed at the defence sector and socio-economic needs are considered. The practical value of the work is that the conceptual model of strategic development of the European financial market in the context of stabilization processes of international financial policy, as well as food and energy security was formed Copyright © The Author(s).

Acceptabilité et faisabilité d'un module TCD-A multi-familles « tolérance à la détresse » proposé à des adolescents ayant un trouble de la personnalité borderline ou des troubles de la régulation émotionnelle

Le trouble de la personnalité borderline est un trouble psychiatrique fréquent qui apparaît à l'adolescence. La thérapie comportementale dialectique adaptée aux adolescents (TCD-A) a montré son efficacité dans la prise en charge psychothérapeutique des adolescents souffrant de conduites suicidaires ou d'auto-agressivité associées au trouble de la personnalité borderline. Au travers de notre étude nous avons souhaité explorer la faisabilité et l'acceptabilité, pour des adolescents présentant un TPL diagnostiqué ou des troubles de la régulation des émotions, d'un module TCD intitulé « tolérance à la détresse » proposé sur le mode d'un groupe multi-familles. Pour ce faire nous avons mis en place un groupe multi-familles de six adolescents et de leurs parents. L'acceptabilité et la faisabilité du protocole étaient excellentes. Les témoignages des adolescents et de leurs parents nous apportent des informations précieuses sur l'intérêt d'un tel groupe et sur les améliorations à introduire. La mise en place d'un tel groupe est une première en France et nous souhaitions montrer par notre étude pilote, sa faisabilité, son acceptabilité et ses effets afin de promouvoir son développement et son implémentation dans le contexte pédopsychiatrique français. Borderline personality disorder is a common psychiatric disorder emerging in adolescence. Dialectical Behavioral Therapy adapted to adolescents (DBT-A) has proven to be effective as a psychotherapeutic treatment for adolescents suffering from borderline-related behaviors, such as suicidal or self-aggressive behaviors. In our study, we were interested in exploring the feasibility and acceptability of a DBT-A module entitled "distress tolerance", which reduces borderline-related behaviors in borderline adolescents or undiagnosed adolescents who experience difficulties in regulating their emotions. To do this, we set up a pilot study with one multi-family treatment group of six adolescents and their parents. The treatment was fully accepted by all adolescents and parents with an excellent acceptability. Comments from adolescents and parents gave us valuable information about the great interest of a multi-family treatment group and potential improvements for its implementation. This is the first study exploring a DBT-A multi-family treatment group in France. It highlights its feasibility, acceptability and potential positive effects. Further studies are needed to promote the implementation and development of such interventions in the context of child and adolescent psychiatry in France. [ FROM AUTHOR] Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Trust is crucial in lockdown—and beyond

Loss of income and education, unemployment, uncertainty, social isolation, and domestic violence are just some of the emerging negative outcomes of the mass closure of businesses and schools, with disproportionate effect on people with fewer resources and poorer health, they say. John Appleby says the data are incomplete, too uncertain, and too fast moving to support reliable conclusions (doi:10.1136/bmj.m1607), a concern echoed by Sheila Bird, who says the UK's reporting of swab tests is "a travesty of science” (doi:10.1136/bmj.m1664). Sufficient capacity for this crucial element of communicable disease control is one of the three criteria set out in the joint European road map towards lifting restrictions (doi:10.1136/bmj.m1549), yet it doesn't feature among the UK government's five tests.

Seven days in medicine: 6-12 May 2020

In a report summarising the feedback it had received,2 the charity noted a litany of "horrendous” safety concerns, as workers were concerned about a lack of personal protective equipment and about their mental health. NICE: assess covid patients for kidney injury Patients with suspected or confirmed covid-19 should be assessed for acute kidney injury (AKI) on hospital admission or transfer, said the National Institute for Health and Care Excellence (NICE). In a new guideline aimed at healthcare professionals who are not kidney specialists, the institute said that patients with suspected or confirmed covid-19 should be monitored for AKI throughout their stay in hospital and managed appropriately if it develops.

How COVID-19 pandemic period influences on the selected mental health parameters of Polish respondents?

Introduction: There are many different articles about COVID-19 pandemic period and its influence on people and their behavior. Nevertheless, there is little research on the slightly later period of the pandemic, that is, the time when specific adaptation mechanisms in society should start to take place. Methods: Our research was conducted by means of an online survey. Four hundred and eighty five adults participated, including 349 (71.96%) women and 136 (28.04%) men. The Buss-Perry aggression scale, Alcohol Use Disorders Identification Test and Generalized Anxiety Disorder 7 scale were used. The results were statistically processed using Statistica 13.3 software. Results: Within the study population, positive correlations were noted between anxiety and generalized aggression, anger, hostility, physical and psychological aggression. In the female group, anxiety correlates positively with generalized aggression, anger, hostility, verbal and physical aggression. Among male subjects, anxiety correlates positively with aggression, anger, and hostility. Alcohol consumption has a significant association with verbal aggression. Statistically, more women experience anxiety, more men have inflated scores on the AUDIT scale and on verbal and physical aggression. Younger people are more likely than older people to experience anxiety and have inflated scores on hostility. Those with secondary education scored significantly higher on the GAD-7 scale and the aggression scale (and all subscales except anger) compared to respondents with higher education. Discussion: As a result of adaptation to the COVID-19 pandemic, anxiety is no longer a factor in increased evels of alcohol consumption. The pandemic has not affected differences in alcohol consumption between men and women. The presence of a positive correlation between anxiety and aggression and the sociodemographic structure of those characterized by increased aggression are also unchanged. Anxiety directly influences aggressive behavior in a relatively strong way. Appropriate health-promoting measures should be implemented to protect the public from the negative effects of the COVID-19 pandemic.

Psychiatric and non-psychiatric population vulnerabilities in time of a crisis: the unsuspected aggression factor.

OBJECTIVES: In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis. METHODS: We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations. RESULTS: Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group. CONCLUSION: New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.

What Happens to Children's Mental Health and Peer Relationships During Periods of Restricted and Unrestricted Social Interactions? Results From the Co-SPACE Study in Primary School-Aged Children

Objective Children's experiences of peer victimization and peer aggression are strongly linked to their mental health. However, we do not know how this relationship is influenced by periods of restricted and unrestricted social interactions. In this study we investigated a) the bidirectional association between children's peer problems and mental health;b) individual differences in the joint development of peer victimization, peer aggression and mental health and c) factors associated with joint trajectories over 13 months during the COVID-19 pandemic in the United Kingdom. Method Our sample consisted of 2160 children aged 4-10 years for whom parents/carers completed a baseline and at least one follow-up online survey between March 2020 and May 2021as part of the Co-SPACE study. We used generalized linear models to examine bidirectional associations, group-based trajectory modelling to map joint trajectories and multinomial logistic regressions to identify factors associated with trajectories. Results Experiencing mental health difficulties during school closures increased the risk of experiencing peer victimization, but not peer aggression on return to school. Experiencing any peer problems during school closures did not predict subsequent mental health difficulties. The majority of children followed joint trajectories of low exposure to peer problems and mental health, however 16-17% of our sample followed joint trajectories of high exposure to peer problems and mental health. Low family income, family conflict, parental distress, special educational needs and lack of friendships were associated with high exposure mental health and peer problem trajectories. Conclusion Increasing children's mental health support during periods of isolation may not only reduce concurrent and future mental health problems but may also prevent subsequent peer problems for both vulnerable and non-vulnerable children. Study preregistration information Co-SPACE (Covid-19: Supporting Parents, Adolescents and Children during Epidemics);https://osf.io/.

Lung pathology

The series of autopsies reported since the beginning of the pandemic have highlighted several patterns of lung damage, both isolated and combined. The factors influencing the occurrence of these different tissue responses to viral aggression by SARS-CoV-2 have not yet been determined. In asymptomatic patients or patients with respiratory symptoms who were not ventilated, lymphocyte pneumonia associated with type II pneumocyte atypical hyperplasia and a few hyaline membranes or focal lesions of acute fibrinous pneumonia have been observed. In critically ill patients, the most frequent pattern is diffuse alveolar damage with interstitial lymphoid infiltration, type II pneumocyte atypia and, very often, capillary or arteriolar microthromboses and/or endothelitis. The precise description of these lesions, which is becoming more and more consensual, makes it possible to understand the favourable effects of corticosteroid therapy in seriously ill patients and the evolution under ventilation towards fibrosis.Copyright © ERS 2021.

Scoping Review on Educational Programs for Medical Professionals on the Management of Acute Agitation.

BACKGROUND: Agitation is a common reason for psychiatric consultation in the general hospital. The consultation-liaison (CL) psychiatrist is often tasked with teaching the medical team how to manage agitation. OBJECTIVE: The purpose of this scoping review is to explore what resources the CL psychiatrist has for educational tools on teaching about agitation management. Given the frequency with which CL psychiatrists help with on-the-ground management of agitation, we hypothesized that there would be a scarcity of educational resources to teach front-line providers how to manage agitation. METHODS: Following current Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a scoping review was conducted. The literature search focused on the electronic databases MEDLINE (PubMed), Embase (Embase.com), The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), PsycInfo (EbscoHost), Cumulated Index to Nursing and Allied Health Literature (CINAHL) (EbscoHost), and Web of Science. Using Covidence software, after screening for titles and abstracts, full texts were screened independently and in duplicate according to our inclusion criteria. For data extraction, we created a predefined set of criteria according to which each article was analyzed. We then grouped the articles in the full-text review according to which patient population a curriculum was designed for. RESULTS: The search yielded a total of 3250 articles. After removing duplicates and reviewing procedures, we included 51 articles. Data extraction captured article type and details; educational program information (staff training, web modules, instructor led seminar); learner population; patient population; and setting. The curricula were further divided based on their target patient population, specifically the acute psychiatric patient (n = 10), the general medical patient (n = 9), and the patient with a major neurocognitive disorder such as dementia or traumatic brain injury (n = 32). Learner outcomes included staff comfort, confidence, skills, and knowledge. Patient outcomes included measurements of agitation or violence using validated scales, PRN medication use, and restraint use. CONCLUSIONS: Despite there being numerous agitation curricula in existence, we found that a large majority of these educational programs were done for patients with major neurocognitive disorders in the long-term care setting. This review highlights the gap in education related to agitation management for both patients and providers in the general medical setting, as less than 20% of total studies are focused on this population. The CL psychiatrist plays a critical role in assisting in agitation management in this setting, which often requires collaboration between technicians, nurses, and nonpsychiatric providers. It calls into question whether the lack of educational programs makes the implementation of management interventions more difficult and less effective, even with the assistance of the CL psychiatrist.

A Review of An Open World: How America Can Win the Contest for Twenty-First-Century Order by Rebecca Lissner and Mira Rapp-Hooper

The authors stress that both economic and military investments will be required to counter China's integration of statecraft and industry.1 It is further suggested that a selective procurement of allies within the Asian-Pacific region is necessary to counter Chinese economic dominance, military aggression, and coercive practices.2 An Open World suggests that the United States should look to build on existing relationships within trade and security cooperatives in the Indo-Pacific region and bolster the Quadrilateral Security Dialogue, known as the Quad, to become a formal alliance that projects a robust military presence to counter Chinese aggression and encroachment within the South China Sea. [...]the authors point out the current dearth of expertise, talent, and diplomatic finesse that exists within the United States Department of State. In November 2020, the four members participated in a joint naval exercise meant to improve sea readiness for their fleets.6 This exercise was followed by a virtual meeting the following March and the establishment of working groups to tackle challenges such as supply-chain resilience and COVID-19 vaccine production and distribution.7 If these working groups are the extent of the Quad's influence, then the United States needs to seek other alliances to combat China's aggressive economic and military tactics. Coupling public and private sector goals While this type of partnership with private firms is promising, the authors admit to the widening gap between the national security interests of the public sector and the industrial mission of private corporations, which seems to weaken their argument.

Violence Risk Assessment in the Emergency Department.

INTRODUCTION: Workplace violence is a prevalent problem in health care, with mental health and emergency departments being the most at-risk settings. The aim of this evidence-based practice project was to pilot use of a violence risk assessment tool, the Broset Violence Checklist, to assess for risk of type II violence and record the interventions that nurses chose to implement to mitigate the situation. Additionally, reports made to the hospital reporting system were tracked and compared to previous reporting frequency. METHODS: Following staff education, nurses were instructed to complete checklists for all patients who have a score of 1 or higher, which indicates the presence of at least 1 high-risk behavior, and continue hourly scoring until the score returned to 0 or the patient was dispositioned. The number of incidents recorded, time of day, scores, interventions applied to mitigate violence, and change in scores after interventions were evaluated. The number of Broset Violence Checklist scoring sheets submitted and reports made via the hospital reporting system were compared. RESULTS: Incidents were most frequent from 11 am until 3 am. The highest scores occurred in the late evening and early morning hours. There were significantly more incidents captured with the use of the Broset Violence Checklist as compared to the hospital reporting system. Incidents significantly associated with higher scores included providing comfort measures, addressing concerns, and applying restraints. DISCUSSION: The Broset Violence Checklist was used successfully in the emergency department setting to identify behaviors associated with violence. Under-reporting to the hospital report system was identified in this project, consistent with reports in the literature. Specific interventions were not associated with a decrease in Broset Violence Checklist scores.

Balanced Development of Tourism and Resort and Recreational Sphere: International, National and Regional Vectors

The subject of the study is international, national and regional vectors of balanced development of tourism and resort and recreational sphere. Methodology. The study used general scientific methods, in particular: theoretical generalization;methods of positive and normative analysis and statistical analysis. The aim is to substantiate the process of balanced development of tourism and resort and recreational sphere using international, national and regional vectors in modern conditions. Conclusion of the study. International experience of balanced tourism development has shown that among the leading countries in tourism are France, USA, China, Spain, Italy, Turkey, Mexico, Thailand. It is emphasized that these countries are annually visited by 30 to 100 million tourists. It was noted that France ranks first among the countries that attract tourists, the tourist flow to which in 2019 amounted to 217.8 million people, in 2020 it decreased to 117.1 million people, or almost 1.86 times;in second place among the leading countries is the United States of America, where in 2019 the tourist flow amounted to 167.4 million people, and in 2020 it decreased by almost 3.7 times and amounted to 44.7 million people;China ranks third in terms of tourist visits in 2019 - 167.5 million people, in 2020 it decreased to 30.4 million people, or 5.3 times. Analysis of the national experience of tourism development showed that the pandemic of viral infection also had the most significant impact on the reduction of tourist flows in Ukraine. It is noted that in 2019, the reduction of inbound tourists was almost 4 times, while the reduction of tourists in 2014 at the beginning of military aggression was 1.8 times. The authors consider it appropriate to predict a slight reduction in tourist flows during a full-scale war between Russia and Ukraine and to ensure the development of an innovative model of balanced development of national tourism. The creation of an innovative model of balanced development of tourism and resort and recreational sphere with the use of international, national and regional vectors is quite relevant in modern conditions. It is proved that such a model should ensure the achievement of public interests, short-term and long-term goals in solving alternative tasks of obtaining quick and maximum profit by the tourism business and meeting the needs of international tourist traffic and international capital in solving the problem of geographical promotion of tourist flows to new territories.

Adaptive interventions for alcohol misuse and violent behaviors among adolescents and emerging adults in the emergency department: A sequential multiple assignment randomized controlled trial protocol.

Alcohol use and violent behaviors among youth are associated with morbidity and mortality. An emergency department (ED) visit provides an opportunity to initiate prevention efforts. Despite promising findings from our single session SafERteens brief intervention (BI), impact is limited by modest effect sizes, with data lacking on optimal boosters to enhance effects. This paper describes the protocol for a sequential, multiple assignment, randomized trial (SMART). Adolescents and emerging adults (ages 14-20) in the ED screening positive for alcohol use and violent behaviors (physical aggression) were randomly assigned to: 1) SafERteens BI + Text Messaging (TM), or 2) SafERteens BI + remote Health Coach (HC). Participants completed weekly surveys over 8 weeks after the ED visit to tailor intervention content and measure mechanisms of change. At one-month, intervention response/non-response is determined (e.g., binge drinking or violent behaviors). Responders are re-randomized to continued intervention condition (e.g., maintenance) or minimized condition (e.g., stepped down). Non-responders are re-randomized to continued condition (e.g., maintenance), or intensified condition (e.g., stepped up). Outcomes were measured at 4 and 8 months, including primary outcomes of alcohol consumption and violence, with secondary outcomes of alcohol consequences and violence consequences. Although the original goal was to enroll 700 participants, COVID-19 impacts on research diminished recruitment in this trial (enrolled n = 400). Nonetheless, the proposed SMART is highly innovative by blending real-time assessment methodologies with adaptive intervention delivery among teens with comorbid alcohol misuse and violent behaviors. Findings will inform the content and timing booster interventions to alter risk behavior trajectories. Trial Registration:ClinicalTrials.govNCT03344666. University of Michigan # HUM00109156.

Neuropsychiatric Side Effects of Steroids during Treatment for Pediatric Acute Lymphoblastic Leukemia: A Comprehensive Narrative Review

Background/Purpose: Pediatric Acute Lymphoblastic Leukemia (ALL) affects ~4000 young Americans each year. Steroids are essential to curative ALL treatment yet have significant neuropsychiatric side effects that decrease quality of life for patients and families. However, incidence and predisposing risk factors are not well understood. This review aims to describe the current literature on neuropsychiatric side effects of steroids in Pediatric ALL. Method(s): A precise search in PubMed and Embase was cultivated using controlled vocabulary terms (MeSH, Emtree) and keywords for the following concepts: pediatrics, steroids, side effects, cancer, and neurobehavioral manifestations. Keywords and controlled vocabulary for each subject were arranged logically and combined with other concepts by Boolean Logic, using the Boolean operator AND, resulting in 642 precise results exploring neurobehavioral side effects of steroids in children with cancer. Results (2010 to date of search) were imported into Covidence systematic review software, and reviewed by SB and AM. Result(s): Twenty-three articles met inclusion criteria. There is marked variability in research methodology and no standard measurement of neuropsychiatric symptoms. Commonly reported symptoms include mood swings, irritability, depression, anxiety, aggression, insomnia, mania, and psychosis with prevalence between 5% and 75%. Heterogeneous research methodology and descriptions of psychiatric symptoms make it difficult to determine risk factors, though dexamethasone, family psychiatric history, and younger age are consistently associated with greater risk of behavioral dysregulation. Genetic predisposition (Bcl1 polymorphism, SNPs in GR gene) may increase susceptibility to developing depression during treatment. Data suggest variable efficacy of antipsychotics, benzodiazepines, hydrocortisone, and potassium-chloride. Conclusions and Implications: Existing data about neuropsychiatric side effects of steroids in pediatric ALL is extremely heterogeneous, creating challenges for standardized assessment and treatment. The burden of these symptoms necessitates further research to identify and treat vulnerable patients. Standard measurement of these symptoms could be a first step in eventually alleviating this source of distress.

Behavioural plasticity and the anthropause: an urban bird becomes less aggressive

Urban areas often impose strong, novel selection pressures on wildlife. Phenotypic plasticity, including behavioural plasticity, is an important mechanism helping organisms establish populations in novel environments. Behavioural plasticity can be difficult to study in urban wildlife because many urban environmental variables are challenging to isolate and manipulate experimentally. We took advantage of the COVID-19 lockdowns to assess whether urban birds expressed territorial aggression differently when relieved from frequent encounters with humans. We used simulated territorial intrusions to measure the behavioural responses of resident dark-eyed juncos, Junco hyemalis, on an urban college campus in Los Angeles, U.S.A. We found that the population overall displayed significantly reduced movement and singing behaviour associated with territorial aggression in a pandemic year (2021) compared to a typical year (2019). Furthermore, individuals measured in both 2019 and 2021 had significantly reduced responses in 2021, demonstrating that individual birds maintained behavioural plasticity in these traits. Our results show that human disturbance likely has a significant effect on the expression of behaviours associated with territorial aggression in urban birds. © 2023 The Author(s)

Aggressive behavior in Italian children with ADHD in the middle of COVID-19 pandemic: Preliminary data on MAOA gene polymorphisms involvement

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by oppositional, defiant, disobedient, disruptive and also aggressive behavior. Many genes are involved in its onset, particularly dopaminergic pathway genes. Moreover, genetic predisposition to aggression appears affected by the polymorphic genetic variants of the serotoninergic system, among which, functional polymorphisms in monoamine oxidase A (MAOA). The risk of contracting coronavirus infection may arouse in some people severe emotional distress characterized by symptoms of fatigue, guilt, and aggression. A survey on the psychological impact of COVID-19 pandemic in Italian families of children with neurodevelopmental disorders such as ADHD showed how children have been particularly affected by the emergency. The aim of this study was to determine whether polymorphisms at the MAOA gene are associated with increased or reduced susceptibility to develop ADHD. Therefore, the variants rs6323, rs587777457 and rs1137070 of the MAOA gene were evaluated by SBT in 35 children (mean age 10.257 range 6-16) with ADHD and 27 healthy individuals. Our analysis allowed us to identify the G/G genotype of the variant rs6323 (Arg297Arg) was significantly associated with an increased risk of ADHD (p = 0.015). Allele G indicates higher levels of the enzyme, while the T allele indicates lower levels of enzyme production. When compared in patients, the G allele was associated with higher anger (p-value = 0.01) and might cause aggressive behavior in males. Our study shows that defining a genetic profile of ADHD can provide important information on the etiopathogenesis of the disease and help identify the best therapeutic option for patients with this disorder.